Vidoman Matej, Kalis Vladimir, Smazinka Martin, Havir Martin, Rusavy Zdenek, Ismail Khaled M
Department of Gynecology and Obstetrics, Faculty Hospital, Trenčín, Slovakia.
Department of Gynecology and Obstetrics, Faculty of Medicine in Pilsen, Charles University, Alej Svobody 76, 304 60, Pilsen, Czechia.
Int Urogynecol J. 2024 Jun;35(6):1155-1162. doi: 10.1007/s00192-024-05780-w. Epub 2024 May 1.
It is reported that up to 60% of women would prefer to spare their uterus during pelvic organ prolapse (POP) repair surgery. A reliable hysteropexy technique is therefore crucial. We aimed to describe the safety profile and initial core patient-reported and clinical outcomes of the Pilsner modification of laparoscopic mesh sacrohysterocolpopexy (PiMMS) in comparison with the laparoscopic sacrohysterocolpopexy technique (standard laparoscopic sacrohysterocolpopexy [sLSH]) previously used in our unit.
This was a retrospective cohort study conducted in a single tertiary referral urogynecological center. All patients who underwent laparoscopic mesh sacrohysterocolpopexy between 1 January 2015, and 31 January 2022 were included in the study. Follow-up clinical, patient-reported, and imaging outcomes at the 12-month follow-up time point are presented.
A total of 87 patients were included. Of these, 49 (56.3%) and 38 (43.7%) underwent sLSH and PiMMS respectively. Low numbers of perioperative complications were found in both groups with no mesh-related complications reported following PiMMS up to 12 months postoperatively. There were no apical compartment failures in either group. There were 8 (17.0%) vs 1 (2.7%) anterior compartment failures (Ba ≤ -1) in the sLSH and PiMMS groups respectively (p = 0.07) at 12 months. At the 1-year follow-up, 42 (89.4%) patients reported a Patient Global Impression of Improvement score of ≤ 2 in the sLSH groups compared with 35 (94.6%) patients following PiMMS.
The PiMMS technique seems to have comparable safety profile and patient-reported outcomes with the sLSH technique. However, there is a trend toward reduced anterior compartment failures with this modification. The findings of this preliminary report need to be re-evaluated in a well-powered prospective study.
据报道，高达60%的女性在盆腔器官脱垂（POP）修复手术中希望保留子宫。因此，一种可靠的子宫固定术技术至关重要。我们旨在描述与我们单位之前使用的腹腔镜骶骨子宫阴道固定术技术（标准腹腔镜骶骨子宫阴道固定术[sLSH]）相比，皮尔森改良腹腔镜网片骶骨子宫阴道固定术（PiMMS）的安全性概况以及患者报告的初始核心临床结局。
这是一项在单一三级转诊泌尿妇科中心进行的回顾性队列研究。纳入了2015年1月1日至2022年1月31日期间接受腹腔镜网片骶骨子宫阴道固定术的所有患者。呈现了12个月随访时间点的随访临床、患者报告及影像学结局。
共纳入87例患者。其中，49例（56.3%）接受了sLSH，38例（43.7%）接受了PiMMS。两组围手术期并发症数量均较少，PiMMS术后12个月内未报告与网片相关的并发症。两组均无顶端腔室失败情况。12个月时，sLSH组和PiMMS组分别有8例（17.0%）和1例（2.7%）前腔室失败（Ba≤ -1）（p = 0.07）。在1年随访时，sLSH组42例（89.4%）患者报告患者整体改善印象评分为≤2，而PiMMS组为35例（94.6%）患者。
PiMMS技术似乎与sLSH技术具有相当的安全性概况和患者报告结局。然而，这种改良有减少前腔室失败的趋势。这一初步报告的结果需要在一项有充分样本量的前瞻性研究中重新评估。
