Long-term anatomical and functional assessment of trans-vaginal cystocele repair using a tension-free polypropylene mesh
Long-term anatomical and functional assessment of trans-vaginal cystocele repair using a tension-free polypropylene mesh
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DOI：
10.1007/s00192-005-0046-x
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发表时间：
2006-10-01
影响因子：
1.8
通讯作者：
Fernandez, Herve
中科院分区：
文献类型：
--
作者：
de Tayrac, Renaud;Deffieux, Xavier;Fernandez, Herve
我们报告了一个病例系列的63名妇女膀胱膨出谁经历了相同的经阴道手术在1999年10月至2002年10月。聚丙烯补片（GyneMesh，Gynecare，Ethicon，France）以无张力方式从耻骨后间隙放置到膀胱下部。患者随访24 ~ 60个月，平均随访37个月。55例患者返回接受随访（87.3%）。随访时，49名女性解剖学治愈（89.1%），5名女性2期阴道前壁脱垂（9.1%），1名复发3期（1.8%）。还调查了功能结果和性功能。53名妇女的生活质量有显着改善（96.4%）。共有3例补片收缩周围局部疼痛（5.5%）和5例补片阴道糜烂（9.1%）。24例患者中有4例发生性交困难（16.7%）。总之，用聚丙烯补片加固阴道前壁脱垂的阴道修补术在2 - 5年随访时有效。然而，我们使用的第一代聚丙烯补片导致局部并发症和性交困难的发生率较高。因此，必须改进聚丙烯补片（减轻重量），并且必须通过随机对照试验记录该技术，然后我们才能推荐其在临床实践中使用。
We report a case series of 63 women with cystocele who underwent the same trans-vaginal procedure between October 1999 and October 2002. The polypropylene mesh (GyneMesh, Gynecare, Ethicon, France) was placed from the retropubic space to the inferior part of the bladder in a tension-free fashion. Patients were followed up for 24 to 60 months, with a mean follow-up of 37 months. Fifty-five patients returned for follow-up (87.3%). At follow-up, 49 women were anatomically cured (89.1%), five women had stage 2 anterior vaginal wall prolapse (9.1%), and one had a recurrent stage 3 (1.8%). Functional results and sexual function were also investigated. Fifty-three women had significant improvement in their quality of life (96.4%). There were a total of three cases of local pain around a mesh shrinkage (5.5%) and five vaginal erosions of the mesh (9.1%). Four out of 24 patients had dyspareunia (16.7%). In conclusion, the vaginal repair of anterior vaginal wall prolapse reinforced with a polypropylene mesh was efficient at 2 to 5 years follow-up. However, the first generation of polypropylene mesh we used was responsible for high rates of local complications and dyspareunia. Therefore, the polypropylene mesh has to be improved (lower weight) and the technique has to be documented by a randomized controlled trial before we could recommend its use in clinical practice.