腹腔镜子宫侧位悬吊术和腹腔镜骶尾部整形术治疗子宫脱垂的结果

Canan Satır Özel, M. Küçükbaş, O. Yardımcı, Vildan Nalbant, Ateş Karateke
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摘要

背景/目的:骶尾部结肠切除术被认为是治疗症状性子宫脱垂患者的黄金标准手术方法。这项技术可通过腹腔镜方法进行。腹腔镜侧位悬吊术已成为盆腔脏器脱垂手术的一种新的替代方法。本研究旨在比较在本院接受腹腔镜骶骨整形术(第1组)和腹腔镜侧悬吊术(第2组)治疗盆腔器官脱垂的患者术后的解剖学改善和性功能结果:第一组有 14 名患者,第二组有 7 名患者。采用经土耳其验证的盆腔器官脱垂/尿失禁性问卷(PISQ-12)、性功能障碍筛查简易问卷和盆腔器官脱垂定量系统(POP-Q)问卷收集相关数据:第 1 组和第 2 组在子宫脱垂的术前分期(2.6 (0.8) vs. 2.7 (0.7) [P=0.534])方面无统计学差异。与第二组相比,第一组的术后时间明显更长(1,014.7 (348.8) 天 vs. 598.4 (276.5) 天 [P=0.013])。在 POP-Q 评估中,第 1 组 C 点的测量值为 -6.6 (1.1) 厘米,第 2 组为 -5.2 (1.5) 厘米,从统计学角度看,C 点的位置更近(P=0.037)。第一组的阴道总长度大于第二组,但差异无统计学意义(8.7 (1.2) cm vs. 8.1 (1.3) cm,[P=0.343])。在随访期间,两组在子宫脱垂分期和性功能方面没有统计学差异:结论:腹腔镜侧位悬吊术是子宫脱垂患者的另一种治疗方法,在解剖学和性功能方面的效果与腹腔镜骶骨结节成形术相当。
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Results of the laparoscopic lateral suspension and laparoscopic sacrocolpopexy techniques done for uterine prolapse
Background/Aim: Sacrocolpopexy is considered the gold-standard surgical treatment for patients with symptomatic uterine prolapse. This technique can be performed using a laparoscopic approach. Laparoscopic lateral suspension has emerged as a new alternative pelvic organ prolapse surgery method. This study aims to compare the postoperative anatomical improvement and sexual function outcomes in patients who underwent laparoscopic sacrocolpopexy (Group 1) versus laparoscopic lateral suspension (Group 2) for pelvic organ prolapse at our institution. Methods: Group 1 consisted of 14 patients, while Group 2 comprised seven patients. Relevant data were collected using the Turkish-validated Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), A Simple Questionnaire to Screen for Sexual Dysfunction, and the Pelvic Organ Prolapse Quantification System (POP-Q) questionnaires. Results: There was no statistically significant difference between Group 1 and Group 2 in terms of the preoperative stage of uterine prolapse (2.6 (0.8) vs. 2.7 (0.7) [P=0.534]). The postoperative period was significantly longer in Group 1 compared to Group 2 (1,014.7 (348.8) days vs. 598.4 (276.5) days [P=0.013]). In the POP-Q evaluation, point C was measured as -6.6 (1.1) cm in Group 1 and -5.2 (1.5) cm in Group 2, indicating a statistically more proximal location (P=0.037). The total vaginal length was greater in Group 1 than in Group 2, but this difference was not statistically significant (8.7 (1.2) cm vs. 8.1 (1.3) cm, [P=0.343]). There was no statistical difference between the groups in terms of uterine prolapse stages and sexual function during the follow-up period. Conclusion: Laparoscopic lateral suspension is an alternative method for patients with uterine prolapse, offering comparable anatomical and sexual outcomes to laparoscopic sacrocolpopexy.
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