Wang Kaiyue, Shi Lijuan, Huang Zheren, Xu Yun
Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Soochow University, Changzhou, China.
Int Neurourol J. 2022 Sep;26(3):239-247. doi: 10.5213/inj.2244076.038. Epub 2022 Sep 30.
The aim of this retrospective study was to compare the anatomical and functional outcomes between bilateral sacrospinous hysteropexy (BSHP) and bilateral sacrospinous ligament fixation with vaginal hysterectomy (BSLF/VH) in women with apical-predominant uterovaginal prolapse.
Clinical data from patients with symptomatic Pelvic Organ Prolapse-Quantification (POP-Q) stage 2 or higher uterovaginal prolapse who underwent either BSHP (48 patients) or BSLF/VH (69 patients) between January 2014 and December 2018 were reviewed retrospectively. The primary outcome was the subjective satisfaction rate evaluated by Patient Global Impression of Improvement, and the secondary outcomes included objective anatomical success rates, impact on disease-specific quality of life evaluated by the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12, Pelvic Floor Distress Inventory-Short Form 20, and Pelvic Floor Impact Questionnaire 7, and surgical complications.
After a median follow-up of 35 months (range, 25-58 months), all patients in both groups demonstrated significant postoperative improvements in anatomical and functional outcomes (P<0.001). There were no significant differences in postoperative subjective and objective results, sexual satisfaction outcomes, or disease-specific quality of life between the BSHP and BSLF/VH groups, and similar incidence rates of intraoperative and postoperative complications were also recorded.
The uterus-sparing BSHP procedure yielded noninferior anatomical and functional outcomes compared to the BSLF/VH procedure and could be adopted as an alternative to conventional hysterectomy-based native-tissue repair modalities for symptomatic apical-predominant uterovaginal prolapse.
本回顾性研究旨在比较双侧骶棘韧带子宫悬吊术（BSHP）和双侧骶棘韧带固定术联合阴道子宫切除术（BSLF/VH）在以顶端为主的子宫阴道脱垂女性中的解剖学和功能学结局。
回顾性分析2014年1月至2018年12月期间接受BSHP（48例患者）或BSLF/VH（69例患者）治疗的有症状的盆腔器官脱垂定量分期（POP-Q）2期或更高期子宫阴道脱垂患者的临床资料。主要结局是通过患者整体改善印象评估的主观满意度，次要结局包括客观解剖学成功率、通过盆腔器官脱垂/尿失禁性功能问卷-12、盆底困扰量表简表20和盆底影响问卷7评估的对疾病特异性生活质量的影响以及手术并发症。
中位随访35个月（范围25 - 58个月）后，两组所有患者在解剖学和功能学结局方面均有显著的术后改善（P<0.001）。BSHP组和BSLF/VH组在术后主观和客观结果、性满意度结果或疾病特异性生活质量方面无显著差异，术中及术后并发症发生率也相似。
与BSLF/VH手术相比，保留子宫的BSHP手术在解剖学和功能学结局方面并不逊色，可作为有症状的以顶端为主的子宫阴道脱垂的传统基于子宫切除术的自体组织修复方式的替代方法。
