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保留子宫的技术治疗盆腔器官脱垂:腹腔镜下的耻骨后悬吊术。

Uterine preserving technique in the treatment of pelvic organ prolapse: Laparoscopic pectopexy.

机构信息

Department of Obstetrics and Gynecology, Gazi Osman Paşa Taksim Research and Education Hospital, Istanbul, Turkey.

Department of Obstetrics and Gynecology, Başakşehir Çam ve Sakura Research and Education Hospital, Istanbul, Turkey.

出版信息

J Obstet Gynaecol Res. 2022 Mar;48(3):850-856. doi: 10.1111/jog.15146. Epub 2022 Jan 9.

Abstract

OBJECTIVE

Apical prolapse constitutes an important part of pelvic organ prolapse. In this study, our aim was to investigate the effectiveness of laparoscopic pectopexy that we made by preserving the uterus in the surgical treatment of apical prolapse.

METHODS

A total of 36 patients with apical prolapse who wanted to preserve their uterus underwent laparoscopic rectopexy. Apical prolapse and sexual function of the patients were evaluated preoperatively and 12 months after surgery using the Pelvic Organ Prolapse Quantification (POP-Q) scale and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) sexual questionnaire form. Preoperative medical records and postoperative clinical results were recorded.

RESULTS

There were no intraoperative or postoperative complications in the patients who underwent laparoscopic pectopexy. The average duration of surgery was 48.7 ± 9.8 min. Two patients had a recurrence of apical prolapse. In the Aa, Ba, C, and D points in the POP-Q staging, significant changes were observed. Postoperative PISQ-12 scores improved significantly (p < 0.05).

CONCLUSION

Uterine-preserving laparoscopic pectopexy is a safe, feasible, and effective method for treating pelvic organ prolapse. It also improved the PISQ-12 and POP-Q scores in POP patients. Laparoscopic pectopexy may increase a surgeon's technical perspective for pelvic organ prolapse surgery.

摘要

目的

顶脱垂是盆腔器官脱垂的重要组成部分。本研究旨在探讨我们通过保留子宫进行腹腔镜悬带固定术治疗顶脱垂的效果。

方法

共 36 例希望保留子宫的顶脱垂患者接受了腹腔镜直肠固定术。术前和术后 12 个月采用盆腔器官脱垂量化(POP-Q)量表和盆腔器官脱垂/尿失禁性功能问卷(PISQ-12)性功能问卷对顶脱垂和性功能进行评估。记录术前病历和术后临床结果。

结果

行腹腔镜悬带固定术的患者均无术中或术后并发症。手术平均时间为 48.7±9.8 分钟。2 例患者出现顶脱垂复发。POP-Q 分期的 Aa、Ba、C 和 D 点有显著变化。术后 PISQ-12 评分明显改善(p<0.05)。

结论

保留子宫的腹腔镜悬带固定术是治疗盆腔器官脱垂的一种安全、可行且有效的方法。它还改善了 POP 患者的 PISQ-12 和 POP-Q 评分。腹腔镜悬带固定术可能增加了外科医生在盆腔器官脱垂手术中的技术视角。

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