Division of Female Pelvic Medicine and Reconstructive Surgery (Drs. Chill, Reuveni-Salzman, and Shveiky); Department of Obstetrics and Gynecology (Drs. Chill, Reuveni-Salzman, Dick, and Shveiky), Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem.
Department of Obstetrics and Gynecology, Hebrew University of Jerusalem School of Medicine (Dr. Cohen and Mr. Navon), Jerusalem, Israel.
J Minim Invasive Gynecol. 2021 Oct;28(10):1759-1764. doi: 10.1016/j.jmig.2021.03.002. Epub 2021 Mar 10.
To compare clinical and anatomic outcomes as well as patient satisfaction in women undergoing vaginal colposuspension using the Uphold Lite system (Boston Scientific Corporation, Marlborough, MA) and transvaginal hysterectomy with uterosacral ligament suspension (VUSLS) for the treatment of apical prolapse.
Retrospective cohort study.
Female pelvic medicine and reconstructive surgery unit at a university-affiliated tertiary medical center.
Women with apical prolapse who underwent either vaginal colposuspension using the Uphold Lite system (uterine-preserving as well as after previous hysterectomy) or VUSLS from 2010 to 2019. Excluded were women with 1 month or less of follow-up.
None.
A total of 164 women were included in the study: 112 women underwent VUSLS, and 52 underwent colposuspension using the Uphold Lite mesh system. Age, body mass index, maximal birth weight, comorbidity rates, and pelvic organ prolapse severity were similar between the groups. The clinical cure rate was similarly high in both groups, with 91.1% in the women who underwent VUSLS and 88.5% in those in the Uphold Lite group (p = .60). No differences were noted between the groups with regard to anatomic cure rate or composite outcome success rate (73.9% vs 76.0%, p = .77 and 70.3% vs 74.0%, p = .63, in the VUSLS and Uphold Lite groups, respectively). An advantage was noted in the VUSLS group with regard to patient satisfaction with 98.1% of the women stating that their condition was very much better (Patient Global Impression of Improvement questionnaire: A) or much better (Patient Global Impression of Improvement questionnaire: B) compared with 83.9% of the women in the Uphold Lite group (p = .023). In an attempt to assess the association between different variables and the composite outcome, a multivariate analysis was performed in which increased body mass index, menopausal status, and increased preoperative genital hiatus were found to decrease composite outcome success.
Vaginal colposuspension using the Uphold Lite system and VUSLS for the treatment of apical prolapse have comparable results with high clinical success rates.
比较经阴道阴道穹窿悬吊带（波士顿科学公司，马萨诸塞州马尔伯勒）和经阴道子宫切除术联合子宫骶骨韧带悬吊术（VUSLS）治疗阴道顶端脱垂的临床和解剖学结局以及患者满意度。
回顾性队列研究。
大学附属三级医疗中心女性盆底医学和重建外科病房。
2010 年至 2019 年期间接受经阴道阴道穹窿悬吊带（保留子宫以及既往子宫切除术后）或 VUSLS 治疗阴道顶端脱垂的女性。排除随访时间少于 1 个月的女性。
无。
共纳入 164 名女性：112 名女性接受 VUSLS，52 名女性接受 Uphold Lite 网片阴道穹窿悬吊带。两组年龄、体重指数、最大出生体重、合并症发生率和盆腔器官脱垂严重程度相似。两组临床治愈率均较高，VUSLS 组为 91.1%，Uphold Lite 组为 88.5%（p=0.60）。两组解剖学治愈率或综合结局成功率无差异（VUSLS 组为 73.9%，Uphold Lite 组为 76.0%，p=0.77；VUSLS 组为 70.3%，Uphold Lite 组为 74.0%，p=0.63）。VUSLS 组在患者满意度方面具有优势，98.1%的女性表示她们的病情“非常好”（患者总体印象改善问卷：A）或“好得多”（患者总体印象改善问卷：B），而 Uphold Lite 组只有 83.9%的女性表示如此（p=0.023）。为了评估不同变量与综合结局之间的关联，进行了多变量分析，结果发现体重指数增加、绝经状态和术前生殖器裂孔增大与综合结局成功率降低有关。
经阴道阴道穹窿悬吊带（Uphold Lite）系统和 VUSLS 治疗阴道顶端脱垂的效果相当，临床成功率均较高。
