[Cystocele repair by vaginal approach with a tension-free transversal polypropylene mesh. Technique and results].
[Cystocele repair by vaginal approach with a tension-free transversal polypropylene mesh. Technique and results].
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DOI：
10.1016/j.gyobfe.2004.02.004
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发表时间：
2004-04-01
期刊：
影响因子：
--
通讯作者：
Ville, Y
中科院分区：
文献类型：
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作者：
Bader, G;Fauconnier, A;Ville, Y
目的：评估中期结果，公差和效率的介入无张力聚丙烯单丝网阴道的方法为修复cystoceles.Patients和方法：连续40名妇女进行了2001年3月和2002年9月之间的新程序。在完全分离膀胱膨出后，聚丙烯补片（Gynemesh），Gynecare，Ethicon，约翰逊和约翰逊，法国），在膀胱下方放置适当的切口，无需任何固定。网片的横向延伸部分在膀胱旁间隙中引入，与骨盆腱筋膜弓接触。结果：手术前所有患者根据POP-Q分类均具有大于或等于II级的膀胱膨出。8例为II级膀胱膨出（20%），32例为III级膀胱膨出（80%）。30名女性（82.5%）有相关的后部或中部脱垂。30名女性有尿失禁（75%）。平均年龄为63.9岁（51-78岁）。在所有病例中，手术均顺利进行。膀胱膨出治愈手术的持续时间为20 min +/- 2.2（16-24）。平均随访时间为16.4个月± 4.7（12-24）。早期并发症发生率为7.5%（2例阴道糜烂和1例需要二次消融的补片完全暴露）。未发生补片感染。成功率为95%。满意度指数超过80%，在我们的患者6个月后，膀胱膨出repair.Discussion和结论：插入的膀胱下横向无张力聚丙烯网的阴道路线似乎是一个很好的程序，在确定的手术治疗等级II和III阴道前壁脱垂。该方法操作简单、创伤小、重复性好、并发症少、耐受性好。
OBJECTIVE: To evaluate mid term results, tolerance and efficiency of interposition of a tension-free polypropylene monofilament mesh by vaginal approach for the repair of cystoceles.PATIENTS AND METHODS: Fourty consecutive women underwent this new procedure between March 2001 and September 2002. After complete dissection of the cystocele, the polypropylene mesh (Gynemesh), Gynecare, Ethicon, Johnson & Johnson, France), proper cut-out was positioned under the bladder without any fixation. The lateral extensions of the mesh where introduced in the para-vesical spaces in contact with the arcus tendinus fascia pelvis.RESULTS: Before surgery all patients had cystocele of more or equal than grade II according to the POP-Q classification. Eight had grade II cystocele (20%) and 32 had grade III cystocele (80%). Thirty women had associated posterior or median prolapse (82.5%). Thirty women had urinary incontinence (75%). Mean age was 63.9 years (51-78). The procedure was performed without any difficulty in all cases. Duration of a cystocele cure procedure was 20 min +/- 2.2 (16-24). Mean follow-up is 16.4 months +/- 4.7 (12-24). The early complication rate was 7.5% (two vaginal erosions and one complete exposition of the mesh which requires secondary ablation). There was no mesh infection. The success rate was 95%. The satisfaction index overpasses 80% in 95% of our patients 6 months after the cystocele repair.DISCUSSION AND CONCLUSIONS: The interposition of a sub-vesical transversal tension-free polypropylene mesh by the vaginal route seems to be an excellent procedure in the definitive surgical treatment of grades II and III anterior vaginal wall prolapse. This new procedure is simple, mini-invasive, reproducible and efficient with low morbidity and good tolerance.