Urology Department, University Hospital of Nîmes, 4 Rue du Professeur Robert Debré, 30029, Nîmes, France.
Int Urol Nephrol. 2019 May;51(5):795-802. doi: 10.1007/s11255-019-02124-2. Epub 2019 Mar 14.
The aim of our study was to assess the impact of laparoscopic sacrocolpopexy on pelvic symptoms, quality of life and sexual function in patients with symptomatic pelvic organ prolapse. Secondary goals included the assessment of anatomical correction, recurrence and complication rates.
This is a prospective, single-center study that included 82 patients between 2009 and 2016. A clinical evaluation took place before surgery, and was repeated at 3, 12, 36 and 60 months postoperatively. Patients routinely received an anterior prosthesis, associated with a posterior prosthesis in case of symptomatic rectocele. Patients included self-administered questionnaires for functional pelvic problems (PFDI-20), quality of life (PFIQ-7), and sexual function (PISQ-12), and a clinical examination with POP-Q staging, at each medical visit.
Functional pelvic problems derived from prolapse (PFDI-20 scores) and their impact on patients' quality of life (PFIQ-7 score) significantly improved at 3, 12, 36 and 60 months postoperatively. Improvement on sexual activity was significant at 3 and 60 months postoperatively. Effective prolapse anatomical correction (POP-Q score < 2) was found in 94.4% and 97.2% of patients at the anterior and middle stages, respectively, at the end of follow-up, but only in 80.3% at the posterior stage. Symptomatic recurrence required surgical intervention in 4 patients (5.3%).
This long-term follow-up prospective analysis confirms the good functional and anatomical results of laparoscopic sacrocolpopexy for pelvic organ prolapse.
本研究旨在评估腹腔镜骶骨阴道固定术对有症状的盆腔器官脱垂患者的盆腔症状、生活质量和性功能的影响。次要目标包括评估解剖矫正、复发和并发症的发生率。
这是一项 2009 年至 2016 年期间进行的前瞻性单中心研究,共纳入 82 例患者。在手术前进行临床评估,并在术后 3、12、36 和 60 个月时重复评估。患者常规接受前假体,如果存在症状性直肠膨出,则联合后假体。患者在每次就诊时,均接受功能性盆腔问题(PFDI-20)、生活质量(PFIQ-7)和性功能(PISQ-12)的自我管理问卷评估,以及盆腔器官脱垂定量(POP-Q)分期的临床检查。
与脱垂相关的功能性盆腔问题(PFDI-20 评分)及其对患者生活质量的影响(PFIQ-7 评分)在术后 3、12、36 和 60 个月时显著改善。术后 3 和 60 个月时,对性行为的改善有显著意义。在随访结束时,在前和中段的解剖矫正有效(POP-Q 评分<2)分别为 94.4%和 97.2%,但在后段仅为 80.3%。4 例(5.3%)患者出现症状性复发,需要手术干预。
这项长期前瞻性分析证实了腹腔镜骶骨阴道固定术治疗盆腔器官脱垂的良好的功能和解剖效果。