Kato Chikako, Kuwata Tomoko, Kashihara Hiromi, Takeyama Masami
Department of Urogynecology Center, Daiichi Towakai Hospital, Takatsuki City, Osaka, Japan.
Int J Urol. 2025 Mar;32(3):251-257. doi: 10.1111/iju.15630. Epub 2024 Nov 2.
This study aimed to investigate the long-term effectiveness and safety of transvaginal mesh surgery for pelvic organ prolapse at a high-volume center in Japan.
Patients who underwent transvaginal mesh surgery between March 2010 and August 2015 were included and followed up for 5 years. As no mesh kits were available in our country, we used a self-cut polypropylene mesh (Japanese-style transvaginal mesh) for the procedures. Objective anatomical restoration and complications were evaluated during outpatient examinations.
Overall, 711 patients were included in this study. Over 5 years, the recurrence rate of stage 2 or higher prolapse at the operated compartment was 8.6% (61 cases), whereas that at the other compartments was 12.8% (91 cases). The frequency of recurrence was highest at 3 months and decreased with each passing year in both compartments. During the follow-up period, 28 patients (three at the operated compartment and 25 at the other compartments) required reoperation owing to recurrence. Overall, there were 13 cases of mesh exposure (1.8%), including two (0.28%) in the bladder, 10 (1.4%) in the vagina, and one (0.14%) in the rectum. Urinary incontinence surgery was performed in 69 patients (9.7%) during the follow-up period.
The frequencies of recurrence requiring reoperation and mesh-related complications were low, and vaginal mesh exposure was mostly asymptomatic. Therefore, the Japanese-style transvaginal mesh is safe and effective.
本研究旨在调查日本一家大型医疗中心进行的经阴道网片手术治疗盆腔器官脱垂的长期有效性和安全性。
纳入2010年3月至2015年8月期间接受经阴道网片手术的患者，并进行5年随访。由于我国没有网片套件，我们在手术中使用了自裁剪聚丙烯网片（日式经阴道网片）。在门诊检查期间评估客观的解剖复位情况和并发症。
本研究共纳入711例患者。在5年多的时间里，手术部位2期或更高程度脱垂的复发率为8.6%（61例），而其他部位的复发率为12.8%（91例）。两个部位的复发频率在术后3个月时最高，随后逐年下降。在随访期间，28例患者（手术部位3例，其他部位25例）因复发需要再次手术。总体而言，有13例网片外露（1.8%），包括膀胱2例（0.28%）、阴道10例（1.4%）和直肠1例（0.14%）。随访期间有69例患者（9.7%）接受了尿失禁手术。
需要再次手术的复发频率和与网片相关的并发症发生率较低，且阴道网片外露大多无症状。因此，日式经阴道网片是安全有效的。
