Yu Bo, Yang Junfang, Nie Qingyang, Zhang Kun, Han Jinsong, Wang Yiting
Department of Obstetrics & Gynecology, Peking University Third Hospital, No. 49 Huayuan North Road, Haidian District, Beijing, 100191, China.
Peking University Health Science Center, Beijing, China.
BMC Surg. 2024 Dec 31;24(1):427. doi: 10.1186/s12893-024-02742-3.
To investigate the mid-term outcomes of transvaginal repair for moderate-severe cystocele using autologous fascia lata harvested through a single small incision.
Between February and October 2022, 35 patients with moderate to severe cystocele undergoing transvaginal repair with autologous fascia lata were included. Patient demographics and perioperative data were collected, with follow-ups through outpatient visits or phone calls. Patients were evaluated by subjective perception of vaginal bulging, physical examination, Pelvic Floor Distress Inventory (PFDI-20) Questionnaire, patient satisfaction, Patient Global Impression of Improvement (PGI-I) scores, regret rate, willingness to recommend, complications, and harvesting site issue.
The patient's mean age was 60.44 ± 6.01 years. Fascia lata harvesting took 32.92 ± 19.72 min, reconstruction surgery lasted 141.21 ± 37.89 min. Follow-up duration was 15.94 ± 2.46 months. 5.7% (2/35) of the patients reported a non-interfering vaginal bulge not requiring treatment. Objective recurrence rate was 4.26% (1/24, Aa or Ba>0) PFDI-20 was significantly improved (P < 0.0001). All 35 patients (100%) were highly satisfied, with PGI-I score very much improved or improved. No patient regretted. 97.14% (34/35) would recommend the procedure. One patient developed poor wound healing at the vaginal apex. One patient developed thromboembolic event. Harvest site: 2.86% (1/35) developed a non-bothersome thigh bulge, 17.14% (6/35) noted an impact on wound appearance, and 8.57% (3/35) reported mild paresthesia.
Autologous fascia lata for cystocele treatment shows promising mid-term outcomes, safely and effectively enhancing QoL with high satisfaction. Despite concerns about leg scarring, no patient regretted and would recommend the procedure. Long-term outcomes require larger follow-up studies.
探讨经单一小切口获取自体阔筋膜进行经阴道修复中重度膀胱膨出的中期疗效。
2022年2月至10月，纳入35例行自体阔筋膜经阴道修复中重度膀胱膨出的患者。收集患者人口统计学和围手术期数据，通过门诊随访或电话进行随访。通过阴道膨出主观感受、体格检查、盆底功能障碍量表（PFDI-20）问卷、患者满意度、患者整体改善印象（PGI-I）评分、后悔率、推荐意愿、并发症及取材部位问题对患者进行评估。
患者平均年龄为60.44±6.01岁。获取阔筋膜用时32.92±19.72分钟，重建手术持续141.21±37.89分钟。随访时间为15.94±2.46个月。5.7%（2/35）的患者报告有不影响生活无需治疗的阴道膨出。客观复发率为4.26%（1/24，Aa或Ba>0），PFDI-20显著改善（P<0.0001）。35例患者（100%）均高度满意，PGI-I评分非常改善或改善。无患者后悔。97.14%（34/35）会推荐该手术。1例患者阴道顶端伤口愈合不良。1例患者发生血栓栓塞事件。取材部位：2.86%（1/35）出现不影响生活的大腿膨出，17.14%（6/35）注意到对伤口外观有影响，8.57%（3/35）报告有轻度感觉异常。
自体阔筋膜治疗膀胱膨出显示出良好的中期疗效，安全有效地提高了生活质量，满意度高。尽管担心腿部留疤，但无患者后悔且会推荐该手术。长期疗效需要更大规模的随访研究。
