改良前盆底重建术治疗阴道前壁中重度膨出的疗效研究

目的：评价改良前盆底重建术治疗阴道前壁中重度膨出的临床效果。方法：对38例阴道前壁中重度膨出的患者采用普理灵网片行改良前盆底重建术,对30例合并张力性尿失禁的患者同时行TVT-O尿道中段悬吊术,回顾分析其临床病理资料。结果：38例均顺利完成改良前盆底重建术,患者恢复良好,无器官损伤、感染、血肿等并发症。术后随访6~12个月,治愈率100%,无阴道狭窄和缩短,无网片局部侵蚀暴露,1例患者术后出现张力性尿失禁,其余无排尿及排便功能障碍。结论：改良的前盆底重建术是治疗阴道前壁中重度脱垂的有效术式,保留子宫和阴道功能,同时加强盆底组织,手术安全、微创、疗效显著、复发率低,值得临床推广。

Modified anterior pelvic floor reconstruction for advanced anterior vaginal wall prolapse

Objective：To explore the clinical effect of the modified anterior pelvic floor reconstruction for moderate or severe anterior vaginal wall prolapse. Methods： A total of 38 patients with advanced anterior vaginal wall prolapse underwent the modified anterior pelvis floor reconstruction with Prolene Mesh, and 30 of them received the tension--free vaginal tape--obturator （TVT--O） procedure due to combined of stress urinary incontinence（SUI）. The clinicopathologic data were retrospectively analyzed. Results： The modified anterior pelvis floor reconstruction was performed successfully for 38 patients, with satisfactory recovery. There were no severe complications including organ injury, infection and hematoma. During follow--up of 6 to 12 months, the coleostenosis, vagina shortening and mesh erosion were not found, and the curative rate was 100%. The SUI occurred in one patient, and the others had the normal urination and defecation function. Conclusion： The modified anterior pelvic floor reconstruction is effective for the treatment of advanced anterior vaginal wall prolapse, with advantages of safety, minimal invasion, satisfactory efficacy and lower recurrence rate, preserving the uterus and vagina functions and enhancing the pelvic tissue.