Department of Gynecology and Obstetrics, Helios Hospital Erfurt, Nordhäuser Straße 74 99089, Erfurt, Germany.
Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf, Germany.
Arch Gynecol Obstet. 2022 Jul;306(1):141-149. doi: 10.1007/s00404-022-06486-4. Epub 2022 Mar 14.
Uterine-preserving techniques are becoming increasingly popular in the last decade. This investigation evaluates a novel hysteropexy technique using a mesh in sling-alike configuration [Splentis (Promedon, Argentina)] which is attached anteriorly to the cervix and suspended to the sacrospinous ligaments bilaterally via the vaginal route in women undergoing surgery for uterine prolapse.
This was a single-center cohort study, evaluating women who underwent transvaginal hysteropexy with Splentis for primary uterine descent. Data have been collected prospectively as part of the quality assurance system. Primary endpoint was treatment success, defined as a combined endpoint including the absence of a vaginal bulge symptom and no retreatment of apical prolapse. A validated questionnaire to evaluate quality-of-life and prolapse symptoms was utilized. Descriptive analysis was applied. Wilcoxon signed-rank test was performed to compare paired samples. The significance level was set at 5%.
A total of 103 women with a median age of 68.0 [IQR 11.5] years with a median apical POP-Q stage of 3 were included. The median surgery time was 22 [IQR 12] minutes and no intraoperative complication occurred. After a median follow-up time of 17 months, treatment success was achieved in 91 (89.2%) patients and quality of life and patient report outcomes improved significantly (p < 0.001). Mesh exposure occurred in 3 (2.9%) patients. Of these, two patients required surgical revision, and one patient was treated conservatively. One patient required partial mesh removal due to dyspareunia.
Bilateral sacrospinous hysteropexy with Splentis offers an efficacious and safe alternative for apical compartment repair, incorporating the advantages of pelvic floor reconstruction via the vaginal route.
在过去十年中，保留子宫的技术越来越受欢迎。本研究评估了一种新的子宫固定技术，使用类似吊带的网片（阿根廷 Promedon 公司的 Splentis），通过阴道途径将其从前部附着于宫颈，并双侧悬挂于骶棘韧带，用于因子宫脱垂而行手术的女性。
这是一项单中心队列研究，评估了接受经阴道 Splentis 子宫固定术治疗原发性子宫下降的女性。数据作为质量保证系统的一部分进行前瞻性收集。主要终点是治疗成功，定义为包括阴道膨出症状消失和无需再次治疗顶脱垂的联合终点。使用了一种经过验证的评估生活质量和脱垂症状的问卷。应用描述性分析。采用 Wilcoxon 符号秩检验比较配对样本。显著性水平设为 5%。
共纳入 103 例中位年龄为 68.0[IQR 11.5]岁、中位顶脱垂 POP-Q 分期为 3 的女性。中位手术时间为 22[IQR 12]分钟，术中无并发症发生。中位随访时间为 17 个月后，91（89.2%）例患者治疗成功，生活质量和患者报告结果显著改善（p<0.001）。3（2.9%）例患者出现网片暴露。其中，2 例患者需要手术修复，1 例患者接受保守治疗。1 例患者因性交困难而需要部分网片切除。
双侧骶棘韧带 Splentis 子宫固定术为顶腔修复提供了一种有效且安全的替代方法，结合了经阴道途径进行盆底重建的优势。
