Yang Yao-Yu, Loo Zi-Xi, Lin Kun-Ling, Long Cheng-Yu
Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan.
Department of Obstetrics and Gynecology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 80145, Taiwan.
J Clin Med. 2024 Sep 10;13(18):5352. doi: 10.3390/jcm13185352.
The Minimally Invasive Prolapse System (MIPS) device, a novel single-incision transvaginal mesh, represents recent advancements in mesh technology, providing lightweight, biocompatible support for pelvic organ prolapse while reducing erosion, allowing for customization and improving surgical outcomes. This study aimed to identify factors associated with pelvic organ prolapse (POP) recurrence after transvaginal mesh (TVM) repair using the Minimally Invasive Prolapse System device. Two hundred and eighteen women with symptomatic stage II to IV POP underwent TVM. Preoperative and postoperative assessments included urinalyses and pelvic examinations using the POP quantification (POP-Q) staging system. During a follow-up period of 12-46 months, 7 of 218 (3.2%) women experienced POP recurrence. Univariate analysis was conducted to identify predictors of surgical failure, revealing no significant differences in body mass index, POP stage, or preoperative urinary symptoms between the recurrence and success groups ( > 0.05). However, functional urethral length <20 mm based on urodynamics ( = 0.011), ICI-Q scores ≥7 ( = 0.012), and the first 60 surgical cases ( = 0.018) were significant predictors of surgical failure. Multivariate logistic regression confirmed these findings. Functional urethral length <20 mm, ICI-Q scores ≥7, and limited surgical experience were significant predictors of TVM failure using the Minimally Invasive Prolapse System kit. POP recurrence after mesh repair is less likely beyond the learning curve.
微创脱垂系统(MIPS)装置是一种新型单切口经阴道网片,代表了网片技术的最新进展,可为盆腔器官脱垂提供轻质、生物相容性良好的支撑,同时减少侵蚀,实现定制化并改善手术效果。本研究旨在确定使用微创脱垂系统装置经阴道网片(TVM)修复后盆腔器官脱垂(POP)复发的相关因素。218例有症状的Ⅱ至Ⅳ期POP女性接受了TVM治疗。术前和术后评估包括尿液分析以及使用盆腔器官脱垂定量(POP-Q)分期系统进行盆腔检查。在12至46个月的随访期内,218例女性中有7例(3.2%)出现POP复发。进行单因素分析以确定手术失败的预测因素,结果显示复发组和成功组在体重指数、POP分期或术前泌尿系统症状方面无显著差异(>0.05)。然而,基于尿动力学的功能性尿道长度<20 mm(=0.011)、ICI-Q评分≥7(=0.012)以及最初的60例手术病例(=0.018)是手术失败的显著预测因素。多因素逻辑回归证实了这些发现。功能性尿道长度<20 mm、ICI-Q评分≥7以及手术经验有限是使用微创脱垂系统套件进行TVM失败的显著预测因素。网片修复后POP复发在学习曲线之外的可能性较小。