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腹腔镜胸壁固定术和阴道骶棘韧带固定术的中期结果:一项对比研究。

Intermediate-term outcomes of laparoscopic pectopexy and vaginal sacrospinous fi xation: a comparative study.

机构信息

Department of Obstetrics and Gynecology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.

Department of Obstetrics and Gynecology, Inönü University Medicine Faculty, Malatya, Turkey.

出版信息

Int Braz J Urol. 2019 Sep-Oct;45(5):999-1007. doi: 10.1590/S1677-5538.IBJU.2019.0103.

Abstract

OBJECTIVE

To compare the intermediate-term follow-up results of laparoscopic pectopexy and vaginal sacrospinous fi xation procedures.

MATERIALS AND METHODS

Forty-three women who had vaginal sacrospinous fixations (SSF) using Dr. Aksakal's Desta suture carrier and 36 women who had laparoscopic pectopexies were re-examined 7 to 43 months after surgery. The PISQ-12 and P-QOL questionnaires were answered by all of the women.

RESULTS

The apical descensus relapse rates did not differ between the groups (14% in the SSF vs. 11.1% in the pectopexy group). The de novo cystocele rates were higher in the SSF group (25.6% in the SSF vs. 8.3% in the pectopexy group). There were no significant differences in the de novo rectocele numbers between the groups. The treatment satisfaction rates were high in both groups (93% in the SSF vs. 91.7% in the pectopexy group), which was not statistically significant. Moreover, the postoperative de novo urge and stress urinary incontinence rates did not differ; however, the postoperative sexual function scores (PISQ-12) (36.86±3.15 in the SSF group vs. 38.21±5.69 in the pectopexy group) were better in the pectopexy group. The general P-QOL scores were not signifi cantly different between the surgery groups.

CONCLUSION

The vaginal sacrospinous fixation maintains its value in prolapse surgery with the increasing importance of native tissue repair. The new laparoscopic pectopexy technique has comparable positive follow-up results with the conventional sacrospinous fixation procedure.

摘要

目的

比较腹腔镜悬韧带固定术和阴道骶棘韧带固定术的中期随访结果。

材料与方法

对 43 例行阴道骶棘韧带固定术(SSF)的患者(采用 Aksakal 医生的 Desta 缝线固定器)和 36 例行腹腔镜悬韧带固定术的患者进行了回顾性研究,所有患者术后 7-43 个月接受了复查。所有患者均回答了 PISQ-12 和 P-QOL 问卷。

结果

两组的顶端下降复发率无差异(SSF 组为 14%,悬韧带固定术组为 11.1%)。SSF 组新发膀胱膨出率较高(SSF 组为 25.6%,悬韧带固定术组为 8.3%)。两组新发直肠膨出的数量无显著差异。两组患者的治疗满意度均较高(SSF 组为 93%,悬韧带固定术组为 91.7%),差异无统计学意义。此外,两组术后新发急迫性和压力性尿失禁发生率无差异;然而,术后性功能评分(PISQ-12)(SSF 组为 36.86±3.15,悬韧带固定术组为 38.21±5.69)在悬韧带固定术组更好。两组手术患者的一般 P-QOL 评分无显著差异。

结论

随着对固有组织修复的重视增加,阴道骶棘韧带固定术在脱垂手术中仍具有重要价值。新的腹腔镜悬韧带固定术具有与传统骶棘韧带固定术相当的阳性随访结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8325/6844353/837178c5c5f2/1677-5538-ibju-45-05-0999-gf01.jpg

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