Department of Gynecology, The Obstetrics and Gynecology Hospital of Fudan University, 128 Shenyang Road, Shanghai, China.
BMC Womens Health. 2021 Oct 11;21(1):362. doi: 10.1186/s12905-021-01505-z.
The objective of this study was to evaluate the overall outcomes and complications of transvaginal mesh (TVM) placement for the management of pelvic organ prolapse (POP) with different meshes with a greater than 10-years of follow-up.
We performed a retrospective review of patients with POP who underwent prolapse repair surgery with placement of transvaginal mesh (Prolift kit or self-cut Gynemesh) between January 2005 and December 2010. Baseline of patient characteristics were collected from the patients' medical records. During follow-up, the anatomical outcomes were evaluated using the POP Quantification system, and the Patient Global Impression of Improvement (PGI-I) was used to assess the response of a condition to therapy. Overall postoperative satisfaction was assessed by the following question: "What is your overall postoperative satisfaction, on a scale from 0 to 10?". Relapse-free survival was analyzed using Kaplan-Meier curves.
In total, 134 patients were included. With a median 12-year (range 10-15) follow-up, 52 patients (38.8%) underwent TVM surgery with Prolift, and Gynemesh was used 82 (61.2%). 91% patients felt that POP symptom improved based on the PGI-I scores, and most satisfied after operation. The recurrence rates of anterior, apical and posterior compartment prolapse were 5.2%, 5.2%, and 2.2%, respectively. No significant differences in POP recurrence, mesh-associated complications and urinary incontinence were noted between TVM surgery with Prolift versus Gynemesh.
Treatment of POP by TVM surgery exhibited long-term effectiveness with acceptable morbidity. The outcomes of the mesh kit were the same as those for self-cutmesh.
本研究旨在评估经阴道网片（TVM）治疗盆腔器官脱垂（POP）的总体结局和并发症，随访时间超过 10 年，使用不同的网片。
我们回顾性分析了 2005 年 1 月至 2010 年 12 月间因 POP 接受脱垂修补术且放置 TVM（普罗利夫套件或自切 GyneMesh）的患者。从患者病历中收集患者特征的基线数据。在随访期间，使用 POP 定量系统评估解剖学结局，使用患者总体印象改善（PGI-I）评估对治疗反应的情况。总体术后满意度通过以下问题进行评估：“您对术后总体满意度如何，评分范围为 0 至 10？”。使用 Kaplan-Meier 曲线分析无复发生存率。
共纳入 134 例患者。中位随访时间为 12 年（范围 10-15 年），52 例（38.8%）患者行普罗利夫 TVM 手术，82 例（61.2%）患者行 GyneMesh 手术。91%的患者根据 PGI-I 评分认为 POP 症状改善，术后满意度高。前、顶和后盆腔脱垂的复发率分别为 5.2%、5.2%和 2.2%。普罗利夫 TVM 手术与 GyneMesh 手术在 POP 复发、网片相关并发症和尿失禁方面无显著差异。
TVM 手术治疗 POP 具有长期有效性，且发病率可接受。网片套件的结局与自切网片相同。
