Tải xuống
Tóm tắt
Background: Pelvic organ prolapse is a common disease, accounting for 31.8% to 97.7% of women at clinical examination, of which clinical symptoms account for 2.9% to 11.4%. Pelvic floor disorders, including urinary incontinence, anal incontinence, and genital prolapse, are highly prevalent, affecting approximately one-third of adult women. While these conditions are not life-threatening, their social and economic consequences may be significant. Nowadays, there are many methods to treat female pelvic prolapse, including laparoscopic surgery, laparotomy and vaginal surgery. Choosing a method of treating pelvic organ prolapse is still controversial. Endoscopic surgery is a method having many advantages. In this study, we reported the treatment results for Pelvic organ prolapse by laparoscopic promontofixation without hysterectomy.
Methods: A study was conducted on 19 female patients with pelvic organ prolapse, who were treated with the laparoscopy promontofixation for uterin preservation at Hue Central Hospital from June 2019 to June 2021.
Results: The average age was 65 years old, the rate of hard work was 77.8%, and the average number of births was 3.8. The rate of macrosomia is 28%. The rate of bladder prolapse stage 2 accounted for 42%, and bladder prolapse stage 3 accounted for the highest rate of 58%. The stage 2 cervical prolapse rate was 32%, of which stage 3 cervical prolapse accounted for the highest rate of 68%. The stage 1 rectal prolapse rate was 50%, and stage 2 rectal prolapse was 1%, of which stage 3 was 42%. The rate of urinary incontinence was 89%. The median hospital stay for surgery was 6.57 days. The average time for laparoscopic promontofixation was 142 minutes, of which the longest time was 180 minutes and the fastest was 60 minutes. There were no complications during surgery. Complications appear after surgery: Burning pain in the lower abdomen was highest at 44%, dull pain in the low back at 33%, constipation at 22%, cystitis at 11%, pain when defecating at 11%. The success rate of the treatment of bladder prolapse after surgery was 100%, the success rate of cervical prolapse was 87.5%, the success rate of rectal prolapse was 88.9%. The rate of no urinary incontinence after 12 months was 75%, the success rate of dysuria treatment was 100%.
Conclusions: Our initial experience renders the use of laparoscopic promontofixation with uterine preservation to be safe and efficient in experienced hands. However, it is difficult to perform this technique; the number of samples is small, and we need further research.
Tài liệu tham khảo
Antoine T, Kayembe, Andy M, Muela, Alex M, Baleka, Dieudonné S, Mushengezi, Rahma R, Tozin. Genital prolapse: epidemiology, clinic and therapeutic at Saint Joseph Hospital of Kinshasa. PAMJ. 2020. 37.
Nguyễn Văn Ân VTTP, Phạm Hữu Đoàn. áp dụng phẫu thuật nội soi treo âm đạo vào mỏm nhô để điều trị sa sinh dục nặng. Y Học TP. Hồ Chí Minh. 2014. 18: 428-429.
Nguyễn Bá Mỹ Nhi, Phan Thị Nga, Văn Phụng Thống. Nhận xét bước đầu sử dụng mảnh ghép tổng hợp trong điều trị ngoại khoa bệnh lý sa tạng chậu nữ tại bệnh viện Từ Dũ. Tạp chí phụ sản. 2012. 10: 228-236.
Baden WF, Walker TA, Lindsey JH. The vaginal profile. Tex Med. 1968. 64: 56-8.
Huebner M, DeLancey JOL, Reisenauer C, Brucker SY, Preibsch H, Fleischer S, et al. Magnetic resonance imaging of vaginal support structure before and after Vecchietti procedure in women with Mayer-Rokitansky-KüsterHauser syndrome. Acta Obstet Gynecol Scand. 2018. 97: 830-837.
Ingelman-Sundberg A. Urinary incontinence in women, excluding fistulas. Acta Obstet Gynecol Scand. 1952. 31: 266-91.
Mustafa S, Amit A, Filmar S, Deutsch M, Netzer I, Itskovitz-Eldor J, et al. Implementation of laparoscopic sacrocolpopexy: establishment of a learning curve and shortterm outcomes. Arch Gynecol Obstet. 2012. 286: 983-8.
Cosson M, Bogaert E, Narducci F, Querleu D, Crépin G. [Laparoscopic sacral colpopexy: short-term results and complications in 83 patients]. J Gynecol Obstet Biol Reprod (Paris). 2000. 29: 746-750.
Agarwala N, Hasiak N, Shade M. Laparoscopic sacral colpopexy with Gynemesh as graft material--experience and results. J Minim Invasive Gynecol. 2007. 14: 577-83.
Antiphon P, Elard S, Benyoussef A, Fofana M, Yiou R, Gettman M, et al. Laparoscopic promontory sacral colpopexy: is the posterior, recto-vaginal, mesh mandatory? Eur Urol. 2004. 45: 655-61.
North CE, Ali-Ross NS, Smith AR, Reid FM. A prospective study of laparoscopic sacrocolpopexy for the management of pelvic organ prolapse. Bjog. 2009. 116: 1251-7.
Moez K JD, Monia F, Fethi Z, La double promontofixation coelioscopique : un échec pour l’étage postérieur ? Vol. 94. 2016: LA TUNISIE MEDICALE
Rozet F, Mandron E, Arroyo C, Andrews H, Cathelineau X, Mombet A, et al. Laparoscopic sacral colpopexy approach for genito-urinary prolapse: experience with 363 cases. Eur Urol. 2005. 47: 230-6.
Bui C, Ballester M, Chéreau E, Guillo E, Daraï E. [Functional results and quality of life of laparoscopic promontofixation in the cure of genital prolapse]. Gynecol Obstet Fertil. 2010. 38: 563-8.
Claerhout F, Roovers JP, Lewi P, Verguts J, De Ridder D, Deprest J. Implementation of laparoscopic sacrocolpopexy- -a single centre’s experience. Int Urogynecol J Pelvic Floor Dysfunct. 2009. 20: 1119-25.
Ross JW , Preston M. Laparoscopic sacrocolpopexy for severe vaginal vault prolapse: five-year outcome. J Minim Invasive Gynecol. 2005. 12: 221-6.
Sarlos D, Brandner S, Kots L, Gygax N, Schaer G. Laparoscopic sacrocolpopexy for uterine and posthysterectomy prolapse: anatomical results, quality of life and perioperative outcome-a prospective study with 101 cases. Int Urogynecol J Pelvic Floor Dysfunct. 2008. 19: 1415-22.
Ganatra AM, Rozet F, Sanchez-Salas R, Barret E, Galiano M, Cathelineau X, et al. The current status of laparoscopic sacrocolpopexy: a review. Eur Urol. 2009. 55: 1089-103.
Gadonneix P, Ercoli A, Salet-Lizée D, Cotelle O, Bolner B, Van Den Akker M, et al. Laparoscopic sacrocolpopexy with two separate meshes along the anterior and posterior vaginal walls for multicompartment pelvic organ prolapse. J Am Assoc Gynecol Laparosc. 2004. 11: 29-35.
Higgs PJ, Chua HL, Smith AR. Long term review of laparoscopic sacrocolpopexy. Bjog. 2005. 112: 1134-8.
Rivoire C, Botchorishvili R, Canis M, Jardon K, Rabischong B, Wattiez A, et al. Complete laparoscopic treatment of genital prolapse with meshes includingvaginal promontofixation and anterior repair: a series of 138 patients. J Minim Invasive Gynecol. 2007. 14: 712-8.
Acsinte OM, Rabischong B, Bourdel N, Canis M, Botchorishvili R. Laparoscopic Promontofixation in 10Steps. J Minim Invasive Gynecol. 2018. 25: 767.
Nguyễn TVT, Nguyễn BMN, Vũ AT. Phân tích các biến chứng phẫu thuật đặt mảnh ghép điều trị sa tạng chậu trong thời gian theo dõi 2 năm. Tạp chí Phụ sản. 2018. 16: 107 - 110.
| Đã xuất bản | 05-01-2025 | |
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| Số tạp chí | Số 83 (2022) | |
| Phân mục | Nghiên cứu | |
| DOI | 10.38103/jcmhch.83.8 | |
| Từ khóa | Treatment of pelvic organ prolapse, laparoscopic sacral hysteropexy, uterine-sparing surgery |
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