Obut Mehmet, Oğlak Süleyman Cemil, Akgöl Sedat
Department of Obstetrics and Gynecology, Etlik Zübeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey.
Department of Obstetrics and Gynecology, Health Sciences University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.
Gynecol Minim Invasive Ther. 2021 Apr 14;10(2):96-103. doi: 10.4103/GMIT.GMIT_67_20. eCollection 2021 Apr-Jun.
We sought to compare the surgical outcomes, safety, effectiveness, and mid-term outcomes in patients who had undergone laparoscopic hysterosacropexy and laparoscopic pectopexy due to apical prolapse.
This prospective randomized study was conducted on a total of 62 women who underwent apical prolapse surgery (32 undergoing a pectopexy and 30 undergoing a sacrohysteropexy) between June 2015 and June 2017. Patients with symptomatic uterine or vaginal vault prolapse with stage 2 or worse were included in the sudy. Before and after the operation, we used the Pelvic Organ Prolapse Quantification System (POP-Q) and questionnaires, which are the Prolapse Quality of Life Questionnaire (P-QOL) and Female Sexual Function Index (FSFI), to evaluated cases. Baseline characteristics, perioperative and postoperative complications, and follow-up results at 12 months were also evaluated.
All domains of POP-Q, P-QOL, and FSFI scores improved significantly after surgery both in pectopexy and sacrohysteropexy group. The postoperative complications of both procedures were similar except for constipation after surgery (3.2% in the pectopexy group and 20% in the hysterosacropexy group [ = 0.036]).
Both sacrohysteropexy and pectopexy are effective surgical options for apical prolapse patients. The pectopexy is an acceptable alternative to laparoscopic sacrohysteropexy because of its less complexity and not reducing pelvic space for the rectum to exist. We suggest that the laparoscopic pectopexy may be widely used in clinical routine.
我们旨在比较因顶端脱垂接受腹腔镜子宫骶骨固定术和腹腔镜耻骨后固定术患者的手术效果、安全性、有效性及中期结局。
本前瞻性随机研究共纳入62例于2015年6月至2017年6月期间接受顶端脱垂手术的女性(32例行耻骨后固定术,30例行子宫骶骨固定术)。纳入研究的患者为有症状的子宫或阴道穹窿脱垂且为2期或更严重程度者。手术前后,我们使用盆腔器官脱垂定量系统(POP-Q)以及问卷,即脱垂生活质量问卷(P-QOL)和女性性功能指数(FSFI)来评估病例。还评估了基线特征、围手术期及术后并发症以及12个月时的随访结果。
耻骨后固定术组和子宫骶骨固定术组术后POP-Q、P-QOL及FSFI评分的所有领域均显著改善。两种手术的术后并发症相似,除了术后便秘(耻骨后固定术组为3.2%,子宫骶骨固定术组为20%[P = 0.036])。
子宫骶骨固定术和耻骨后固定术都是顶端脱垂患者有效的手术选择。耻骨后固定术因其操作不太复杂且不减少直肠存在的盆腔空间,是腹腔镜子宫骶骨固定术可接受的替代方法。我们建议腹腔镜耻骨后固定术可能会在临床常规中广泛应用。