Long-Term Patient Satisfaction With Michigan Four-Wall Sacrospinous Ligament Suspension for Prolapse
Long-Term Patient Satisfaction With Michigan Four-Wall Sacrospinous Ligament Suspension for Prolapse
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DOI：
10.1097/aog.0b013e3182a7f0d5
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发表时间：
2013-11-01
影响因子：
7.2
通讯作者：
Morgan, Daniel M.
中科院分区：
文献类型：
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作者：
Larson, Kindra A.;Smith, Tovia;Morgan, Daniel M.
目的：描述患者满意度后，密歇根州四壁骶棘韧带悬吊脱垂，并确定与satisfaction.METHODS：四百五十三名患者被要求评价他们的满意度与手术和完整的验证生活质量的仪器。从病历中提取术后支持，并在可能时进行评估。与“高度满意”患者独立相关的因素通过多变量logistic回归确定。结果：62%（242/392）的患者在8.0 +/- 1.7年后报告了他们的满意度。57%的患者既往脱垂手术失败，56%的患者术前脱垂超过处女膜4 cm或更大。90%的人表示满意; 76%的人表示“完全”或“非常”满意，他们被认为是“非常满意”的分析。14%的人表示“中等”满意，他们被认为是“不太满意”。在术后骨盆底不适量表-20中得分较低的女性更有可能“非常满意”。67%（162/242）的患者可获得术后解剖数据，86%的患者在处女膜处或上方观察到阴道支撑。术前Baden步行者3级或4级脱垂的妇女比2级脱垂的妇女更有可能“高度满意”。晚期术后脱垂（3级或4级）的妇女不太可能，2级支持的妇女与0级或1级支持的妇女一样可能“高度满意”。结论：密歇根州四壁骶棘韧带悬吊术是一种解剖学上有效的穹窿悬吊术，长期患者满意度高。处女膜术后阴道支撑不会对患者满意度产生负面影响。
OBJECTIVE: To describe patient satisfaction after Michigan four-wall sacrospinous ligament suspension for prolapse and identify factors associated with satisfaction.METHODS: Four hundred fifty-three patients were asked to rate their satisfaction with surgery and complete validated quality-of-life instruments. Postoperative support was extracted from the medical record and assessed when possible. Factors independently associated with patients who were "highly satisfied" were identified with multivariable logistic regression.RESULTS: Sixty-two percent (242/392) reported how satisfied they were 8.0 +/- 1.7 years later. Fifty-seven percent had failed prior prolapse surgery, and 56% had a preoperative prolapse 4 cm or greater beyond the hymen. Ninety percent were satisfied; 76% were "completely" or "very" satisfied and they were considered "highly satisfied" for analysis. Fourteen percent reporting being "moderately" satisfied and they were considered among those "less satisfied." Women with lower scores on the postoperative Pelvic Floor Distress Inventory-20 were more likely to be "highly satisfied." Postoperative anatomic data were available for 67% (162/242) and vaginal support was observed at or above the hymen in 86%. Women with preoperative Baden Walker grade 3 or 4 prolapse were more likely than those with grade 2 prolapse to be "highly satisfied." Women with advanced postoperative prolapse (grade 3 or 4) were less likely and those with grade 2 support were as likely to be "highly satisfied" as those with grade 0 or 1 support.CONCLUSION: The Michigan four-wall sacrospinous ligament suspension is an anatomically effective approach to vault suspension with a high rate of long-term patient satisfaction. Postoperative vaginal support at the hymen does not negatively affect patient satisfaction.