論文

国際誌
2021年4月19日

A new method of adjusting mesh tension using cystoscopy during laparoscopic sacrocolpopexy.

International urogynecology journal
  • Yukiko Nomura
  • ,
  • Yoshiyuki Okada
  • ,
  • Aya Hiramatsu
  • ,
  • Eiji Matsubara
  • ,
  • Kumiko Kato
  • ,
  • Yasukuni Yoshimura

記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s00192-021-04791-1

We aimed to examine the usefulness of cystoscopic findings to guide mesh tension adjustment during laparoscopic sacrocolpopexy (LSC) to promote better repair of pelvic organ prolapse (POP) and prevent de novo stress urinary incontinence (SUI). In this technique, the bladder wall was observed using a cystoscope when various traction pressures were applied by pulling the mesh arm with forceps before fixation to the promontory during LSC. Adjustment was performed on 20 patients, and postoperative outcomes of POP repair and development of de novo SUI were evaluated. When excessive traction was applied on the mesh arm, a bladder neck opening and a cord-like elevation in the center of the trigone and posterior wall were observed in all cases. The tension was gradually loosened, and precisely when the above-mentioned cystoscopic finding ("Central Road") disappeared, an anatomically appropriate elevation of the vaginal apex was achieved; the mesh arm was fixed to the promontory. At 6 months after LSC, anterior wall recurrences were diagnosed in four patients (beyond the hymen in one) with few symptoms, while no occurrence of de novo SUI. Cystoscopic findings during mesh tension adjustment in LSC could be useful in achieving improved POP repair.

リンク情報
DOI
https://doi.org/10.1007/s00192-021-04791-1
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33871668
ID情報
  • DOI : 10.1007/s00192-021-04791-1
  • PubMed ID : 33871668

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