改良式阴道旁修补术治疗伴有阴道旁缺损的膀胱膨出：一项回顾性研究。

A modified technique for paravaginal repair of cystocele with paravaginal defect: A retrospective study.

机构信息

Department of Gynecology and Obstetrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2022 Feb;269:108-113. doi: 10.1016/j.ejogrb.2021.12.028. Epub 2021 Dec 28.

DOI:10.1016/j.ejogrb.2021.12.028

PMID:34992032

Abstract

OBJECTIVE

We aimed to determine the efficacy and safety of a modified protocol for paravaginal repair of symptomatic paravaginal defects and cystocele.

METHODS

This study was an observational case series of 98 consecutive female patients, referred to our hospital between June 2014 and May 2018, with symptomatic grade II to IV paravaginal defects and cystocele. Our modified technique for paravaginal repair is based on the conventional protocol but incorporates reverse bridge repair and the cross-stitching of bilateral sutures. The curative effect of this new technique was evaluated subjectively and objectively during postoperative follow-up.

RESULTS

All operations were successful. Patients were followed up for 12 to 48 months, until June 2019; the mean follow-up period was 32.4 months. Three months after surgery, the rate of success was 100% (98/98 cases); in each case, the top of the vagina lay above the level of the sciatic spine. The rate of success was 94.9% (93/98 cases) at 12 months after surgery, 91.0% (61/71 cases) at 24 months after surgery, and 76.2% (16/21 cases) at 48 months after surgery. Four cases required a second surgery; three of these cases were treated with sacrocolpopexy, and one case was treated with sacrospinous ligament fixation.

CONCLUSION

Our modified technique for paravaginal repair was safe and effective for anterior vaginal prolapse and cystocele, as confirmed by the results observed over a mean follow-up period of 32.4 months.

摘要

目的

本研究旨在评估改良版阴道旁修补术治疗症状性阴道旁缺陷和膀胱膨出的疗效和安全性。

方法

本研究为一项回顾性观察病例系列研究，纳入 2014 年 6 月至 2018 年 5 月期间我院收治的 98 例症状性 II 至 IV 度阴道旁缺陷和膀胱膨出的女性患者。我们的改良阴道旁修补术基于传统术式，但采用了反向桥接修复和双侧缝线交叉缝合技术。在术后随访中，从主观和客观两个方面评估该新技术的疗效。

结果

所有手术均成功完成。患者随访 12 至 48 个月，随访截止日期为 2019 年 6 月，平均随访时间为 32.4 个月。术后 3 个月，成功率为 100%（98/98 例）；每例患者阴道顶端均高于坐骨棘水平。术后 12 个月的成功率为 94.9%（93/98 例），术后 24 个月为 91.0%（61/71 例），术后 48 个月为 76.2%（16/21 例）。4 例患者需要再次手术，其中 3 例接受了骶骨阴道固定术，1 例接受了骶棘韧带固定术。