Departament of Obstetrics and Gynecology, Medical University of Wroclaw, Poland.
Ginekol Pol. 2021;92(7):471-474. doi: 10.5603/GP.a2021.0004. Epub 2021 Apr 12.
To present anterior abdominal fixation - a new surgical technique for the treatment of pelvic organ prolaps (POP) and to evaluate the results of the treatment of patients with stage III and IV POP operated using this technique.
Anterior abdominal fixation for treating stage III and IV POP was carried out in 42 women, who were qualified according to the Pelvic Organ Prolapse Quantification System (POP-Q) scale at baseline and after 12 months. The Pelvic Floor Disability Index-20 (PFDI-20), along with its symptom scales, were evaluated.
The mean age 42 operated women was 64.5 years, and the average BMI was 27.3 (83% women were overweight). At baseline, 29 (69%) women had POP stage IV, and 13 (31%) women had POP stage III. Overall, 14 (33%) underwent laparoscopy, 28 (67%) underwent laparotomy. At 12 months, 14 (33.3%) women had POP stage I; 21 (50%) women had POP stage II. Seven patients (16.6%) experienced a recurrence of disease with advancement at the degree of III/IV; 4 (9.5%) women required adjuvant surgery in the form of anterior and posterior vaginal wall surgery. No early complications after surgery were observed. The comparison of the results before and after surgery showed statistically significant improvement in terms of the P-QoL score as well as PFDI-20 along with its 3 symptom scales.
Anterior abdominal fixation of the uterus to the anterior abdominal wall is effective, safe, and technically easy to perform in the treatment of POP of advanced stage.
介绍一种新的治疗盆腔器官脱垂（POP）的外科技术——前腹部固定术，并评估该技术治疗 III 期和 IV 期 POP 患者的效果。
根据盆腔器官脱垂量化系统（POP-Q）量表，对 42 名符合条件的 III 期和 IV 期 POP 患者进行了前腹部固定术治疗。在基线和 12 个月后，对盆腔底部功能障碍指数-20（PFDI-20）及其症状量表进行了评估。
42 名接受手术的女性平均年龄为 64.5 岁，平均 BMI 为 27.3（83%的女性超重）。基线时，29 名（69%）女性为 IV 期 POP，13 名（31%）女性为 III 期 POP。总体而言，14 名（33%）女性接受了腹腔镜手术，28 名（67%）女性接受了剖腹手术。12 个月时，14 名（33.3%）女性的 POP 分期为 I 期；21 名（50%）女性的 POP 分期为 II 期。7 名（16.6%）患者疾病复发，进展至 III/IV 度；4 名（9.5%）女性需要进行阴道前后壁修补术的辅助手术。术后未观察到早期并发症。手术前后结果的比较显示，在 P-QoL 评分以及 PFDI-20 及其 3 个症状量表方面均有统计学意义的改善。
子宫前腹部固定术是一种有效、安全、技术上易于操作的治疗晚期 POP 的方法。
