[1]贺飞,邬绍文,陈宋林,等.腹腔镜下Mesh网片阴道骶骨前固定治疗膀胱脱垂疗效及安全性分析[J].中华腔镜泌尿外科杂志(电子版),2016,10(01):13-17.[doi:10.3877/cma.j.issn.1674-3253.2016.01.004 ]
　He Fei,Wu Shaowen,Chen Songlin,et al.Efficacy and safety of laparoscopic sacrocolpopexy with Mesh in the treatment of female with low urinary tract symptoms induced by cystocele[J].,2016,10(01):13-17.[doi:10.3877/cma.j.issn.1674-3253.2016.01.004 ]
点击复制

腹腔镜下Mesh网片阴道骶骨前固定治疗膀胱脱垂疗效及安全性分析()
分享到：

中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
10
期数:
2016年01期
页码:
13-17
栏目:
临床研究
出版日期:
2016-04-29

文章信息/Info

Title:
Efficacy and safety of laparoscopic sacrocolpopexy with Mesh in the treatment of female with low urinary tract symptoms induced by cystocele
作者:
贺飞; 邬绍文; 陈宋林; 杨青山; 宋明哲; 陈海; 张晓忠
518045深圳中山泌尿外科医院
Author(s):
He Fei;  Wu Shaowen;  Chen Songlin;  Yang Qingshan;  Song Mingzhe;  Chen Hai;  Zhang Xiaozhong.
Department of Urology, Shenzhen Zhong-shan Urological Hospital. Guangdong 518045, China.
关键词:
阴道骶骨前固定术; 膀胱脱垂; 女性; 下尿路症状
DOI:
10.3877/cma.j.issn.1674-3253.2016.01.004
摘要:
目的探讨腹腔镜下 Mesh网片阴道骶骨前固定术（ LSC）在治疗膀胱脱垂导致女性顽固下尿路症状（ LUTS）中的临床疗效及安全性。方法 2013年 3月至 2014年 6月深圳中山泌尿外科医院应用 LSC治疗膀胱脱垂导致女性顽固 LUTS患者 10例，年龄 46~77岁，病程 4~12年，比较患者手术前后下尿路症状、性功能改善情况及尿流率、残余尿改善情况。通过 Bristol女性下尿路症状问卷表（ FLUTS-Q），分析 LSC的疗效和安全性。结果 10例手术均顺利完成，手术时间（ 195±52）min；术中出血量（ 150±88）ml。9例患者尿频症状完全消失（ 90%），1例较术前明显改善；10例患者排尿困难症状均消失（ 100%）；术前有尿急症状的患者中，3例症状改善（ 60%），无尿急症状的 5例患者中，术后新发尿急症状 2例（ 40%），术后 2个月改善；术前有压力性尿失禁的 4例患者中 2例（ 50%）症状改善； 6例术前无压力性尿失禁，术后新发 1例（ 17%）；手术前后最大尿流率、残余尿量和 Bristol（FLUTS-Q）评分比较差异有统计学意义（ P<0.05）。结论 LSC可以有效改善女性膀胱脱垂导致的下尿路症状，微创、并发症少、安全有效。但对腹腔镜技术要求较高，学习曲线较长。

参考文献/References:

[1] Yoon SM, Jung JK, Lee SB, et al. Treatment of female urethral syndrome refractory to antibiotics [J]. Yonsei Med J, 2002, 43(5): 644-651.
[2] Digesu GA, Chaliha C, Salvatore S, et al. The relationship of vaginal prolapse severity to symptoms and quality of Life [J]. BJOG, 2005, 112(7): 971-976.
[3] Bradley CS, Zimmerman MB, Wang Q, et al. Vaginal descent and pelvic floor symptoms in postmenopausal women: a longitudinal study[J]. Obstet Gynecol, 2008, 111(5): 1148-1153.
[4] Gutman RE, Ford DE, Quiroz LH, et al. Is there a pelvic organ prolapse threshold that predicts pelvic floor symptoms?[J]. Am J Obstet Gynecol, 2008, 199(6): 683. e1-7.
[5] de Boer TA, Salvatore S, Cardozo L, et al. Pelvic organ prolapse and overactive bladder[J]. Neurourol Urodyn, 2010, 29(1): 30-39.
[6] Miranne JM, Lopes V, Carberry CL, et al. The effect of pelvic organ prolapse severity on improvement in overactive bladder symptoms after pelvic reconstructive surgery[J]. Int Urogynecol J, 2013, 24(8): 1303-1308.
[7] Patil A, Duckett JR. Effect of prolapse repair on voiding and bladder overactivity [J]. Curr Opin Obstet Gynecol, 2010, 22(5): 399-403.
[8] Wattiez A, Boughizane S, Alexandre F, et al. Laparoscopic procedures for stress incontinence and prolapse [J]. Curr Opin Obstet Gynecol, 1995, 7(4): 317-321.
[9] Swift S, Woodman P, O'boyle A, et al. Pelvic organ support study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects [J]. Am J Obstet Gynecol, 2005, 192(3): 795-806.
[10] Fialkow MF, Newton KM, Weiss NS. Incidence of recurrent pelvic organ prolapse 10 years following primary surgical management: a retrospective cohort study [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2008, 19(11): 1483-1487.
[11] Grody MH. Urinary incontinence and concomitant prolapsed [J]. Clin Obstet Gynecol, 1998, 41(3): 777-785.
[12] Kleeman S, Vassallo B, Segal J, et al. The ability of history and a negative cough stress test to detect occult stress incontinence in patients undergoing surgical repair of advanced pelvic organ prolapse [J]. Int Urogynecol J Pelvic Floor Dysfunct, 2006, 17(1): 27-29.
[13] Reena C, Kekre AN, Kekre N. Occult stress incontinence in women with pelvic organ prolapsed [J]. Int J Gynaecol Obstet, 2007, 97(1): 31-34.
[14] Rapp DE, King AB, Rowe B, et al. Comprehensive evaluation of anterior elevate system for the treatment of anterior and apical pelvic floor descent: 2-year followup [J]. J Urol, 2014, 191 (2): 389-394.
[15] Rice NT, Hu Y, Slaughter JC, et al. Pelvic mesh complications in women before and after the 2011 FDA public health notification [J]. Female Pelvic Med Reconstr Surg, 2013, 19(6): 333-338.
[16] Ellington DR, Richter HE. The role of vaginal mesh procedures in pelvic organ prolapse surgery in view of complication risk [J]. Obstet Gynecol Int, 2013, 356960.
[17] Su TH, Lau HH, Huang WC, et al. Single-incision mesh repair versus traditional native tissue repair for pelvic organ prolapsed: results of a cohort study [J]. Int Urogynecol J, 2014, 25 (7): 901-918.
[18] Chesson R, Hallner B. Why complex pelvic organ prolapse should be repaired vaginally[J]. Curr Opin Urol, 2013, 23(4): 312-316.
[19] Maher CF, Feiner B, Decuyper EM, et al. Laparoscopic sacral colpopexy versus total vaginal mesh for vaginal vault prolapse: a randomized trial[J]. Am J Obstet Gynecol, 2011, 204(4): 360.e1-7.
[20] Sutherland SE. Should asymptomatic anterior pelvic organ prolapse be corrected to treat irritative urinary symptoms? [J]. Curr Urol Rep, 2010, 11(5): 338-342.

相似文献/References:

[1]贺飞,邬绍文,张晓忠,等.无张力尿道中段吊带术联合proliftTM网片治疗女性压力性尿失禁合并膀胱脱垂的早期经验[J].中华腔镜泌尿外科杂志(电子版),2012,(06):479.
　HE Fei,WU Shao-wen,ZHANG Xiao-zhong,et al.Initial experience with concomitant proliftTM system and tension-free vaginal tape procedures in patients with stress urinary incontinence associated with cystocele[J].,2012,(01):479.

备注/Memo

备注/Memo:
通讯作者：贺飞，Email：szhefei@sohu.com
本文编辑：阮星星 李文标） 贺飞,邬绍文,陈宋林,等.腹腔镜下 Mesh网片阴道骶骨前固定治疗膀胱脱垂疗效及安全性分析[J/CD].中华腔镜泌尿外科杂志:电子版, 2016, 10(1
更新日期/Last Update: 1900-01-01