经阴道网片治疗晚期尿道脱垂：回顾性手术、功能和声像图 3 年后的结果。

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2024-11-08 DOI:10.1016/j.ejogrb.2024.11.009

Tsia-Shu Lo , Fazlin Harun , Lan-Sin Jhang , Wu-Chiao Hsieh , Yiap Loong Tan , Aisha Alzabedi

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引用次数: 0

摘要

研究目的本研究对改良经阴道网片（TVM）Surelift治疗晚期盆腔器官脱垂（POP）3年随访期的结果进行评估，重点关注手术成功率、功能改善和声像图结果：方法：对 2018 年 7 月至 2020 年 1 月期间因晚期 POP III 期和 IV 期而接受 Surelift 系统手术的 99 名妇女进行回顾性审查。客观评估包括盆腔器官脱垂定量（POP-Q）、多通道尿动力学（UDS）和内侧二维超声测量。主观评估采用尿失禁影响问卷-7（IIQ-7）、泌尿生殖器压力量表-6（UDI-6）、盆腔器官脱垂压力量表-6（POPDI-6）、结肠直肠肛门压力量表-8（CRADI-8）和盆腔器官脱垂/尿失禁性问卷（PISQ-12）等有效问卷。结果在术后 3 个月、每年和 3 年进行检查。次要结果包括新发或持续性尿动力压力性尿失禁（USI）和手术并发症：结果：85 名妇女被纳入最终分析。术后 3 年的客观治愈率为 94.1%，主观治愈率为 91.8%。超声波检查显示，网片在术后第一年出现拉长和增厚，到第三年有所缓解，而膀胱颈与网片之间的距离保持稳定。POP-Q 成分（Aa、Ba、C、Ap、Bp 和 p 的 TVL）显著改善：Surelift 系统 TVM 在治疗晚期前-腹尖 POP 方面具有安全性和有效性，治愈率高，网片放置安全，术后 3 年并发症极少。

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Modified surelift anterior-apical transvaginal mesh for advanced urogenital prolapse: Retrospective surgical, functional and sonographic outcomes at 3 years

Objective

This study evaluates the outcomes of modified transvaginal mesh (TVM) Surelift in managing advanced pelvic organ prolapse (POP) over a 3-year follow-up period, focusing on surgical success, functional improvement, and sonographic findings.

Methods

A retrospective review was conducted on 99 women who underwent Surelift System surgery for advanced POP Stage III and IV between July 2018 to January 2020. Objective evaluation included Pelvic Organ Prolapse Quantification (POP-Q), multichannel urodynamic (UDS), and introital 2D ultrasonographic measurement. Subjective evaluation uses validated questionnaires of Incontinence Impact Questionnaire-7(IIQ-7), Urogenital Distress Inventory-6(UDI-6), Pelvic Organ Prolapse Distress Inventory 6(POPDI-6), Colorectal Anal Distress Inventory-8(CRADI-8) and Pelvic organ prolapse/ Urinary Incontinence Sexual Questionnaire (PISQ-12). Outcomes were examined at 3 months, yearly and at 3 years postoperative. Secondary outcome included de novo or persistent urodynamic stress incontinence (USI) and surgical complications.

Results

Eighty-five women were included in the final analysis. At 3 years postoperative, the objective cure rate was 94.1 % and subjective cure rate of 91.8 %. Ultrasonography revealed initial mesh elongation and thickening at first year, resolving by the third year, while the distance between the bladder neck and mesh remained stable. Significant improvement in POP-Q components (Aa,Ba,C,Ap,Bp and TVL of p < 0.001), UDS (p < 0.001) and all validated Quality of Life (QoL) questionnaires (p < 0.001) were seen. De Novo USI and persistent USI occurred in 31.5 %. Complications included vaginal mesh exposure requiring excision in 4.7 % of patients, and one intraoperative bladder injury corrected promptly.

Conclusion

The Surelift System TVM demonstrates safety and efficacy in treating advanced anterior-apical POP, achieving high cure rates, secured mesh placement, and minimal complications at 3 years post-operative.

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来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.