Ghanbari Zinat, Veisi Firoozeh, Eftekhar Tahereh, Deldar Maryam, Mostaan Fatemeh, Adabi Khadijeh
Division of Female Pelvic Medicine and Surgery, Department of Obstetrics and Gynecology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Division of Female Pelvic Medicine and Surgery, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Taiwan J Obstet Gynecol. 2023 Mar;62(2):252-255. doi: 10.1016/j.tjog.2022.09.008.
Pericervical ring reconstruction through restoration of pubocervical and rectovaginal fascia is performed concomitantly with sacrospinous hysteropexy as a transvaginal native tissue procedure for vaginal apical prolapse. The main goal of this study was to assess subjective and objective outcomes of sacrospinous hysteropexy and additional pericervical ring reconstruction.
We conducted a prospective and observational study. All participants underwent sacrospinous hysteropexy and pericervical ring reconstruction and perineorrhaphy. Surgical complications, anatomical and functional efficacy were assessed.
108 cases were included in this study. The mean follow-up timeframe was 18.62 ± 1.22 months (minimum 12 and maximum 26 months). All parameters of subjective outcomes were improved significantly. The overall anatomic success rate was 92.59%. Mean operation time was 50.64 ± 20.8 min. No major intraoperative or postoperative complications were found. There was no statistically significant difference in demographic characteristics including age, BMI, gravidity, medical comorbidities, menopausal status, sexual activity, pretreatment prolapse severity scores between subjects with failure, and good anatomical outcome. Recurrence was mostly observed in patients with higher prolapse stages of anterior and apical compartments. Baseline POP-Q parameters Ba, C, D were significantly higher in cases with failure.
Our study disclosed sustainable anatomic and subjective outcomes of modified sacrospinous hysteropexy by means of additional pericervical ring reconstruction.
经阴道自体组织手术治疗阴道顶端脱垂时，通过修复耻骨宫颈筋膜和直肠阴道筋膜进行宫颈环重建，并同时进行骶棘韧带子宫固定术。本研究的主要目的是评估骶棘韧带子宫固定术及额外的宫颈环重建的主观和客观结果。
我们进行了一项前瞻性观察研究。所有参与者均接受了骶棘韧带子宫固定术、宫颈环重建术和会阴修补术。评估手术并发症、解剖和功能疗效。
本研究纳入108例病例。平均随访时间为18.62±1.22个月（最短12个月，最长26个月）。主观结果的所有参数均有显著改善。总体解剖成功率为92.59%。平均手术时间为50.64±20.8分钟。未发现重大术中或术后并发症。在年龄、体重指数、妊娠次数、合并症、绝经状态、性活动、治疗前脱垂严重程度评分等人口统计学特征方面，手术失败组和解剖结果良好组之间无统计学显著差异。复发大多发生在前庭和顶端间隔脱垂程度较高的患者中。手术失败病例的基线POP-Q参数Ba、C、D显著更高。
我们的研究揭示了通过额外的宫颈环重建改良骶棘韧带子宫固定术可持续的解剖和主观结果。
