Lowder Jerry L
Jerry L. Lowder, MD, MSc, is Associate Professor and Director, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Washington University School of Medicine.
Mo Med. 2017 May-Jun;114(3):171-175.
Pelvic organ prolapse is common among women who have delivered vaginally or had a hysterectomy. In a total hysterectomy, the apical vaginal support is transected. Although evidence supports re-establishment of apical support, our research showed that this rarely occurs in hysterectomies. To address our lack of definitions of "significant" apical support loss and recommendations to guide surgeons as to when they should perform an apical support procedure, we analyzed patient data and found that a simple assessment of the genital hiatus can effectively screen for significant apical support loss. Our work will hopefully highlight the importance of apical support loss and current deficits in research and clinical guidelines.
盆腔器官脱垂在经阴道分娩或接受子宫切除手术的女性中很常见。在全子宫切除术中，阴道顶端的支撑结构被切断。尽管有证据支持重建顶端支撑，但我们的研究表明，这种情况在子宫切除术中很少发生。为了解决我们对“严重”顶端支撑丧失缺乏定义以及缺乏指导外科医生何时应进行顶端支撑手术的建议的问题，我们分析了患者数据，发现对生殖裂孔进行简单评估可以有效筛查出严重的顶端支撑丧失。我们的工作有望突出顶端支撑丧失的重要性以及当前研究和临床指南中的不足。
