{"title":"骶前-子宫骶部子宫切除术-一种新的盆腔器官脱垂的天然组织修复方法。","authors":"Xiaojuan Wang, Jie Zhang, Keqin Hua, Yisong Chen","doi":"10.52054/FVVO.2025.75","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Uterine-preserving procedures for pelvic organ prolapse (POP) are favoured and are becoming increasingly popular. Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) presacral-uterosacral hysteropexy is a novel native tissue repair for POP.</p><p><strong>Objectives: </strong>This study aimed to evaluate the safety of this uterine-preserving procedure and its midterm efficacy in treating POP.</p><p><strong>Methods: </strong>Between December 2020 and December 2022, patients with symptomatic POP who underwent vNOTES presacral-uterosacral hysteropexy at a tertiary teaching hospital were retrospectively analysed. The patient characteristics, follow-up outcomes, and complications were recorded and analysed.</p><p><strong>Main outcomes measures: </strong>We investigated anatomical success, subjective improvement, perioperative parameters, and operative complications.</p><p><strong>Results: </strong>Fifty-eight patients (median age 41 years) completed a mean 24.4-month (± 6.8) follow-up. There were two women (3.4%) who experienced recurrence. There was a significant improvement in POP-Q scores in all compartments at the last follow-up compared to the baseline (<i>P</i><0.001). 94.8% of patients were satisfied with their operations. The urinary and prolapse symptoms improved significantly (<i>P</i><0.001), and sexual function was significantly improved (<i>P</i><0.001). There were no intraoperative complications, and one patient experienced fever and delayed haemorrhage after surgery.</p><p><strong>Conclusions: </strong>vNOTES presacral-uterosacral hysteropexy may be a safe and feasible technique for women with POP who desire to preserve their uterus. This procedure demonstrates promising medium-term anatomical and subjective outcomes in treating POP.</p><p><strong>What is new?: </strong>This is a new mesh-free surgical procedure that combines the benefits of laparoscopic sacrohysteropexy and vNOTES uterosacral ligament hysteropexy to treat women with POP who desire uterine preservation, aiming to gain long-term anatomical success and minor complications.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"17 2","pages":"130-137"},"PeriodicalIF":1.4000,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233107/pdf/","citationCount":"0","resultStr":"{\"title\":\"The presacral-uterosacral hysteropexy - a novel native tissue repair for pelvic organ prolapse.\",\"authors\":\"Xiaojuan Wang, Jie Zhang, Keqin Hua, Yisong Chen\",\"doi\":\"10.52054/FVVO.2025.75\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Uterine-preserving procedures for pelvic organ prolapse (POP) are favoured and are becoming increasingly popular. Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) presacral-uterosacral hysteropexy is a novel native tissue repair for POP.</p><p><strong>Objectives: </strong>This study aimed to evaluate the safety of this uterine-preserving procedure and its midterm efficacy in treating POP.</p><p><strong>Methods: </strong>Between December 2020 and December 2022, patients with symptomatic POP who underwent vNOTES presacral-uterosacral hysteropexy at a tertiary teaching hospital were retrospectively analysed. The patient characteristics, follow-up outcomes, and complications were recorded and analysed.</p><p><strong>Main outcomes measures: </strong>We investigated anatomical success, subjective improvement, perioperative parameters, and operative complications.</p><p><strong>Results: </strong>Fifty-eight patients (median age 41 years) completed a mean 24.4-month (± 6.8) follow-up. There were two women (3.4%) who experienced recurrence. There was a significant improvement in POP-Q scores in all compartments at the last follow-up compared to the baseline (<i>P</i><0.001). 94.8% of patients were satisfied with their operations. The urinary and prolapse symptoms improved significantly (<i>P</i><0.001), and sexual function was significantly improved (<i>P</i><0.001). There were no intraoperative complications, and one patient experienced fever and delayed haemorrhage after surgery.</p><p><strong>Conclusions: </strong>vNOTES presacral-uterosacral hysteropexy may be a safe and feasible technique for women with POP who desire to preserve their uterus. This procedure demonstrates promising medium-term anatomical and subjective outcomes in treating POP.</p><p><strong>What is new?: </strong>This is a new mesh-free surgical procedure that combines the benefits of laparoscopic sacrohysteropexy and vNOTES uterosacral ligament hysteropexy to treat women with POP who desire uterine preservation, aiming to gain long-term anatomical success and minor complications.</p>\",\"PeriodicalId\":46400,\"journal\":{\"name\":\"Facts Views and Vision in ObGyn\",\"volume\":\"17 2\",\"pages\":\"130-137\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-06-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233107/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Facts Views and Vision in ObGyn\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.52054/FVVO.2025.75\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Facts Views and Vision in ObGyn","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.52054/FVVO.2025.75","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
The presacral-uterosacral hysteropexy - a novel native tissue repair for pelvic organ prolapse.
Background: Uterine-preserving procedures for pelvic organ prolapse (POP) are favoured and are becoming increasingly popular. Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) presacral-uterosacral hysteropexy is a novel native tissue repair for POP.
Objectives: This study aimed to evaluate the safety of this uterine-preserving procedure and its midterm efficacy in treating POP.
Methods: Between December 2020 and December 2022, patients with symptomatic POP who underwent vNOTES presacral-uterosacral hysteropexy at a tertiary teaching hospital were retrospectively analysed. The patient characteristics, follow-up outcomes, and complications were recorded and analysed.
Main outcomes measures: We investigated anatomical success, subjective improvement, perioperative parameters, and operative complications.
Results: Fifty-eight patients (median age 41 years) completed a mean 24.4-month (± 6.8) follow-up. There were two women (3.4%) who experienced recurrence. There was a significant improvement in POP-Q scores in all compartments at the last follow-up compared to the baseline (P<0.001). 94.8% of patients were satisfied with their operations. The urinary and prolapse symptoms improved significantly (P<0.001), and sexual function was significantly improved (P<0.001). There were no intraoperative complications, and one patient experienced fever and delayed haemorrhage after surgery.
Conclusions: vNOTES presacral-uterosacral hysteropexy may be a safe and feasible technique for women with POP who desire to preserve their uterus. This procedure demonstrates promising medium-term anatomical and subjective outcomes in treating POP.
What is new?: This is a new mesh-free surgical procedure that combines the benefits of laparoscopic sacrohysteropexy and vNOTES uterosacral ligament hysteropexy to treat women with POP who desire uterine preservation, aiming to gain long-term anatomical success and minor complications.
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