Long Jin, Lee Chung Lyul, Yang Seung Woo, Lee Ji Yong, Lee Jae Geun, Song Ki Hak, Lim Jae Sung, Park Jong Mok, Na Yong Gil, Gil Geon, Shin Ju Hyun
Department of Urology, College of Medicine, Chungnam National University, Daejeon, Korea.
Well Urogoly Clinic, Daejeon, Korea.
J Exerc Rehabil. 2021 Feb 23;17(1):59-65. doi: 10.12965/jer.2142098.049. eCollection 2021 Feb.
We studied the long-term efficacy and safety of cystocele operation by polypropylene mesh. A total of 198 women with stage ≥2 cystocele who had anterior vaginal wall repair with transobturator four-arm polypropylene mesh during 2003 to 2015 were evaluated. Outcomes including clinical characteristics and complications were reviewed by extracting patient data from electronic medical records. In addition, telephone interviews were conducted using a validated questionnaire along with physical examination. The follow-up period was 9.3±0.3 years. The cystocele stage in patients was significantly decreased post-operation compared to that preoperation. The anatomical cure rate for cystocele was 93.4%, and that for stress urinary incontinence was 95%. Comparing the three questionnaires indicated overall average score was improved significantly, except for Female Sexual Function Index Assessment. Early complications were either resolved spontaneously or controlled medically in four cases of hematoma or abscess, three cases of vaginal infection and urinary tract infection, and four cases of difficult micturition. In late complications, four cases of pain were managed, five cases of recurrence were observed and two cases of mesh exposure were treated with ointment and local excision. Transobturator four-arms mesh is an effective and safe method for cystocele repair with low rate of recurrence and complications. We suggest that the use of transobturator four-arm mesh is a still good choice for the old patients with cystocele who are not suitable for general anesthesia and reside in areas where laparoscopy and robots are not available.
我们研究了聚丙烯网片治疗膀胱膨出手术的长期疗效和安全性。对2003年至2015年间198例≥2期膀胱膨出且采用经闭孔四臂聚丙烯网片行阴道前壁修补术的女性进行了评估。通过从电子病历中提取患者数据，回顾了包括临床特征和并发症在内的结果。此外，使用经过验证的问卷进行电话访谈并进行体格检查。随访期为9.3±0.3年。与术前相比，患者术后膀胱膨出分期显著降低。膀胱膨出的解剖学治愈率为93.4%，压力性尿失禁的治愈率为95%。比较三种问卷显示，除女性性功能指数评估外，总体平均得分显著提高。早期并发症中，4例血肿或脓肿、3例阴道感染和尿路感染以及4例排尿困难均自行缓解或通过药物控制。晚期并发症中，处理了4例疼痛，观察到5例复发，2例网片外露采用药膏和局部切除治疗。经闭孔四臂网片是一种有效且安全的膀胱膨出修复方法，复发率和并发症发生率低。我们建议，对于不适合全身麻醉且所在地区无法进行腹腔镜手术和机器人手术的老年膀胱膨出患者，使用经闭孔四臂网片仍是一个不错的选择。
