Département de Chirurgie Gynécologique, Hôpital Universitaire de Strasbourg, Strasbourg, France.
Département de Chirurgie Gynécologique, Hôpital Universitaire de Strasbourg, Strasbourg, France.
J Gynecol Obstet Hum Reprod. 2023 Jun;52(6):102575. doi: 10.1016/j.jogoh.2023.102575. Epub 2023 Mar 26.
Pelvic organ prolapse (POP) is a common condition that affects 50% of women who have given birth in their lifetime. With stop of vaginal mesh sale in 2019, the sacrospinous fixation technique according to Richter with native tissue has seen its incidence tripled in 15 years. Classically, sacrospinous fixation according to Richter is performed unilaterally, however its unilateral or bilateral character is controversial. Objective of this work is to evaluate the efficacy and safety of bilateral sacrospinous fixation according to Richter by the posterior approach with native tissue (SSB).
We performed a retrospective single-center study. From March 12, 2010 to March 23, 2020, all first-time operated patients who underwent SSB in CHU Strasbourg gynecological surgery unit for symptomatic POP management were included. The main endpoint of our work is the anatomical and functional success rate at 12 and 24 months. The secondary judgment criteria of our work were based on the postoperative evaluation of patient's quality of life according to the PFDI-20 score as well as the rate of postoperative complications.
77 patients were included in our work. The anatomical success rate at 12 months is 94 and 81% at 24 months regardless of the compartment affected. The functional success rate is 94% at 12 months and 82% at 24 months. Quality of life evaluation through the PFDI-20 scale revealed a clear improvement in the symptomatology related to POP: 127/300 +/- 27.3. preoperatively and 59.8 ± 14.7 postoperatively.
Bilateral sacrospinous fixation according to Richter by posterior approach with native tissue is a safe and effective surgical technique allowing a clear improvement in patients quality of life.
盆腔器官脱垂（POP）是一种常见的疾病，影响 50%的生育过的女性。自 2019 年阴道网片销售停止以来，15 年内，里希特氏骶棘韧带固定术（SSB）采用原生组织的应用发生率增加了两倍。经典地，里希特氏骶棘韧带固定术是单侧进行的，但它是单侧还是双侧的性质存在争议。本研究旨在评估经后路采用原生组织的双侧里希特氏骶棘韧带固定术（SSB）的疗效和安全性。
我们进行了一项回顾性单中心研究。2010 年 3 月 12 日至 2020 年 3 月 23 日，所有在斯特拉斯堡大学附属医院妇科手术单元因 POP 管理而接受 SSB 初次手术的患者均被纳入研究。我们研究的主要终点是 12 个月和 24 个月时的解剖学和功能成功率。我们研究的次要判断标准是基于术后根据 PFDI-20 评分对患者生活质量的评估以及术后并发症的发生率。
我们的研究共纳入 77 例患者。12 个月时的解剖学成功率为 94%，24 个月时为 81%，与受影响的部位无关。12 个月时的功能成功率为 94%，24 个月时为 82%。通过 PFDI-20 量表评估生活质量显示，POP 相关症状明显改善：术前 127/300 +/- 27.3，术后 59.8 +/- 14.7。
经后路采用原生组织的双侧里希特氏骶棘韧带固定术是一种安全有效的手术技术，可显著改善患者的生活质量。
