Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan.
Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan.
Taiwan J Obstet Gynecol. 2021 Mar;60(2):187-192. doi: 10.1016/j.tjog.2021.01.031.
Transvaginal mesh (TVM) insertion for the treatment of pelvic organ prolapse (POP) is significantly associated with lower failure rates, although its use remains controversial due to the potential risk of mesh-related complications. In this review, we collected the published literature regarding the use of TVM to treat POP in an attempt to assess both the efficacy and complications related to TVM usage in Taiwan. We searched 25 English language articles using PubMed related to TVM in Taiwan from 2010 to 2019. The present article focuses on the efficacy and complications of TVM and analyzes the data. There were 25 studies on TVM selected for this review. Regarding their success rate, 21 out of the 22 studies (95.5%) had more than a 90% objective success rate. Twenty studies (90.9%) had less than 10% major complications of TVM. Twenty out of the 25 studies (80.0%) had 5% or less mesh exposure. For self-cut TVM and the later single-incision TVM, both the complication rates and exposure rates decreased. The rate of de novo dyspareunia ranged from 2.6% to 14.3%, and the incidence decreased yearly from 2011 to 2019. This review showed both the high treatment efficacy and low complication rate of TVM usage for the short-term treatment of POP in Taiwan. However, a longer-term study is needed to draw a conclusion regarding the safety of this treatment.
经阴道网片(TVM)置入术治疗盆腔器官脱垂(POP)的失败率显著降低,尽管其应用仍存在争议,因为存在与网片相关的并发症风险。在本综述中,我们收集了已发表的关于在台湾使用 TVM 治疗 POP 的文献,试图评估 TVM 在台湾的疗效和相关并发症。我们使用 PubMed 检索了 2010 年至 2019 年期间与台湾 TVM 相关的 25 篇英文文章。本文重点分析了 TVM 的疗效和并发症,并对数据进行了分析。共有 25 项关于 TVM 的研究被纳入本综述。关于其成功率,22 项研究中的 21 项(95.5%)的客观成功率超过 90%。20 项研究(90.9%)的 TVM 主要并发症发生率低于 10%。25 项研究中有 20 项(80.0%)的网片暴露率为 5%或更低。对于自切割 TVM 和后来的单切口 TVM,并发症发生率和暴露率均降低。新发性交困难的发生率为 2.6%至 14.3%,且该发生率从 2011 年到 2019 年逐年下降。本综述显示,TVM 在台湾用于治疗 POP 的短期疗效较高,并发症发生率较低。然而,仍需要进行更长期的研究来确定这种治疗方法的安全性。