Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
University of Milano-Bicocca, Monza, Italy.
Eur J Obstet Gynecol Reprod Biol. 2024 Oct;301:206-209. doi: 10.1016/j.ejogrb.2024.08.020. Epub 2024 Aug 13.
Surgical repair is the mainstay of genital prolapse management. Among native-tissue apical procedures, high uterosacral ligaments suspension is considered a valid and effective option for central compartment repair. In this study, we aimed to evaluate the effectiveness, complications rate, and functional results of high USL suspension as a primary prolapse repair technique in a large cohort of patients.
Patients who underwent vaginal hysterectomy followed by high uterosacral ligaments suspension for POP between January 2008 and December 2020 were retrospectively analyzed. Questionnaires and clinical interviews were preoperatively performed to assess symptoms and severity of urinary, bowel, and sexual dysfunctions. After surgical procedure, diagnostic cystoscopy was performed to evaluate ureteral patency. Postoperative data, objective, and subjective cure rate were then noted at the follow-up evaluation.
A total of 1099 patients underwent high uterosacral ligaments suspension. The total complication rate was 3.4 % and recurrence in any of the vaginal compartments was 12.4 %. Reoperation for symptomatic prolapse recurrence or pessary treatment was required in 9 women (0.9 %). In the evaluation of postoperative questionnaires, functional outcomes analysis revealed a significant improvement (p < 0.05) in terms of stress urinary incontinence, urge urinary incontinence, voiding symptoms, constipation, and dyspareunia after prolapse repair.
Uterosacral ligament suspension is a safe and effective procedure for primary surgical treatment of pelvic organ prolapse. Anatomical, functional, and subjective outcomes were very satisfactory, and the reoperation rate for recurrence was below 1%.
手术修复是治疗生殖器脱垂的主要方法。在原生组织顶壁手术中，高子宫骶韧带悬吊术被认为是中央隔修复的有效方法。本研究旨在评估高子宫骶韧带悬吊术作为一种主要脱垂修复技术在大量患者中的有效性、并发症发生率和功能结果。
回顾性分析 2008 年 1 月至 2020 年 12 月期间因 POP 接受阴道子宫切除术联合高子宫骶韧带悬吊术的患者。在术前进行问卷调查和临床访谈，以评估尿、肠和性功能障碍的症状和严重程度。手术完成后，进行诊断性膀胱镜检查以评估输尿管通畅性。然后在随访评估时记录术后数据、客观和主观治愈率。
共 1099 例患者接受了高子宫骶韧带悬吊术。总并发症发生率为 3.4%，任何阴道壁的复发率为 12.4%。9 名患者（0.9%）因有症状的脱垂复发或需要佩戴子宫托而再次手术。在术后问卷调查的功能结果分析中，脱垂修复后压力性尿失禁、急迫性尿失禁、排尿症状、便秘和性交困难等方面均有显著改善（p<0.05）。
子宫骶韧带悬吊术是治疗盆腔器官脱垂的一种安全有效的手术方法。解剖学、功能和主观结果非常满意，复发的再次手术率低于 1%。
