Short-Term Complications Following Transvaginal Sacrospinous Ligament Rectopexy: A Retrospective Cohort Study.

IF 1.8 3区 医学 Q3 OBSTETRICS & GYNECOLOGY
Alireza Hadizadeh, Henry H Chill, Angela Leffelman, Claudia Paya-Ten, Cecilia Chang, Jungeun Lee, Roger P Goldberg, Steven D Abramowitch, Ghazaleh Rostaminia
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引用次数: 0

Abstract

Introduction and hypothesis: Obstructed defecation syndrome (ODS) affects over 12% of middle-aged women, characterized by excessive straining, incomplete evacuation, and splinting. Current surgical options such as ventral mesh rectopexy, though effective, involve risks associated with mesh use and abdominal entry. This study evaluates the short-term complications of transvaginal sacrospinous ligament rectopexy.

Methods: This retrospective cohort study was conducted at a tertiary medical center, including patients over 21 years who underwent transvaginal sacrospinous ligament suture rectopexy for ODS from January 2018 to May 2024. Demographic, intraoperative, and 30-day postoperative complication data were collected.

Results: A total of 190 patients with a mean age of 62.3 years underwent transvaginal sacrospinous ligament suture rectopexy. Intraoperative complications were rare, with four rectal injuries: two occurred during posterior dissection, one due to aggressive posterior repair, and another was discovered during exploration for postoperative pain. All rectal injuries were managed successfully. One patient experienced significant intraoperative bleeding, resulting in a hematoma that required evacuation 5 days later. Postoperative urinary retention was the most common complication, affecting 29.8% of patients. This was associated with concurrent procedures, such as mid-urethral sling placement and anterior colporrhaphy. Reoperation within 30 days was necessary for six patients (3.7%): two for urinary retention due to sling-related issues, two for sacrospinous pain necessitating suture removal, and two for vaginal bleeding related to hematoma formation. No cases of surgical site infection, sepsis, or mortality were observed.

Conclusions: Transvaginal sacrospinous ligament suture rectopexy appears to be a safe alternative for ODS treatment, with low short-term complication rates.

经阴道骶棘韧带直肠固定术的短期并发症:回顾性队列研究。
介绍和假设:排便障碍综合征(ODS)影响超过12%的中年妇女,其特征是过度紧张,排便不完全和夹板。目前的手术选择,如腹侧补片直肠固定术,虽然有效,但涉及与补片使用和腹部进入相关的风险。本研究评估经阴道骶棘韧带直肠固定术的短期并发症。方法:本回顾性队列研究在某三级医疗中心进行,纳入2018年1月至2024年5月接受经阴道骶棘韧带缝合直肠固定术治疗ODS的21岁以上患者。收集人口统计学、术中及术后30天并发症数据。结果:共190例患者行经阴道骶棘韧带缝合直肠固定术,平均年龄62.3岁。术中并发症罕见,直肠损伤4例,其中2例发生于后路剥离,1例因后路积极修复,1例为术后疼痛探查时发现。所有直肠损伤均处理成功。1例患者术中出现明显出血,导致血肿,5天后需要撤离。术后尿潴留是最常见的并发症,发生率为29.8%。这与并发手术有关,如尿道中吊带放置和前阴道破裂。6例(3.7%)患者需要在30天内再次手术:2例因吊带相关问题导致尿潴留,2例因骶棘疼痛需要拆线,2例因血肿相关阴道出血。未观察到手术部位感染、败血症或死亡病例。结论:经阴道骶棘韧带缝合直肠固定术似乎是一种安全的替代ODS治疗,短期并发症发生率低。
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来源期刊
CiteScore
3.80
自引率
22.20%
发文量
406
审稿时长
3-6 weeks
期刊介绍: The International Urogynecology Journal is the official journal of the International Urogynecological Association (IUGA).The International Urogynecology Journal has evolved in response to a perceived need amongst the clinicians, scientists, and researchers active in the field of urogynecology and pelvic floor disorders. Gynecologists, urologists, physiotherapists, nurses and basic scientists require regular means of communication within this field of pelvic floor dysfunction to express new ideas and research, and to review clinical practice in the diagnosis and treatment of women with disorders of the pelvic floor. This Journal has adopted the peer review process for all original contributions and will maintain high standards with regard to the research published therein. The clinical approach to urogynecology and pelvic floor disorders will be emphasized with each issue containing clinically relevant material that will be immediately applicable for clinical medicine. This publication covers all aspects of the field in an interdisciplinary fashion
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