Hoffman M S, Harris M S, Bouis P J
Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, USA.
J Reprod Med. 1996 May;41(5):299-303.
To investigate the morbidity and results of vaginal hysterectomy with concomitant sacrospinous colpopexy for uterovaginal prolapse.
An observational study was carried out from June 17, 1986, to September 22, 1992. Patients were selected if it was thought that the cardinal-uterosacral ligaments could not be relied upon for vaginal vault support.
During the study period, 265 vaginal hysterectomies were performed. Forty-five (17%) were with concomitant sacrospinous colpopexy. The mean patient age was 54 years. There was one incidental cystotomy during hysterectomy, and two patients required transfusion. Postoperatively, eight patients were treated for soft tissue infection, one developed new-onset urinary incontinence, and no apparent nerve injuries were diagnosed. The mean day of discharge was 4.4. Six patients were lost to follow-up after the early postoperative period. The mean follow-up for the remaining patients was 29 months (12-66). One patient required subsequent vaginal repair for recurrent cystocele and enterocele. Four patients had persistent stress urinary incontinence.
Sacrospinous colpopexy at the time of vaginal hysterectomy is reasonably safe and effective for reestablishing upper vaginal support.
探讨阴道子宫切除术联合骶棘韧带固定术治疗子宫阴道脱垂的发病率及疗效。
1986年6月17日至1992年9月22日进行了一项观察性研究。如果认为主韧带和子宫骶骨韧带不可靠以支持阴道穹窿，则选择患者。
在研究期间，进行了265例阴道子宫切除术。45例（17%）联合骶棘韧带固定术。患者平均年龄为54岁。子宫切除术中发生1例意外膀胱切开术，2例患者需要输血。术后，8例患者接受软组织感染治疗，1例出现新发尿失禁，未诊断出明显神经损伤。平均出院日为4.4天。术后早期有6例患者失访。其余患者的平均随访时间为29个月（12 - 66个月）。1例患者因复发性膀胱膨出和肠膨出需要后续阴道修复。4例患者存在持续性压力性尿失禁。
阴道子宫切除术时行骶棘韧带固定术对重建阴道上段支持是相当安全有效的。
