生殖医学杂志

目的评价改良盆底重建术治疗盆腔脏器脱垂的临床效果。方法盆腔脏器脱垂定量(POP-Q)分度为Ⅲ～Ⅳ度35例患者行改良盆底重建术,观察手术时间、术中出血量、住院时间等围手术期指标,以POP-Q分度为客观疗效评价指标,以临床症状消失为主观治愈指标。术后定期随访,观察疗效。结果手术平均时间(55士20.2)min、术中平均出血(100±40.2)ml,术后住院平均(4.5±1.5)d,术后随访3～18个月、中位随访时间6个月,客观治愈率94%(33/35),主观有效率91%(32/35)。术后仅1例发生网片侵蚀,3例发生排尿困难,2例发生性交痛,2例发生急迫性尿失禁。结论改良盆底重建术是治疗盆腔脏器脱垂的有效术式,保留子宫同时加强盆底组织,手术简单、安全、微创、经济,远期疗效有待进一步观察。

Objective:To evaluate the effect of modified pelvic floor reconstruction on pelvic organ prolapse. Methods:Modified total pelvic floor reconstruction was performed,from Sep.2007 to sept.2009 in the hospital,on 35 patients with pelvic organ prolapse at stage ofⅢ-Ⅳ,classified by the international pelvic organ prolapse staging system(POP-Q).Operation time,blood loss during operation and length of hospital stay were recorded.Patients were followed up at 3,6 and 12 months postoperation.Pelvic status and organ prolapse were evaluated with POP-Q system,and symptoms reported by patients. Results:The operation was successfully conducted in all patients,without any operation-related injure to internal organs.The mean operation time was 55±20.2 minutes,mean blood loss was 100±40.2 ml, and mean hospital stay was 4.5±1.5 days.The median follow-up was 6 months(3-18 months).The pelvic organ prolapse,evaluated by POP-Q system,was totally relived in 33(94.3%) patients and partially relived in the other two.One mesh erosion was observed 5 weeks after operation,and mended.Three patients reported dysuria,2 experienced stress urinary incontinence and 2 complained dyspareunia,but recovered over time.Sexual activities were improved in all but two patients.No severe complications were found in any patients. Conclusions:Modified pelvic floor reconstruction is a simple,safe,effective,economic and micro-invasive method for pelvic organ prolapse.Its long-term effect needs to be followed up.