经阴道子宫骶骨韧带高位悬吊术联合网片修复术治疗重度阴道前后壁膨出

Transvaginal suspension of uterosacral ligament combined with mesh repair in the treatment of severe vaginal prolapse

目的 总结经阴道子宫骶骨韧带高位悬吊术联合网片修复术治疗重度阴道前后壁膨出的临床经验。方法 回顾性分析我院2015年1月~2018年1月我院收治的95例重度阴道前后壁膨出患者的临床资料,所有患者均接受经阴道子宫骶骨韧带高位悬吊术联合网片修复术。结果 本组95例患者均顺利完成手术,手术时间(187.5±62.1)min,术中出血量(167.2±74.6),尿管留置时间(3.4±1.1)d,住院时间(6.5±3.1)。术后均达到POP-QⅡ度及以下,达到预期效果。术后1年复发率为4%(4/95)。术后1年盆底肌肌电(10.2±1.2)μV,低于术前(11.0±1.5)μV;PFDI-20(11.3±5.3)分,低于术前(72.1±16.2)分;PFIQ-7(9.7±4.2)分,低于术前(70.4±13.2)分,差异均有统计学意义(P <0.05)。结论 经阴道子宫骶骨韧带高位悬吊术联合网片修复术治疗重度阴道前后壁膨出的手术效果可维持较长时间,进一步降低术后复发。

Objective To summarize the treatment of severe vaginal prolapse by transvaginal uterosacral ligament suspension combined with mesh repair Clinical experience.Methods the clinical data of 95 patients with severe vaginal prolapse from January 2015 to January 2018 were analyzed retrospectively.All patients received transvaginal uterosacral ligament suspension combined with mesh repair.Results 95 patients in this group successfully completed the operation,the operation time was(187.5±62.1)min,the intraoperative blood loss was(167.2±74.6),the catheter retention time was(3.4±1.1)d,and the hospitalization time was(6.5±3.1).After the operation,all patients achieved the degree of POP-QⅡand below,and achieved the expected effect.The 1-year recurrence rate was 4%(4/95).One year after operation,the EMG of pelvic floor was(10.2±1.2)μV,lower than that before operation(11.0±1.5)μV;pfdi-20 was(11.3±5.3),lower than that before operation(72.1±16.2);pfiq-7 was(9.7±4.2),lower than that before operation(70.4±13.2),the difference was statistically significant(P<0.05).Conclusion The results of transvaginal uterosacral ligament suspension combined with mesh repair for severe vaginal prolapse can be maintained for a long time,and further reduce the recurrence.