Department of Urology, Kyorin University School of Medicine, Tokyo, Japan.
Nursing Department, Kyorin University Hospital, Tokyo, Japan.
Low Urin Tract Symptoms. 2022 Jan;14(1):64-71. doi: 10.1111/luts.12411. Epub 2021 Sep 14.
This study aimed to compare the efficacy of modified transvaginal mesh (TVM) surgery and vaginal pessary in patients with symptomatic pelvic organ prolapse (POP).
We retrospectively analyzed 130 patients with symptomatic POP treated with either modified TVM (n = 62) or vaginal pessary (n = 68). To evaluate the prolapse, lower urinary tract, bowel, and sexual symptoms and prolapse-related quality of life (QOL) were assessed using the prolapse QOL questionnaire. All questionnaires were completed before treatment and 1 year after the treatment.
One year after the treatment, the prolapse and voiding symptoms and all prolapse-related QOL domains, except for the personal relationships and sleep/energy, were significantly improved in the pessary group. The prolapse, urinary storage, voiding, bowel, and sexual symptoms and all QOL domains significantly improved in the modified-TVM group.
Both the modified TVM surgery and vaginal pessary effectively treated prolapse and voiding symptoms and improved most of the prolapse-related QOL domains. Modified TVM surgery was more effective in improving urinary storage, bowel, and sexual symptoms than the pessary treatment. Modified TVM seemed to position the organs more correctly to improve bladder, bowel, and sexual function than pessary insertion.
本研究旨在比较改良经阴道网片（TVM）手术和阴道子宫托治疗有症状的盆腔器官脱垂（POP）患者的疗效。
我们回顾性分析了 130 例接受改良 TVM（n=62）或阴道子宫托（n=68）治疗的有症状 POP 患者。为了评估脱垂、下尿路、肠道和性功能症状以及与脱垂相关的生活质量（QOL），使用脱垂 QOL 问卷进行评估。所有问卷均在治疗前和治疗 1 年后完成。
治疗 1 年后，子宫托组的脱垂和排尿症状以及除人际关系和睡眠/精力外的所有脱垂相关 QOL 领域均显著改善。改良 TVM 组的脱垂、尿储存、排尿、肠道和性功能症状以及所有 QOL 领域均显著改善。
改良 TVM 手术和阴道子宫托均可有效治疗脱垂和排尿症状，并改善大多数与脱垂相关的 QOL 领域。改良 TVM 手术在改善尿储存、肠道和性功能症状方面比子宫托治疗更有效。与子宫托插入相比，改良 TVM 似乎更能正确定位器官，从而改善膀胱、肠道和性功能。
