Department of Urogynecology, Université Claude Bernard Lyon 1, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69677, Lyon-Bron, France.
Hôpital de la Croix Rousse, Service de Chirurgie Gynécologique, 103 Grande Rue de la Croix Rousse, 69317, Lyon cedex 04, France.
Int Urogynecol J. 2022 Sep;33(9):2533-2541. doi: 10.1007/s00192-021-04764-4. Epub 2021 Mar 20.
We assessed 3-year anatomic and functional results using synthetic glue to fix mesh in laparoscopic sacrocolpopexy.
Prospective multicenter cohort study in three academic urogynecology departments. Seventy consecutive patients with stage ≥ 3 POP-Q (Pelvic Organ Prolapse Quantification) anterior and/or apical prolapse underwent laparoscopic sacrocolpopexy using synthetic surgical glue to fix anterior and posterior meshes to the vagina. Patients were followed up at 1, 2 and 3 years. Primary outcome was anterior and apical anatomic success (POP-Q stage ≤ 1) at 3 years. Secondary outcomes comprised functional results (international quality of life and sexuality scales), mesh-related morbidity and urinary incontinence at 3 years.
Mean age was 56.7 ± 1.2 years. Mean follow-up was 43 months. Anterior compartment anatomic success rate was 87% at 2 years (Ba, -2.4 cm; p < 0.0001) and 86.5% at 3 years (Ba, -2.3 cm; p < 0.0001); apical success was 96.3% at 2 years (C, -6.8 cm; p < 0.0001) and 97.3% at 3 years (C, -6.5 cm; p < 0.0001). All quality-of-life scores improved significantly and lastingly at 3 years: PFDI-20, PFIQ-7 and PISQ-12, respectively, p < 0.0001, p < 0.0001 and p = 0.01. There was one case of vaginal mesh exposure at 3 years (2.8%) and five of mesh shrinkage at 1 year (7.8%), none at 2 years and two at 3 years (5.4%). Urinary incontinence rate was 29.7% at 1 year, 14.8% at 2 years and 11.1% at 3 years.
Vaginal mesh adhesive in laparoscopic sacrocolpopexy remained effective at 3 years, with excellent tolerance and no specific complications. Anatomic and functional results were good and enduring in terms of both anterior and apical correction.
我们评估了使用合成胶固定网片在腹腔镜骶骨阴道固定术中 3 年的解剖和功能结果。
在三个学术泌尿科中心进行前瞻性多中心队列研究。70 例盆腔器官脱垂量化（Pelvic Organ Prolapse Quantification，POP-Q）≥3 期前壁和/或顶壁脱垂的连续患者接受腹腔镜骶骨阴道固定术，使用合成手术胶将前壁和后壁网片固定到阴道。患者在 1、2 和 3 年时进行随访。主要结局为 3 年时前壁和顶壁解剖学成功（POP-Q 分期≤1）。次要结局包括 3 年时的功能结果（国际生活质量和性生活量表）、与网片相关的发病率和尿失禁。
平均年龄为 56.7±1.2 岁。平均随访时间为 43 个月。前壁解剖成功率在 2 年时为 87%（Ba，-2.4cm；p<0.0001），在 3 年时为 86.5%（Ba，-2.3cm；p<0.0001）；顶壁成功率在 2 年时为 96.3%（C，-6.8cm；p<0.0001），在 3 年时为 97.3%（C，-6.5cm；p<0.0001）。所有生活质量评分在 3 年时均显著且持久地改善：PFDI-20、PFIQ-7 和 PISQ-12，分别为 p<0.0001、p<0.0001 和 p=0.01。3 年后有 1 例阴道网片暴露（2.8%），1 年时有 5 例网片收缩（7.8%），2 年时无，3 年时有 2 例（5.4%）。尿失禁率在 1 年时为 29.7%，2 年时为 14.8%，3 年时为 11.1%。
在腹腔镜骶骨阴道固定术中，阴道网片胶粘剂在 3 年后仍然有效，具有良好的耐受性，没有特定的并发症。前壁和顶壁的解剖和功能结果均良好且持久。
