Female and Functional Urology Department, Fundació Puigvert, Barcelona, Spain,
Female and Functional Urology Department, Fundació Puigvert, Barcelona, Spain.
Urol Int. 2021;105(1-2):137-142. doi: 10.1159/000510530. Epub 2020 Oct 19.
Although the use of transvaginal mesh (TVM) in the repair of pelvic organ prolapse (POP) has been restricted, there are still some cases in which TVM may be the most appropriate approach. The TVM Surelift® anterior repair surgical technique has not been described previously.
The aim of this study was to describe the surgical technique and to report our preliminary results regarding efficacy and complications.
A step-by-step description of surgical technique is presented. A descriptive retrospective analysis was performed to evaluate our preliminary results in 17 women who underwent POP repair using the Surelift® anterior repair system in our department between 2014 and 2017. TVM was offered to patients with symptomatic apical (primary or recurrent) or recurrent anterior POP stage ≥2. POP recurrence was classified as asymptomatic anatomic or symptomatic. Patients rated satisfaction with surgery on a scale from 0 to 10. Complications during follow-up were classified according to the International Urogynecological Association/International Continence Society recommendations.
Median (IQR) follow-up was 19.9 months (24.8). Two (11.8%) anatomic recurrences were identified, both symptomatic, but neither required further surgery. No cases of pelvic pain, dyspareunia, voiding, or defecatory dysfunction were detected. Two (11.8%) patients presented a <1-cm vaginal mesh exposure (2AaT3S2) requiring partial mesh removal through a vaginal approach. At the end of follow-up, median satisfaction (IQR) with the surgery was 9 (3.1).
The Surelift® anterior repair system is effective in correcting apical or recurrent anterior POP, with a high patient satisfaction rate. Complications after this surgery are infrequent and are mostly related to vaginal mesh exposure.
尽管经阴道网片（TVM）在治疗盆腔器官脱垂（POP）中的应用已受到限制，但在某些情况下，TVM 可能仍是最合适的方法。TVM Surelift®前修补术式此前尚未被描述。
本研究旨在描述手术技术，并报告我们在 2014 年至 2017 年间使用 Surelift®前修补系统治疗 17 例 POP 患者的初步疗效和并发症。
对手术技术进行了分步描述。对我科 17 例采用 Surelift®前修补系统治疗的 POP 患者进行了回顾性描述性分析。对 TVM 的适应证为有症状的顶端（原发性或复发性）或复发性前 POP 分期≥2 患者。POP 复发分为无症状解剖学复发或有症状复发。患者对手术的满意度评分范围为 0 至 10。随访期间的并发症根据国际尿控协会/国际控尿协会的建议进行分类。
中位（IQR）随访时间为 19.9 个月（24.8）。发现 2 例（11.8%）解剖学复发，均为有症状，但均无需进一步手术。无盆腔疼痛、性交困难、排尿或排便功能障碍病例。2 例（11.8%）患者存在＜1cm 的阴道网片暴露（2AaT3S2），需要通过阴道途径部分切除网片。随访结束时，手术满意度的中位数（IQR）为 9（3.1）。
Surelift®前修补系统治疗顶端或复发性前 POP 有效，患者满意度高。该手术后的并发症少见，且多与阴道网片暴露有关。
