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经阴道置入的历史补片和手术:我的患者做过什么?

Historic transvaginal meshes and procedures: what did my patient have done?

机构信息

Division of Female Pelvic Medicine and Reconstructive Surgery, Rush University, Chicago, Illinois.

Division of Female Pelvic Medicine and Reconstructive Surgery, Allina Health, St. Paul, Minnesota, USA.

出版信息

Curr Opin Obstet Gynecol. 2019 Dec;31(6):477-484. doi: 10.1097/GCO.0000000000000587.

Abstract

PURPOSE OF REVIEW

Transvaginal mesh kits were widely used to treat pelvic organ prolapse for over a 10-year period in the early 2000s. Due to safety concerns and FDA regulations, these mesh kits are no longer available for use. Thus, current Obstetricians and Gynecologists are likely to encounter these meshes, but may have no previous experience or exposure to the devices making it difficult to adequately monitor, counsel, and care for patients that underwent these types of procedures. This review highlights the most commonly used transvaginal mesh kit types, provides insight into signs and symptoms related to transvaginal mesh complications, and provides guidance for management of mesh complications.

RECENT FINDINGS

Not all transvaginal mesh will give rise to a complication. If complications do occur, treatment options range from conservative observation to total mesh excision. Management must be customized to an individual patient's needs and goals.

SUMMARY

Transvaginal mesh kits promised increased durability of surgical repair for pelvic organ prolapse. Safety concerns over time caused these kits to no longer be available for use. Practicing Obstetricians and Gynecologists should be aware of the history of transvaginal mesh and the signs and symptoms of mesh complications.

摘要

目的综述

在 21 世纪初的 10 多年时间里,经阴道网片套件被广泛用于治疗盆腔器官脱垂。由于安全性问题和 FDA 规定,这些网片套件已不再使用。因此,目前的妇产科医生可能会遇到这些网片,但可能以前没有接触过这些设备,这使得难以充分监测、咨询和照顾接受过这类手术的患者。本篇综述重点介绍了最常用的经阴道网片套件类型,深入了解与经阴道网片并发症相关的症状和体征,并为网片并发症的处理提供指导。

最近发现

并非所有经阴道网片都会引起并发症。如果确实发生并发症,治疗选择范围从保守观察到完全切除网片。必须根据患者的个体需求和目标来定制治疗方案。

总结

经阴道网片套件承诺增加盆腔器官脱垂手术修复的耐用性。随着时间的推移,对安全性的担忧导致这些套件不再使用。妇产科医生应该了解经阴道网片的历史以及网片并发症的症状和体征。

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