Combined anterior trans-obturator mesh (Surelift-A) and sacrospinous ligament fixation for advanced urogenital prolapse: Surgical and functional outcomes at 1 year

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology Pub Date : 2025-03-01 DOI:10.1016/j.tjog.2024.10.016

Tsia-Shu Lo , Aisha Alzabedi , Eyal Rom , Lan-Sin Jhang , Wu-Chiao Hsieh , Fazlin Harun

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引用次数: 0

Abstract

Objective

To determine the objective and subjective outcomes of a Combined anterior trans-obturator mesh (Surelift-A) and sacrospinous ligament fixation (SSF) for advanced pelvic organ prolapse (POP), along with the evaluation of surgical complications, postoperative impact on quality of life (QoL), and lower urinary tract symptoms.

Methods

Retrospective cohort study in a tertiary center from May 2021–December 2022 included 150 patients with symptomatic anterior or apical POP stage III and IV, who underwent pelvic reconstructive surgery with Surelift-A mesh combined with SSF. All completed a 72-h voiding diary, urodynamic study (UDS), and multiple validated QoL questionnaires at baseline, 6 and 12 months postoperatively. Primary outcomes were the development of post operative de novo stress urinary incontinence (SUI), objectively via cough stress test and UDS, and subjectively by evaluation of UDI-6, question 3 score >1 and IIQ-7, QoL and surgical complications. Secondary outcomes were the objective cure of POP, defined as anterior and apical prolapse Pelvic Organ Prolapse Quantification System ≤ stage I, and subjective cure based on negative answers to Pelvic Organ Prolapse Distress Inventory 6, quality of life, sexual function, major and minor complications.

Result

At one-year follow-up, the objective cure rate was 96.7 %, whereas the subjective cure rate was 93.3 %, with favorable anatomical outcomes. Significant QoL improvements were observed. Among those without mid-urethral sling (MUS), a (60.0 %) improvement in SUI occurred. De novo SUI emerged in 10.5 % objectively and 12 % subjectively. Mesh exposure rate was 1.3 %.

Conclusion

The Combined Surelift-A and SSF approach shows effective cure rates with minimal complications, and a slight risk of de novo SUI.

查看原文本刊更多论文

联合前路经闭孔补片（Surelift-A）和骶棘韧带固定治疗晚期泌尿生殖脱垂：1年的手术和功能结果

目的探讨前路经闭孔补片（Surelift-A）联合骶棘韧带固定（SSF）治疗晚期盆腔器官脱垂（POP）的客观和主观效果，并评估手术并发症、术后对生活质量（QoL）的影响和下尿路症状。方法回顾性队列研究于2021年5月至2022年12月在某三级中心进行，纳入150例有症状的前或根尖POP III期和IV期患者，这些患者采用Surelift-A补片联合SSF进行盆腔重建手术。所有患者在基线、术后6个月和12个月完成了72小时排尿日记、尿动力学研究（UDS）和多项有效的生活质量问卷调查。主要观察指标为术后新生压力性尿失禁（SUI）的发生情况，客观上通过咳嗽压力测试和UDS，主观上通过UDI-6、问题3评分和IIQ-7、生活质量和手术并发症的评价。次要结果为POP的客观治愈，定义为盆腔器官脱垂量化系统≤I期；主观治愈基于盆腔器官脱垂困扰问卷6、生活质量、性功能、主要和次要并发症的负面回答。结果随访1年，客观治愈率为96.7%，主观治愈率为93.3%，解剖效果良好。观察到显著的生活质量改善。在未使用中尿道吊带（MUS）的患者中，SUI的改善率为60.0%。新发SUI在客观上占10.5%，主观上占12%。网片曝光率为1.3%。结论Surelift-A联合SSF入路治愈率高，并发症少，新发SUI风险小。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Taiwanese Journal of Obstetrics & Gynecology OBSTETRICS & GYNECOLOGY-

CiteScore

3.60

自引率

23.80%

发文量

207

审稿时长

4-8 weeks

期刊介绍： Taiwanese Journal of Obstetrics and Gynecology is a peer-reviewed journal and open access publishing editorials, reviews, original articles, short communications, case reports, research letters, correspondence and letters to the editor in the field of obstetrics and gynecology. The aims of the journal are to: 1.Publish cutting-edge, innovative and topical research that addresses screening, diagnosis, management and care in women''s health 2.Deliver evidence-based information 3.Promote the sharing of clinical experience 4.Address women-related health promotion The journal provides comprehensive coverage of topics in obstetrics & gynecology and women''s health including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. Taiwan Association of Obstetrics and Gynecology.