经阴道植入TiLOOP网片的盆底重建术的临床疗效和安全性分析

目的:评价经阴道植入轻型钛化聚丙烯网片TiLOOP的盆底重建术的临床短期疗效和安全性。方法:回顾性分析南京医科大学附属无锡妇幼保健院2017年11月至2019年7月，以阴道前壁膨出Ⅲ~Ⅳ度为主的50例盆腔器官脱垂（POP）患者，对其实施经阴道植入TiLOOP网片的盆底重建术，其中自行裁剪TiLOOP网片的“协和式”盆底...

Clinical efficacy and safety of transvaginal pelvic floor reconstruction with TiLOOP mesh

Objective To evaluate the short-term clinical efficacy and safety of transvaginal pelvic floor reconstruction with TiLOOP mesh,a titanized polypropylene lightweight mesh.Methods From November 2017 to July 2019,50 patients underwent surgery,who were with anterior vaginal prolapse stageⅢ-Ⅳand(or)apical prolapse and posterior vaginal prolapse(stageⅠ-Ⅱ);37 patients underwent self-cut TiLOOP mesh and 13 patients underwent pre-cut mesh-kit procedure.The subjective and objective parameters(including surgical success)of them were evaluated.Results The mean follow-up time was(18±6)months.The overall surgical success rate was 90%(45/50).Prolapse recurrence rates were isolated anterior 2%(1/50),isolated apical 2%(1/50)and isolated posterior 6%(3/50).None of recurrent patients underwent re-treatment,including either surgery or use of a pessary at last follow-up.According to patient global impression of improvement(PGI-I),46 patients(92%,46/50)were very much better,and 4 patients(8%,4/50)were much better.After the operation,pelvic floor distress inventory-short form 20(PFDI-20)and pelvic floor impact questionnaire-short form 7(PFIQ-7)scores were significantly lower than those before operation(all P<0.05);pelvic organ prolapse-urinary incontinence sexual questionnaire 12(PISQ-12)score was no significant difference before and after operation(P>0.05),but without dyspareunia.The vaginal mesh erosion rate was 12%(6/50)and the stress urinary incontinence was observed in 2 cases(4%,2/47).Conclusion Transvaginal pelvic floor reconstruction with TiLOOP mesh is a safe and effective surgery,short-term efficacy is acceptable,how to reduce the mesh erosion still need to be explored.