Misawa Akihiko, Kimura Eizo, Inoue Miho, Mitsuya Shion, Osaka Makoto, Sato Yasunori, Osanai Kiyono, Suzuki Atsushi
Department of Gynecology, Asoka Hospital, 1-18-1 sumiyoshi, Koyo-ku, Tokyo 135-0002, Japan.
Department of Obstetrics and Gynecology, Kyorin Suginami Hospital, 2-25-1 wada, Suginami-ku, Tokyo 166-0012, Japan.
J Surg Case Rep. 2025 Jul 14;2025(7):rjaf537. doi: 10.1093/jscr/rjaf537. eCollection 2025 Jul.
Tension-free vaginal mesh repair surgery (TVM) has decreased due to complications related to mesh use and the lack of superiority compared to native tissue repair (NTR). In japan it is still performed as a treatment for pelvic organ prolapse (POP). However, recurrent prolapse after TVM does occur, necessitating appropriate management. The patient was underwent TVM-A surgery at another hospital 12 years ago for cystocele. POP-Q stage II rectocele was observed, and the LeFort colpocleisis was performed. Although TVM surgery is effective via the vaginal approach, recurrent posterior vaginal wall prolapse may occur over time, as seen in this case, even in patients who had single-mesh procedures for anterior vaginal wall repair. When conservative treatment is difficult, vaginal closure surgery, a traditional approach, can be safely performed.
由于与网片使用相关的并发症以及与自体组织修复(NTR)相比缺乏优势,无张力阴道网片修复手术(TVM)的实施有所减少。在日本,它仍作为盆腔器官脱垂(POP)的一种治疗方法进行。然而,TVM术后确实会出现复发性脱垂,需要进行适当的处理。该患者12年前在另一家医院接受了TVM - A手术治疗膀胱膨出。观察到POP - Q分期为II度的直肠膨出,并进行了LeFort阴道闭合术。尽管TVM手术通过阴道途径是有效的,但随着时间的推移,后阴道壁可能会出现复发性脱垂,如此病例所示,即使是接受过前阴道壁单网片修复手术的患者也是如此。当保守治疗困难时,可以安全地实施传统的阴道闭合手术。