Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (9): 102-107.doi: 10.6040/j.issn.1671-7554.0.2022.0120

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Simplified paravaginal repair for both anterior and middle pelvic floor defect

ZHANG Ying, ZHOU Jing, WANG Changhe   

  1. Department of Gynaecology, Jining No.1 Peoples Hospital, Jining 272000, Shandong, China
  • Published:2022-09-02

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Abstract: Objective To investigate the clinical value of simplified paravaginal repair in the treatment of anterior and middle pelvic floor defect(namely anterior vaginal prolapse and uterine prolapse). Methods This prospective observational study involved 41 consecutive patients with typical anterior vaginal prolapse and uterine prolapse. All patients received simplified paravaginal repair. The subjective symptoms and objective results of physical examinations were recorded during regular follow-up. Results All operations were successful. The average operation time was(56.6±18.6)min, and the median blood loss was 150.0(50.0, 200.0)mL. During the median follow-up of 12 months(range, 6-23 months), 5 cases were lost, 3 cases had relapse, but 2 of which were asymptomatic, and 1 case had vaginal pain. The objective and subjective cure rate was 91.7% and 94.4%, respectively. Conclusion Simplified paravaginal repair, as a novel surgical procedure, is safe and effective for treating anterior vaginal prolapse and uterine prolapse.

Key words: Simplified paravaginal repair, Anterior vaginal prolapse, Uterine prolapse, Anterior pelvic floor defect, Middle pelvic floor defect

CLC Number: 

  • R713.3
[1] Albright TS, Gehrich AP, Davis GD, et al. Arcus tendineus fascia pelvis: a further understanding[J]. Am J Obstet Gynecol, 2005, 193(3 Pt 1): 677-681.
[2] Delancey JO. Fascial and muscular abnormalities in women with urethral hypermobility and anterior vaginal wall prolapse[J]. Am J Obstet Gynecol, 2002, 187(1): 93-98.
[3] Cosson M, Boukerrou M, Lacaze S, et al. A study of pelvic ligament strength[J]. Eur J Obstet Gynecol Reprod Biol, 2003, 109(1): 80-87.
[4] Pit MJ, De Ruiter MC, Lycklama A Nijeholt AA, et al. Anatomy of the arcus tendineus fasciae pelvis in females[J]. Clin Anat, 2003, 16(2): 131-137.
[5] Richardson AC, Lyon JB, Williams NL. A new look at pelvic relaxation[J]. Am J Obstet Gynecol, 1976, 126(5): 568-573.
[6] Richardson AC, Edmonds PB, Williams NL. Treatment of stress urinary incontinence due to paravaginal fascial defect[J]. Obstet Gynecol, 1981, 57(3): 357-362.
[7] DeLancey JO. Anatomic aspects of vaginal eversion after hysterectomy[J]. Am J Obstet Gynecol, 1992, 166(6 Pt 1): 1717-1724.
[8] Barber MD. Contemporary views on female pelvic anatomy[J]. Cleve Clin J Med, 2005, 72(Suppl 4): S3-11.
[9] Arenholt L, Pedersen BG, Glavind K, et al. Paravaginal defect: anatomy, clinical findings, and imaging[J]. Int Urogynecol J, 2017, 28(5): 661-673.
[10] Chen L, Swenson CW, Xie B, et al. A new 3D stress MRI measurement strategy to quantify surgical correction of prolapse in three support systems[J]. Neurourol Urodyn, 2021, 40(8): 1989-1998.
[11] Shull BL. Clinical evaluation of women with pelvic support defects[J]. Clin Obstet Gynecol, 1993, 36(4): 939-951.
[12] Whiteside JL, Barber MD, Paraiso MF, et al. Clinical evaluation of anterior vaginal wall support defects: interexaminer and intraexaminer reliability[J]. Am J Obstet Gynecol, 2004, 191(1): 100-104.
[13] Barber MD, Cundiff GW, Weidner AC, et al. Accuracy of clinical assessment of paravaginal defects in women with anterior vaginal wall prolapse[J]. Am J Obstet Gynecol, 1999, 181(1): 87-90.
[14] Segal JL, Vassallo BJ, Kleeman SD, et al. Paravaginal defects: prevalence and accuracy of preoperative detection[J]. Int Urogynecol J Pelvic Floor Dysfunct, 2004, 15(6): 378-383.
[15] White GR. Cystocele: a radical cure by suturing lateral sulci of vagina to white line of pelvic fascia[J]. JAMA, 1909, LIII(21): 1707-1710.
[16] Richardson AC, Lyon JB, Williams NL. A new look at pelvic relaxation[J]. Am J Obstet Gynecol, 1976, 126(5): 568-573.
[17] Shull BL, Baden WF. A six-year experience with paravaginal defect repair for stress urinary incontinence[J]. Am J Obstet Gynecol, 1989, 160(6): 1432-1439.
[18] Richardson AC, Saye WB, Miklos JR, et al. Repairing paravaginal defects laparoscopically[J]. Contemp Ob Gyn, 1997, 42(11): 125-130.
[19] Bai SW, Jeon JD, Chung KA, et al. The effectiveness of modified six-corner suspension in patients with paravaginal defect and stress urinary incontinence[J]. Int Urogynecol J Pelvic Floor Dysfunct, 2002, 13(5): 303-307.
[20] 申桂华, 李旻, 吕秋波,等. 改良阴道旁修补术在盆底重建中的作用[J]. 中华老年医学杂志, 2010, 29(9): 742-744.
[21] Kim WB, Lee SW, Lee KW, et al. Robot-assisted laparoscopic paravaginal repair and sacrocolpopexy in patients with pelvic organ prolapse[J]. Urology, 2022, 164: 151-156. doi: 10.1016/j.urology.2021.12.011.
[22] Chinthakanan O, Miklos JR, Moore RD. Laparoscopic paravaginal defect repair: surgical technique and a literature review[J]. Surg Technol Int, 2015, 27: 173-183.
[23] Behnia-Willison F, Seman EI, Cook JR, et al. Laparoscopic paravaginal repair of anterior compartment prolapse[J]. J Minim Invasive Gynecol, 2007, 14(4): 475-480.
[24] Lowder JL, Park AJ, Ellison R, et al. The role of apical vaginal support in the appearance of anterior and posterior vaginal prolapse[J]. Obstet Gynecol, 2008, 111(1): 152-157.
[25] 中华医学会妇产科学分会妇科盆底学组. 盆腔器官脱垂的中国诊治指南(2020年版)[J]. 中华妇产科杂志,2020, 55(5): 300-306.
[26] Young SB, Daman JJ, Bony LG. Vaginal paravaginal repair: one-year outcomes[J]. Am J Obstet Gynecol, 2001, 185(6): 1360-1366.
[27] Occelli B, Narducci F, Hautefeuille J, et al. Anatomic study of arcus tendineus fasciae pelvis[J]. Eur J Obstet Gynecol Reprod Biol, 2001, 97(2): 213-219.
[28] Maher C, Baessler K. Surgical management of anterior vaginal wall prolapse: an evidencebased literature review[J]. Int Urogynecol J Pelvic Floor Dysfunct, 2006, 17(2): 195-201.
[29] Zhang W, Cheon WC, Zhang L, et al. Comparison of the effectiveness of sacrospinous ligament fixation and sacrocolpopexy: a meta-analysis[J]. Int Urogynecol J, 2022, 33(1): 3-13.
[30] Margulies RU, Rogers MA, Morgan DM. Outcomes of transvaginal uterosacral ligament suspension: systematic review and metaanalysis[J]. Am J Obstet Gynecol, 2010, 202(2): 124-134.
[31] Iglesia CB, Smithling KR. Pelvic organ prolapse[J]. Am Fam Physician, 2017, 96(3): 179-185.
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