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腹腔镜骶骨阴道固定术联合子宫切除术与阴道固定术治疗中重度女性泌尿生殖系统脱垂的比较。

Comparison between laparoscopic sacrocolpopexy with hysterectomy and hysteropexy in advanced urogenital prolapse.

机构信息

Andrological and Urogynecological Clinic, Santa Maria Terni Hospital, University of Perugia, Piazzale di Joanuccio 1, Posta Code 05100, Terni, Italy.

Department of Urology, University Hospital of Patras, Rio, Greece.

出版信息

Int Urogynecol J. 2020 Oct;31(10):2069-2074. doi: 10.1007/s00192-020-04260-1. Epub 2020 Mar 5.

DOI:10.1007/s00192-020-04260-1
PMID:32140751
Abstract

INTRODUCTION AND HYPOTHESIS

The aim of this study was to compare the outcomes in women who underwent laparoscopic sacrocolpopexy (LSC) with or without hysterectomy for pelvic organ prolapse (POP).

METHODS

This was a single-centre prospective study. We included women with symptomatic POP (III-IV stage) who underwent LSC with or without hysterectomy. The preoperative evaluation included a history, clinical examination and urodynamic test; all patients completed FSFI, UDI-6 and IIQ-7 questionnaires. They were followed up at 1, 3, 6 and 12 months after surgery and then annually thereafter with the same preoperative flow chart. At the last visit, they also completed the PGI-I questionnaire.

RESULTS

Between 2012 and 2016, a total of 136 patients with POP were included (82 in the LSC with hysterectomy group and 54 in the hysteropexy group). At a median follow-up of 65.3 months (36-84 months), there were improvements in the anatomical and functional outcomes of both groups without differences between the two approaches. The apical success rate was 100% in all women, without recurrence in either group; the anterior and posterior success rates of hysterectomy were higher than those of uterine preservation.

CONCLUSION

This study showed that there were no differences in the anatomical and functional outcomes between LSC with or without hysterectomy for POP.

摘要

简介与假设

本研究旨在比较因盆腔器官脱垂(POP)行腹腔镜骶骨阴道固定术(LSC)加或不加子宫切除术的女性患者的结局。

方法

这是一项单中心前瞻性研究。我们纳入了因有症状的 POP(III-IV 期)而行 LSC 加或不加子宫切除术的女性患者。术前评估包括病史、临床检查和尿动力学检查;所有患者均完成了 FSFI、UDI-6 和 IIQ-7 问卷。她们在术后 1、3、6 和 12 个月以及之后每年进行随访,随访流程与术前相同。在最后一次就诊时,她们还完成了 PGI-I 问卷。

结果

2012 年至 2016 年间,共纳入 136 例 POP 患者(LSC 加子宫切除术组 82 例,子宫固定术组 54 例)。在中位数为 65.3 个月(36-84 个月)的随访中,两组患者的解剖学和功能结局均得到改善,两种方法之间无差异。所有女性的顶端成功率均为 100%,两组均无复发;子宫切除术的前位和后位成功率高于子宫保留术。

结论

本研究表明,LSC 加或不加子宫切除术治疗 POP 的解剖学和功能结局无差异。

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