Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei 220409, Taiwan.
Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and the Hospital, Taipei 100225, Taiwan.
Medicina (Kaunas). 2022 Jan 19;58(2):148. doi: 10.3390/medicina58020148.
: To identify the predictors of clinical outcomes in women with pelvic organ prolapse (POP) who underwent transvaginal reconstruction surgery, especially with transobturator mesh fixation or sacrospinous mesh fixation. : All women with POP who underwent transvaginal reconstruction surgery, especially with transobturator mesh fixation or sacrospinous mesh fixation, were reviewed. Between January 2011 and May 2019, a total of 206 consecutive women were reviewed, including 68 women receiving POP reconstruction with transobturator mesh fixation and 138 women who underwent POP reconstruction with sacrospinous mesh fixation. The least experienced surgeon (hazard ratio = 804.6) and advanced stage of cystocele (hazard ratio = 8.80) were the predictors of POP recurrence, especially those women with stage 4 of cystocele. Young age (hazard ratio = 0.94) was a predictor for mesh extrusion, especially those women with age ≤67 years. Follow-up interval (odds ratio = 1.03, = 0.02) was also an independent predictor of mesh extrusion. High maximum flow rate (Qmax, hazard ratio = 1.03) was the sole predictor of postoperative stress urinary incontinence, especially those women with Qmax ≥19.2 mL/s. Preoperative overactive bladder syndrome (hazard ratio = 3.22) were a predictor for postoperative overactive bladder syndrome. In addition, overactive bladder syndrome rate improved after surgery in the sacrospinous group ( = 0.0001). Voiding dysfunction rates improved after surgery in both sacrospinous and transobturator groups. Predictors of clinical outcome in women who underwent transvaginal POP mesh reconstruction are identified. The findings can serve as a guide for preoperative consultation of similar procedures.
：为了明确行经阴道重建手术的盆腔器官脱垂（POP）女性的临床结局的预测因素，特别是经闭孔网片固定或骶骨固定术。
：回顾了 2011 年 1 月至 2019 年 5 月期间行经阴道重建手术的所有 POP 女性，包括 68 例行经闭孔网片固定术的 POP 重建患者和 138 例行骶骨固定术的 POP 重建患者。经验最少的外科医生（风险比=804.6）和中重度膀胱膨出（风险比=8.80）是 POP 复发的预测因素，特别是那些中重度膀胱膨出患者。年轻的年龄（风险比=0.94）是网片突出的预测因素，尤其是那些年龄≤67 岁的患者。随访间隔（比值比=1.03，=0.02）也是网片突出的独立预测因素。最大尿流率（Qmax，风险比=1.03）高是术后压力性尿失禁的唯一预测因素，尤其是那些 Qmax≥19.2mL/s 的患者。术前膀胱过度活动症（OAB）（风险比=3.22）是术后 OAB 的预测因素。此外，骶骨固定组术后 OAB 发生率改善（=0.0001）。骶骨固定组和经闭孔组术后排尿功能障碍发生率均改善。
：明确了行经阴道 POP 网片重建术的女性的临床结局的预测因素。这些发现可作为类似手术术前咨询的指导。
