网片改良式吊带阴道后路悬吊术治疗子宫脱垂的临床应用

Application of Posterior Intravaginal Slingplasty for the Treatment of Uterine Prolapse

目的:探讨网片改良式吊带阴道后路悬吊术保留子宫的可行性。方法:9例子宫脱垂及3例残留宫颈脱垂患者,将聚丙烯网片剪成各式类似吊带,用特制的器械穿刺做阴道后路悬吊术及各类修补术。因其它疾病先予宫颈锥切术4例,之后12例均行阴道后路悬吊术;阴道前壁膨出行经闭孔悬吊12例,压力性尿失禁经闭孔悬吊术4例,12例均行后壁桥式缝合及会阴体修补术。结果:手术时间平均为100 ml,术中出血量平均为110 min,住院时间平均为10.6 d;无严重并发症,近期随访无复发。结论:阴道后路悬吊术是治疗子宫脱垂的最佳方案之一,网片改良式吊带效果明显,经济实用、易推广。

Objective： To explore the feasibility of posterior intravaginal slingplasty（P-IVS） treatment for uterine prolapse.Methods： Nine patients with uterine prolapse and three patients with remain cervical prolapse post-operation underwent P-IVS,polypropylene meshes were cut into several types of homeo-slings and a tailor-made perforator was adopted for punctuation.Four patients underwent cervical cone excision before P-IVS,all 12 patients underwent anterior vaginal wall prolapse colporrhaphy as well,four patients underwent stress urinary incontinerce（SUI） slingplasty,and all 12 patients underwent perineal body neoplasty.Results： The average operation time was 100 minutes and average blood loss was 110 ml.No recurrence was found in short-term follow-up.Conclusion： P-IVS is one of the best methods in treating uterine prolapse,the improvement type slingplasty is more acceptable,and economic for patients with uterine prolapse,and simple in surgical technique.