盆底重建术治疗盆腔脏器脱垂的临床分析

目的探讨盆腔器官脱垂（POP）患者运用盆底修复网片系统进行盆底重建治疗的疗效。方法选择Ⅲ度及以上子宫或（和）阴道壁脱垂患者32例,24例行全盆重建术（75.0%）,8例行前盆重建术（25.0%）,10例合并压力性尿失禁同时行TVT-O尿道中段悬吊术（31.3%）。结果 32例患者手术过程均较顺利,术中无严重并发症。术后随访2～4年,除1例（3.13%）子宫、阴道前壁轻度膨出外,余无复发,另有1例患者术后足月孕剖宫产一子,产后未发现POP复发迹象。术后性生活困难、急迫性尿失禁、网片侵蚀的发生几率分别为21.43%,6.25%和0。结论用盆底修复网片系统进行盆底重建治疗POP是一种安全、有效、微创的术式,中短期疗效满意。

The clinical analysis of pelvic floor reconstruction in treating female pelvic organ prolapse

Objective To explore the curative effect of the Gynecare Prolift in surgery therapy on pelvic organ prolapse（POP）.Methods Thirty two cases with stage Ⅲ or more severe uterine and/or vagina prolapse underwent the pelvic organ prolapse quantification examination（POP-Q） were enrolled.All the 32 cases underwent pelvic floor reconstruction by using total pelvic floor reconstruction（24 cases,75%） and anterior pelvic floor reconstruction（8 cases,25%） and 10 cases（31.3%） therein,who suffered from stress urinary incontinence,with tension-free vaginal tape obturator system（TVT-O） procedure simultaneously.Results There were no severe operative complications in all 32 cases.All the cases were followed up for 2 to 4 years.It was no recurrence except 1 in 32 cases was anterior wall of vagina expand slightly（3.13%）.1 in 32 cases underwent cesarean section after term pregnancy and there was no recurrence of POP.The occurrence probability of dyspareunia,imperative urinary incontinence and asymptomatic erosion were 21.43%,6.25% and 0 respectively after operation.Conclusion Gynecare Prolift system is considered as a safe,effective and mini-invasive surgery therapy on POP.This surgery has a stable middle and short-term curative effect.