Wang Yuquan, Guo Xuewang, Yang Weina, Liu Dong, Wang Meng, Xu Yanying
Department of Gynecology, The Second Hospital of Tianjin Medical University, No. 23 Pingjiang Road, Hexi District, Tianjin, China.
Sci Rep. 2025 Jul 1;15(1):21153. doi: 10.1038/s41598-025-07878-7.
The aim of this retrospective study was to analyze the efficacy and safety of lateral abdominal wall suspension during surgery compared with traditional procedures in patients with pelvic organ prolapse without uterine preservation. Collect the data of patients with uterine and vaginal wall prolapse who underwent surgery from January 2022 to December 2023. All patients were divided into three groups according to different surgical procedures: Study Group (laparoscopic total hysterectomy + bilateral salpingectomy/oophorectomy + lateral abdominal wall suspension + posterior colporrhaphy), Control Group 1 (laparoscopic-assisted vaginal total hysterectomy + bilateral salpingectomy/bilateral oophorectomy + anterior and posterior colporrhaphy), and Control Group 2 (vaginal total hysterectomy + anterior and posterior colporrhaphy).Statistically analyze the clinical indicators and recurrence situations in different Groups. Patients in Study group exhibited significantly higher preoperative POP-Q staging for pelvic organ prolapse severity(P < 0.01), longer operative times(P = 0.01, P < 0.01), but significantly reduced intraoperative blood loss(P = 0.01, P < 0.01)and shorter postoperative urinary catheterization duration(P = 0.01, P < 0.01) compared to the other two groups. No differences were detected in postoperative infection, vaginal bleeding or duration of hospitalization(P > 0.05). However, stress incontinence in 1-year after operation has no difference between study group and control groups. Recurrence rates in Control Group 1 is higher than Study Group (P = 0.02), While, it has no difference between Study Group and Control Group 2. Lateral abdominal wall suspension, despite a longer operative duration, surpasses traditional surgeries in minimizing intraoperative blood loss, cutting down the time of postoperative urinary catheter retention, and lowering the postoperative recurrence rate. To firmly establish the long-term curative effects and safety of lateral abdominal wall suspension, future research with larger sample sizes and longer follow-up periods is essential.
本回顾性研究的目的是分析在不保留子宫的盆腔器官脱垂患者中，与传统手术相比，术中腹壁悬吊术的疗效和安全性。收集2022年1月至2023年12月接受手术的子宫和阴道壁脱垂患者的数据。所有患者根据不同手术方式分为三组：研究组（腹腔镜全子宫切除术+双侧输卵管切除术/卵巢切除术+腹壁悬吊术+阴道后壁修补术）、对照组1（腹腔镜辅助阴道全子宫切除术+双侧输卵管切除术/双侧卵巢切除术+阴道前后壁修补术）和对照组2（阴道全子宫切除术+阴道前后壁修补术）。对不同组别的临床指标和复发情况进行统计学分析。研究组患者术前盆腔器官脱垂严重程度的POP-Q分期显著更高（P<0.01），手术时间更长（P=0.01，P<0.01），但与其他两组相比，术中出血量显著减少（P=0.01，P<0.01），术后导尿时间更短（P=0.01，P<0.01）。术后感染、阴道出血或住院时间方面未发现差异（P>0.05）。然而，术后1年压力性尿失禁在研究组和对照组之间没有差异。对照组1的复发率高于研究组（P=0.02），而研究组和对照组2之间没有差异。腹壁悬吊术尽管手术时间较长，但在减少术中出血量、缩短术后导尿时间和降低术后复发率方面优于传统手术。为了牢固确立腹壁悬吊术的长期疗效和安全性，未来需要进行更大样本量和更长随访期的研究。
