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前阴道壁修补术和阴道旁修补术治疗前阴道壁膨出:综述。

Anterior Colporrhaphy and Paravaginal Repair for Anterior Compartment Prolapse: A Review.

机构信息

Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan.

Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan.

出版信息

Medicina (Kaunas). 2024 Nov 14;60(11):1865. doi: 10.3390/medicina60111865.

Abstract

Pelvic organ prolapse, particularly in the anterior compartment, is a prevalent condition that significantly impacts women's quality of life. Two common surgical approaches for managing anterior vaginal wall prolapse are anterior colporrhaphy and paravaginal repair. Anterior colporrhaphy, a traditional technique, involves the plication of weakened fascial tissues to restore support to the bladder and anterior vaginal wall. Paravaginal repair addresses lateral detachment of the anterior vaginal wall by reattaching it to its supportive structures. This review aimed to compare the indications, techniques, and outcomes between these surgical methods, discussing their efficacy, recurrence rates, and complications. Although anterior colporrhaphy is widely used, paravaginal repair may offer superior results in specific cases, particularly those involving lateral defects. The review also explored the evolution of these techniques, the role of grafts and mesh, and the potential benefits of minimally invasive approaches such as laparoscopy and robotic surgery. The goal is to provide clinicians with comprehensive insights into choosing the appropriate surgical option based on individual patient anatomy and clinical presentation, thus optimizing outcomes and minimizing recurrence.

摘要

盆腔器官脱垂,特别是前盆腔器官脱垂,是一种常见疾病,严重影响女性的生活质量。治疗阴道前壁脱垂的两种常见手术方法是阴道前壁修补术和阴道旁修补术。阴道前壁修补术是一种传统技术,涉及对薄弱的筋膜组织进行折叠,以恢复对膀胱和阴道前壁的支撑。阴道旁修补术通过将阴道前壁重新附着到其支持结构上来解决阴道前壁的侧方分离。本综述旨在比较这些手术方法的适应证、技术和结果,讨论它们的疗效、复发率和并发症。尽管阴道前壁修补术应用广泛,但在特定情况下,阴道旁修补术可能会提供更好的结果,特别是涉及侧方缺陷的情况。本综述还探讨了这些技术的演变、移植物和网片的作用,以及腹腔镜和机器人手术等微创方法的潜在益处。目的是为临床医生提供全面的见解,根据患者的个体解剖结构和临床表现选择合适的手术方案,从而优化结果并降低复发率。

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