Pelvic support defects and visceral and sexual function in women treated with sacrospinous ligament suspension and pelvic reconstruction

被引:157
作者
Paraiso, MFR
Ballard, LA
Walters, MD
Lee, JC
Mitchinson, AR
机构
[1] CLEVELAND CLIN,DEPT OBSTET & GYNECOL,CLEVELAND,OH
[2] CLEVELAND CLIN,DEPT BIOSTAT & EPIDEMIOL,CLEVELAND,OH
关键词
sacrospinous ligament suspension; vaginal prolapse;
D O I
10.1016/S0002-9378(96)70085-6
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: Our purpose was to evaluate the efficacy and consequences of sacrospinous ligament suspension and pelvic reconstruction. STUDY DESIGN: Patients who underwent sacrospinous ligament suspension between 1978 and 1991 were evaluated from follow-up visits, telephone interviews, questionnaires, and chart reviews. Before and after operation, vaginal support was graded in three segments. Postoperative visceral and sexual function was evaluated. RESULTS: Mean length of follow-up for 243 patients was 73.6 months. Of these, 102 (42.0%) had a support defect in at least one segment; anterior, posterior, and apical defects were found in 91 (37.4%), 33 (13.6%), and 20 (8.2%) patients, respectively. A clinically significant defect was defined as a symptomatic first-degree or any second- or third-degree prolapse. Defect-free survival rates at 1, 5, and 10 years were 88.3%, 79.7%, and 51.9%, respectively. Eleven patients (4.5%) underwent subsequent pelvic reconstruction CONCLUSION: Sacrospinous ligament suspension and pelvic reconstruction are effective for vaginal apex support, but vaginal prolapse recurs with time, most commonly in the anterior segment.
引用
收藏
页码:1423 / 1430
页数:8
相关论文
共 19 条
[1]  
BACKER MH, 1992, SURG GYNECOL OBSTET, V175, P419
[2]  
Baden W F, 1972, Clin Obstet Gynecol, V15, P1048, DOI 10.1097/00003081-197212000-00020
[3]  
Bonney V, 1934, J OBSTET GYNECOL BR, V41, P669, DOI [10.1111/j.1471-0528.1934.tb08799.x, DOI 10.1111/J.1471-0528.1934.TB08799.X]
[4]   SACROSPINOUS LIGAMENT FIXATION AT THE TIME OF TRANSVAGINAL HYSTERECTOMY [J].
CRUIKSHANK, SH ;
COX, DW .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1990, 162 (06) :1611-1619
[5]  
DIOKNO AC, 1984, J AM GERIATR SOC, V35, P940
[6]   VAGINAL LENGTH AND SEXUAL FUNCTION AFTER COLPOPEXY FOR COMPLETE UTEROVAGINAL EVERSION [J].
GIVEN, FT ;
MUHLENDORF, IK ;
BROWNING, GM .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1993, 169 (02) :284-288
[7]  
HOLLEY RL, 1995, J AM COLL SURGEONS, V180, P444
[8]  
KETTEL LM, 1989, SURG GYNECOL OBSTET, V68, P318
[9]   SACROSPINOUS LIGAMENT FIXATION FOR EVERSION OF THE VAGINA [J].
MORLEY, GW ;
DELANCEY, JOL .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1988, 158 (04) :872-881
[10]   SACROSPINOUS FIXATION FOR MASSIVE EVERSION OF THE VAGINA [J].
NICHOLS, DH .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1982, 142 (07) :901-904