Anglim Breffini, O'Sullivan Orfhlaith, O'Reilly Barry
Department of Urogynaecology, Cork University Maternity Hospital, Wilton, Cork, Ireland.
ASSERT Centre, University College Cork, Cork, Ireland.
Int Urogynecol J. 2018 Aug;29(8):1075-1079. doi: 10.1007/s00192-018-3685-4. Epub 2018 Jun 11.
Increasingly, uterine preservation surgeries are being performed for treating apical prolapse. Several types of procedures and surgical approaches to correct apical prolapse have been described in the literature. Despite this, there remains inadequate information to provide evidence-based recommendations regarding the optimal treatment approach and materials to use, and trials are ongoing to identify the optimal techniques. In the future, our patients may be the strongest determining influence when it comes to choice of apical prolapse surgery, with factors such as autonomy, reproduction, intimacy and fear influencing their decision. It is our opinion that the two most powerful forces behind the choice of apical POP surgical technique are the woman's personal desire for uterine preservation or not and the surgeon's personal choice of procedure based on training received. Present management of apical prolapse involves understanding patient goals and acknowledging their treatment preferences and values.
越来越多地，子宫保留手术被用于治疗顶端脱垂。文献中描述了几种用于纠正顶端脱垂的手术类型和手术方法。尽管如此，关于最佳治疗方法和使用材料仍缺乏足够信息以提供基于证据的建议，并且正在进行试验以确定最佳技术。未来，在顶端脱垂手术的选择上，我们的患者可能是最具决定性的影响因素，诸如自主性、生育、亲密关系和恐惧等因素会影响他们的决定。我们认为，顶端盆腔器官脱垂手术技术选择背后的两个最强大因素是女性个人对保留子宫与否的渴望以及外科医生基于所接受培训的个人手术选择。目前顶端脱垂的管理涉及了解患者目标并认可他们的治疗偏好和价值观。
