A multicenter, randomized, prospective, controlled study comparing sacrospinous fixation and transvaginal mesh in the treatment of posthysterectomy vaginal vault prolapse
A multicenter, randomized, prospective, controlled study comparing sacrospinous fixation and transvaginal mesh in the treatment of posthysterectomy vaginal vault prolapse
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DOI：
10.1016/j.ajog.2012.08.016
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发表时间：
2012-10-01
影响因子：
9.8
通讯作者：
Halaska, Michael J.
中科院分区：
文献类型：
--
作者：
Halaska, Michael;Maxova, Katerina;Halaska, Michael J.
目的：本研究的目的是比较骶棘固定（SSF）和prolene网片技术在乳房切除术后阴道穹窿脱垂的初步治疗中的复发率和并发症。研究设计：接受拱顶脱垂手术的患者被纳入一项多中心、随机、对照研究，比较SSF和全补片（proflift; Gynecare/Ethicon, Somerville， NJ）。检查包括盆腔器官脱垂量化、尿动力学、超声和术前、术后3个月和12个月的生活质量（QoL）问卷。结果：168例随机患者中，83例行SSF， 85例行补片修复。SSF组和补片组12个月后脱垂复发率分别为39.4%和16.9% （P = 0.003）。网片曝光率为20.8%。两组患者在生活质量改善、新发应激性尿失禁和膀胱过度活动方面无显著差异。结论：与SSF相比，接受补片手术的患者脱垂复发率较低，这与补片暴露的发生是平衡的。
OBJECTIVE: The objective of the study was to compare recurrence and complication rates for sacrospinous fixation (SSF) and prolene mesh techniques for the primary treatment of posthysterectomy vaginal vault prolapse.STUDY DESIGN: Patients undergoing surgery for vault prolapse were included in a multicenter, randomized, controlled study comparing SSF or total mesh (Prolift; Gynecare/Ethicon, Somerville, NJ). The examination included pelvic organ prolapse quantification, urodynamics, ultrasound, and quality-of-life (QoL) questionnaires before and 3 and 12 months after surgery.RESULTS: Of 168 randomized patients, 83 underwent SSF and 85 mesh repair. Prolapse recurrence after 12 months occurred in 39.4% of the SSF group and in 16.9% of the mesh group (P = .003). The mesh exposure rate was 20.8%. No difference in QoL improvement as well as of de novo stress urinary incontinence and overactive bladder onset was found.CONCLUSION: Mesh exposure occurrence was balanced against a lower prolapse recurrence rate in the patients undergoing mesh surgery compared with those undergoing SSF.