补片在盆腔脏器脱垂修复手术中的作用

The Current Status of Mesh in the Surgical Repair of Pelvic Organ Prolapse

盆腔器官脱垂(POP)手术治疗在过去的几十年里经历了很大的发展,创新的手术器械产品不断应用到治疗中。各种补片/吊带的出现以及便捷的经阴道手术方式,使得用以治疗尿失禁(UI)和脱垂的补片/吊带在短时间内大量使用。治疗的理想目标是手术效果提高,同时保障患者的安全。但由于补片出现侵蚀、感染、患者盆底疼痛、性交困难等不良反应,使得目前补片在POP手术治疗中遭受争议。尤其是近几年美国食品药物监督管理局(FDA)连续发布了经阴道放置补片修补盆腔器官脱垂相关并发症的警告。本文回顾了相关文献,总结补片应用的相关临床结局和并发症,审视补片用于盆腔器官脱垂修复手术的现状和发展趋势。

The techniques of pelvic organ prolapse （POP） surgery have undergone substantial development in the past few decades. Innovative products of surgical devices have been incorporated into the treatment. The emergence of various me- shes/slings and the convenient approach of transvaginal surgeries lead to large-- scale uses of the meshes/slings for the treatment of urinary incontinence（UI） and POP in a short time. Although the ideal goal of treatment should be the im- provement of surgery effect and guaranteed safety of patients. Unfortunately, the mesh erosion, infection, pelvic pain in patients, dyspareunia, and other complications make today mesh surgery in POP treatment controversial. In recent years, the Food and Drug Administration （FDA） issue several warnings of transvaginal mesh--related complications of POP re- pair. In this article, we review the literature, sum up the ideal synthesis and biological characteristics and the in vivo be- havior of the meshes, analyze the related clinical outcomes and complications in the application of the meshes, and investi- gate the status and trend of POP repair surgery.