目的本研究旨在系统评价网片(Mesh)治疗盆腔脏器脱垂与传统阴道修补术的有效性和安全性。方法计算机检索Cochrane Library、PubMed、EMBASE、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库,检索时间截至2011年1...目的本研究旨在系统评价网片(Mesh)治疗盆腔脏器脱垂与传统阴道修补术的有效性和安全性。方法计算机检索Cochrane Library、PubMed、EMBASE、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库,检索时间截至2011年10月。检索词为pelvic organ prolapsed、POP、Mesh、盆腔脏器脱垂、网片等。纳入传统手术和网片对比治疗盆腔脏器脱垂的随机对照试验,由两名研究员分别独立提取数据和进行文献质量评价,并进行meta分析。结果共纳入5篇RCTs,meta分析结果显示:网片治疗妇女盆腔脏器脱垂并未增加手术成功率[RR=1.09,95%CI(0.58,2.02),P=0.79]、降低术后POP-Q分度[MD=0.11,95%CI(-0.15,0.36),P=0.41],同时术后性交困难[OR=1.25,95%CI(0.54,2.87),P=0.60]和复发率[RR=0.76,95%CI(0.10,5.28),P=0.78]等并未降低。结论当前证据表明:与传统手术相比,网片并不能增加手术的客观成功率,亦不能降低术后POP-Q分度以及术后感染等,尚需经济学评价及适用性研究以指导临床实践。展开更多
The purpose of this study was to determine factors that are associated with recurrent prolapse. Of 389 women who underwent vaginal prolapse and incontinence between June 1996 and May 1999, 176 women had 1-year follow...The purpose of this study was to determine factors that are associated with recurrent prolapse. Of 389 women who underwent vaginal prolapse and incontinence between June 1996 and May 1999, 176 women had 1-year followup evaluations. Recurrent prolapse was analyzed by both pelvic organ prolapse quantification stage and centimeter measurements that were relative to the hymen. Logistic regression was used to determine odds ratios and 95%CI for factors that were associated with recurrent prolapse. One year after surgery, 102 women (58%) had recurrent prolapse (≥stage II). Seventeen women (10%) had prolapse ≥1 cm beyond the hymen. Age <60 years (odds ratio, 3.2; 95%CI, 1.6-6.4; P =. 001) and preoperative pelvic organ prolapse quantification stage III or IV (odds ratio, 2.7; 95%CI, 1.3-5.3; P =. 005) were associated with a greater likelihood of recurrent prolapse (≥stage II) at 1 year. Younger women and women with more advanced prolapse are more likely to experience recurrent prolapse after vaginal repair.展开更多
This study was undertaken to evaluate the outcomes of vaginal surgery for pelvic organ prolapse, comparing cases implementing graft augmentation to those without graft augmentation. Study design: This was a retrospect...This study was undertaken to evaluate the outcomes of vaginal surgery for pelvic organ prolapse, comparing cases implementing graft augmentation to those without graft augmentation. Study design: This was a retrospective cohort study of 312 patients who underwent vaginal surgery for prolapse from February 1998 to January 2004. Results: Of the 312 patients, 98 (31.4% ) had graft augmentation. The median follow up was 9 months (3- 67 months). Graft use was not associated with reduction in recurrent prolapse, recurrent stage 3 prolapse, recurrent incontinence, or additional surgery for prolapse. After controlling for confounders, there was still no diffe rence in surgical outcomes. Complications such as vaginal/graft infection (18.4% vs 4.7% ; P < .001) and granulation tissue (38.8% vs 17.3% ; P < .001) were more common after cases in which graft was used. Conclusion: In the early postoperative period, there was no benefit in using graft for prolapse repair. Graft use leads to a higher rate of postoperative complications.展开更多
文摘目的本研究旨在系统评价网片(Mesh)治疗盆腔脏器脱垂与传统阴道修补术的有效性和安全性。方法计算机检索Cochrane Library、PubMed、EMBASE、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库,检索时间截至2011年10月。检索词为pelvic organ prolapsed、POP、Mesh、盆腔脏器脱垂、网片等。纳入传统手术和网片对比治疗盆腔脏器脱垂的随机对照试验,由两名研究员分别独立提取数据和进行文献质量评价,并进行meta分析。结果共纳入5篇RCTs,meta分析结果显示:网片治疗妇女盆腔脏器脱垂并未增加手术成功率[RR=1.09,95%CI(0.58,2.02),P=0.79]、降低术后POP-Q分度[MD=0.11,95%CI(-0.15,0.36),P=0.41],同时术后性交困难[OR=1.25,95%CI(0.54,2.87),P=0.60]和复发率[RR=0.76,95%CI(0.10,5.28),P=0.78]等并未降低。结论当前证据表明:与传统手术相比,网片并不能增加手术的客观成功率,亦不能降低术后POP-Q分度以及术后感染等,尚需经济学评价及适用性研究以指导临床实践。
文摘The purpose of this study was to determine factors that are associated with recurrent prolapse. Of 389 women who underwent vaginal prolapse and incontinence between June 1996 and May 1999, 176 women had 1-year followup evaluations. Recurrent prolapse was analyzed by both pelvic organ prolapse quantification stage and centimeter measurements that were relative to the hymen. Logistic regression was used to determine odds ratios and 95%CI for factors that were associated with recurrent prolapse. One year after surgery, 102 women (58%) had recurrent prolapse (≥stage II). Seventeen women (10%) had prolapse ≥1 cm beyond the hymen. Age <60 years (odds ratio, 3.2; 95%CI, 1.6-6.4; P =. 001) and preoperative pelvic organ prolapse quantification stage III or IV (odds ratio, 2.7; 95%CI, 1.3-5.3; P =. 005) were associated with a greater likelihood of recurrent prolapse (≥stage II) at 1 year. Younger women and women with more advanced prolapse are more likely to experience recurrent prolapse after vaginal repair.
文摘This study was undertaken to evaluate the outcomes of vaginal surgery for pelvic organ prolapse, comparing cases implementing graft augmentation to those without graft augmentation. Study design: This was a retrospective cohort study of 312 patients who underwent vaginal surgery for prolapse from February 1998 to January 2004. Results: Of the 312 patients, 98 (31.4% ) had graft augmentation. The median follow up was 9 months (3- 67 months). Graft use was not associated with reduction in recurrent prolapse, recurrent stage 3 prolapse, recurrent incontinence, or additional surgery for prolapse. After controlling for confounders, there was still no diffe rence in surgical outcomes. Complications such as vaginal/graft infection (18.4% vs 4.7% ; P < .001) and granulation tissue (38.8% vs 17.3% ; P < .001) were more common after cases in which graft was used. Conclusion: In the early postoperative period, there was no benefit in using graft for prolapse repair. Graft use leads to a higher rate of postoperative complications.
