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各种手术治疗盆腔器官脱垂后患者生活质量的改善。

Quality-of-life improvements in patients after various surgical treatments for pelvic organ prolapse.

机构信息

Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 North Garden Street, Beijing, 100191, China.

出版信息

Arch Gynecol Obstet. 2024 Mar;309(3):813-820. doi: 10.1007/s00404-023-07140-3. Epub 2023 Jul 19.

Abstract

OBJECTIVE

To compare the improvements in quality of life of patients with pelvic organ prolapse (POP) treated using various surgical methods.

MATERIALS AND METHODS

The PUBMED, MEDLINE and Cochrane Library online databases were searched using the keywords "pelvic organ prolapse", "surgery", "PFDI-20" and "PFIQ-7" for articles published from January 2010 to December 2022 that included quality-of-life scores before and after surgery.

RESULTS

Forty-nine articles were include. The mean postoperative PFDI-20 and PFIQ-7 scores decreased by 67.50% and 76.98%, respectively, compared with those before surgery. In 76.9% of patients, this change did not decrease with increased postoperative time. The improvement rate in PFDI-20 scores after colpocleisis did not differ statistically from that after sacrocolpopexy and was significantly higher than that after other procedures. The improvement rate in PFIQ-7 scores after colpocleisis did not statistically differ from that after high uterosacral ligament suspension and was significantly higher than that after other procedures. The improvement rate in PFDI-20 scores after transvaginal mesh-based repair (TVM) did not significantly differ from that after sacrospinous ligament fixation and was significantly lower than that after other procedures except traditional vaginal wall repair. The improvement rate in PFIQ-7 scores after TVM did not significantly differ from that after new procedures and was significantly lower than that after other procedures.

CONCLUSIONS

Surgical treatment can significantly improve the quality of life of patients with POP. Colpocleisis may offer more advantages than those of other surgical procedures, and improvement was lower after TVM than after other procedures.

摘要

目的

比较不同手术方法治疗盆腔器官脱垂(POP)患者生活质量的改善情况。

材料与方法

检索 PUBMED、MEDLINE 和 Cochrane Library 在线数据库,使用“盆腔器官脱垂”“手术”“PFDI-20”和“PFIQ-7”等关键词,检索 2010 年 1 月至 2022 年 12 月发表的包含手术前后生活质量评分的文章。

结果

共纳入 49 篇文章。与术前相比,术后 PFDI-20 和 PFIQ-7 评分平均分别降低了 67.50%和 76.98%。在 76.9%的患者中,这种变化并未随着术后时间的延长而减少。经阴道闭孔尿道中段悬吊术(colpocleisis)后的 PFDI-20 评分改善率与经骶骨阴道固定术(sacrocolpopexy)相比无统计学差异,且显著高于其他术式。经 colpocleisis 后的 PFIQ-7 评分改善率与经高子宫骶韧带悬吊术(high uterosacral ligament suspension)相比无统计学差异,且显著高于其他术式。经阴道网片修补术(transvaginal mesh-based repair,TVM)后的 PFDI-20 评分改善率与经骶骨棘固定术(sacrospinous ligament fixation)相比无统计学差异,但显著低于其他术式(除传统阴道壁修补术)。经 TVM 后的 PFIQ-7 评分改善率与新术式相比无统计学差异,但显著低于其他术式。

结论

手术治疗可显著改善 POP 患者的生活质量。经 colpocleisis 治疗可能比其他手术方法更具优势,且 TVM 后的改善率低于其他手术方法。

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