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Journal of Clinical and Nursing Research 2024年第4期8卷 197-202页

作者： Chao Wang Shuo Feng Department of Gynecology The Second Affiliated Hospital of Shandong Second Medical UniversityWeifang 261031China

Objective:To evaluate the clinical advantages of laparoscopic transverse abdominal wall suspension in treating pelvic organ prolapse.Methods:Sixty patients diagnosed with moderate to severe pelvic organ prolapse and underwent surgical treatment in our hospital between January 2022 and December 2023 were selected.According to different surgical methods,they were divided into an observation group(given laparoscopic transverse abdominal wall suspension)and a control group(given transvaginal mesh implantation),with 30 subjects/group.The data on perioperative-related indicators,quality of life scores,postoperative recurrence,and complications of the two groups of patients were collected.Results:The postoperative hospitalization days and intraoperative bleeding volume of the observation group were significantly lower than those of the control group,but had longer operation time than that of the control group(Ppelvic Floor Disease Quality of Life Impact Questionnaire(PFIQ-7)score of the observation group was significantly higher than the control group(P0.05).Conclusion:Laparoscopic transverse abdominal wall suspension was more effective in treating pelvic organ prolapse and is an ideal surgical procedure.

关键词： pelvic organ prolapse Laparoscopic transverse abdominal wall suspension Clinical advantages

Transvaginal mesh implant for pelvic organ prolapse:Huaxi protocol

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UroPrecision 2024年第1期2卷 24-29页

作者： Jie Zhang Deyi Luo Hong Shen Department of Urology Institute of Urology(Laboratory of Reconstructive Urology)West China HospitalSichuan UniversityChengduChina pelvic Floor Diseases Center West China Tianfu HospitalSichuan UniversityChengduSichuanChina

With increasing age,pelvic organ prolapse(POP),due to its high incidence,has become a common disease that seriously affects patients’quality of life and places a heavy economic burden on families and society.Transvaginal mesh(TVM)is a minimally invasive and effective treatment for POP,although its use remains controversial due to the potential risk of mesh-related complications.The US Foods and Drugs Administration,along with authorities in England,Australia,New Zealand,and other countries,have banned the sale and distribution of commercial TVM kits designed for POP.The TVM procedure remains an option for POP treatment and still appeals to many surgeons and patients today in Asia and most European countries,which suggests that a considerable number of POP patients can benefit from its continued refinement.Here we introduce the Huaxi protocol of the TVM plant for the treatment of POP.

关键词： pelvic floor reconstruction pelvic organ prolapse POP transvaginal mesh TVM

Telomerase-mediated immortalization of human vaginal wall fibroblasts derived from patients with pelvic organ prolapse

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Chinese Medical Journal 2023年第5期136卷 578-587页

作者： Tao Guo Ting Xie Jinghe Lang Zhijing Sun Department of Obstetrics and Gynecology Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesNational Clinical Research Center for Obstetric&Gynecologic DiseasesBeijing 100730China Department of Medical Research Center Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China.

Background: Extracellular matrix (ECM) remodeling is the most important pathomechanism of pelvic organ prolapse (POP). Fibroblasts are the key to ECM regulation. The passaging capacity of human vaginal wall fibroblasts (hVWFs) is limited in vitro . Here, we aimed to immortalize hVWFs through the introduction of human telomerase reverse transcriptase (hTERT). Methods: Primary cells were derived from the vaginal wall tissue of patients with POP. Cellular senescence was detected via senescence-associated β-galactosidase staining. We employed a lentiviral transfection vector to stably express hTERT in hVWFs at passage 3, generating immortalized hVWFs (i-hVWFs). We then assessed cellular proliferation via the CCK-8 and EdU assays as well as cellular migration via wound healing assays. G-banded chromosome karyotypic analysis was performed to evaluate chromosomal karyotype stability. Finally, cellular tumorigenesis capacity was assessed in nude mice. A two-tailed Student’s t test was used to compare differences between the two groups. Results: Our results showed that senescence of primary hVWFs significantly increased from passage seven. From passage 11, hVWFs showed a significantly higher senescence percentage than i-hVWFs. During the continuous passage, i-hVWFs presented stability in proliferation, migration capacity, expression of ECM regulation-related genes, and chromosome karyotype. In vivo tumorigenesis was absent in i-hVWFs. Conclusions: The senescence of hVWFs significantly increased from the seventh passage, and we successfully used hTERT to immortalize hVWFs derived from patients with POP. Studies on POP that require a long-lived hVWF line will benefit from our technique.

关键词： pelvic organ prolapse Fibroblasts Telomere shortening Cellular senescence

New native tissue repair for pelvic organ prolapse:Medium-term outcomes of laparoscopic vaginal stump-round ligament fixation

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World Journal of Clinical Cases 2023年第15期11卷 3457-3463页

作者： Toshiyuki Kakinuma Ayaka Kaneko Kaoru Kakinuma Ken Imai Nobuhiro Takeshima Michitaka Ohwada Department of Obstetrics and Gynecology International University of Health and WelfareNasushiobara 329-2763Japan

BACKGROUND Laparoscopic sacrocolpopexy for pelvic organ prolapse(POP)is a new and widely used approach;however,ever since the United States Food and Drug Administration warned against the use of surgical mesh,repairs performed using patients’tissues[i.***.native tissue repair(NTR)]instead of mesh have attracted much attention.At our hospital,laparoscopic sacrocolpopexy(the Shull method)was introduced in 2017.However,patients with more severe POP who have a long vaginal canal and overextended uterosacral ligaments may not be candidates for this procedure.AIM To validate a new NTR treatment for POP,we examined patients undergoing laparoscopic vaginal stump–round ligament fixation(the Kakinuma method).METHODS The study patients were 30 individuals with POP who underwent surgery using the Kakinuma method between January 2020 and December 2021 and who were followed up for>12 mo after surgery.We retrospectively examined surgical outcomes for surgery duration,blood loss,intraoperative complications,and incidence of recurrence.The Kakinuma method involves round ligament suturing and fixation on both sides,effectively lifting the vaginal stump after laparoscopic hysterectomy.RESULTS The patients’mean age was 66.5±9.1(45-82)years,gravidity was 3.1±1.4(2-7),parity was 2.5±0.6(2-4)times,and body mass index was 24.5±3.3(20.9-32.8)kg/m2.According to the POP quantification stage classification,there were 8 patients with stage Ⅱ,11 with stage Ⅲ,and 11 with stage Ⅳ.The mean surgery duration was 113.4±22.6(88-148)min,and the mean blood loss was 26.5±39.7(10-150)mL.There were no perioperative complications.None of the patients exhibited reduced activities of daily living or cognitive impairment after hospital discharge.No cases of POP recurrence were observed 12 mo after the operation.CONCLUSION The Kakinuma method,similar to conventional NTR,may be an effective treatment for POP.

关键词： pelvic organ prolapse Native tissue repair Laparoscopic surgery Round ligament Kakinuma method

Medium-term outcomes of laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with posterior approach for a pelvic organ prolapse:A retrospective study of 124 cases

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Laparoscopic, Endoscopic and Robotic Surgery 2023年第4期6卷 154-159页

作者： Yunshan Zhu Xiao Zhang Danxia Chen Guangxiao Li Shanliang Shang Jianqiong Li Jianhua Yang Department of Obstetrics and Gynecolbgy Sir Run Run Show Hospital Zhejlang University School of MedicineHangzhou 310016China Key Laborutory of Reproductive Dysfunction Management of Zhejiang Provinar Hangzhou 310016China

Objective:pelvic organ prolapse(POP)is a common gynecological disease in middle-aged and older women that seriously affects patients'physical health and quality of life,increases the financial burden for patients,and becomes a major public health concern.The aim of this study was to investigate the medium-term outcomes of laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach for patients with severe POP.Methods:Patients with severe POP quantitation stage III-IV who underwent laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach at the Department of Obstetrics and Gynecology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine between September 2016 and December 2020 were enrolled in this study.The results and complications were recorded.Data were retrospectively reviewed.Results:In total,124 patients were analyzed.Patients were followed up for 32.2712.90 months.The objective cure rate for patients who underwent hysterectomy was 917%(100/109),with 7(6.4%)patients had anterior vaginal wall prolapse and 2(1.8%)patients had posterior vaginal wall prolapse.The objective cure rate for patients who retained uterus was 66.7%(10/15).All 5 patients with recurrence had uterine prolapse,and 3(20.0%)of them also had anterior vaginal wall prolapse.Conchusions:Laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with the posterior approach is a safe,minimally invasive,and effective method for patients with severe POP.Long-term follow-up is needed to confirm the clinical effects.

关键词： pelvic organ prolapse Laparoscopy Pubocervical fascia reconstruction Sacrospinous ligament fixation

Sensory threshold for defecation and its correlation with pelvic organ prolapse:An exploration of related factors

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Gynecology and Obstetrics Clinical Medicine 2023年第3期3卷 149-153页

作者： Yanhua Liu Man Tan Cheng Tan Xin Yang Department of Obstetrics and Gynecology Peking University People's HospitalBeijingChina Department of Gynecological pelvic Floor and Oncology Chongqing Health Center for Women and ChildrenChongqingChina

Objectives This research aimed to investigate changes in defecation sensory threshold and related factors in patients with posterior vaginal wall prolapse.Methods A total of 214 patients with pelvic organ prolapse were recruited between October 2019 to January 2021.All patients underwent a defecation sensory threshold examination,physical examination,and pelvic floor ultrasound examination.Factors related to the defecation sensory threshold were analyzed.Results(1)Among the participants,57 patients(26.6%)had a defecation sensory threshold of more than 90ml.Patients with a threshold>90ml showed higher scores of defecation dysfunction in the Constipation Scoring System(CSS)score(p=0.003)and higher scores of constipation in the Colorectal-anal Distress Inventory 8(CRADI-8)score(p=0.002).(2)The defecation sensation threshold positively correlated with the Ap point(r=0.448,ppelvic organ prolapse commonly experience an increased threshold of defecation sensation.Elevated thresholds were associated with more frequent constipation symptoms.Additionally,the severity of posterior pelvic prolapse positively correlated with the defecation sensory threshold.

关键词： Anorectal function Defecation sensory threshold pelvic organ prolapse

Using a needle for sacrospinous ligament fixation for pelvic organ prolapse based on the Miyazaki technique

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Gynecology and Obstetrics Clinical Medicine 2022年第2期2卷 82-85页

作者： Ilnur Irekovich Musin Alfiya Galimovna Yashchuk Valentin Nikolaevich Pavlov Jianliu Wang Xiuli Sun Raisa Arkadevna Naftulovich Elena Mikhailovna Popova Federal State Budgetary Educational Institution of Higher Education Bashkir State Medical University of the Ministry of Health of the Russian Federation Lenina 3UfaRepublic of Bashkortostan450008Russia Department of Obstetrics and Gynecology Peking University People's Hospital11th Xizhimen South StreetXicheng DistrictBeijing100044China

Background:Approximately 7%of all women will require surgery to correct pelvic organ prolapse during their lives.Of these,approximately 10%-13%will require another operation within 5 years due to recurrence of the disease.Increases in life expectancy and elderly individuals with estrogen deficiencies will mean higher rates of pelvic organ prolapse,significantly reducing the quality of life for millions of people.This study introduces technologies that can help treat pelvic prolapse while reducing the rate of recurrence.Methods:This paper outlines how to properly perform sacrospinous ligament fixation using the Miyazaki technique.Results:A needle was used to successfully perform a sacrospinous ligament fixation using Miyazaki's technique.Conclusions:Considering the Food and Drug Administration’s 2019 decision to permit surgeries with native tissue,this method can be used with sacrospinous ligament fixation as the primary treatment option for pelvic organ prolapse.

关键词： pelvic organ prolapse Sacrospinous ligament fixation Sacrocolpopexy pelvic surgery

Management of Urinary Incontinence before and after Total pelvic Reconstruction for Advanced pelvic organ prolapse with and without Incontinence

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Chinese Medical Journal 2018年第5期131卷 553-558页

作者： Yu Song Xiao-Juan Wang Yi-Song Chen Ke-Qin Hua Medical Center of Diagnosis and Treatment for Cervical Diseases Obstetrics and Gynecology Hospital of Fudan University Shanghai 200011 China Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases Shanghai 200011 China Department of Gynecology Obstetrics and Gynecology Hospital of Fudan University Shanghai 200011 China

Background： The effectiveness of an anti-incontinence procedure concomitant with prolapse reconstruction for pelvic organ prolapse （POP） in preventing urinary incontinence （UI） after surgery remains controversial. Our study aimed to describe the incidence of pre- and postoperative UI for pelvic reconstructive surgery and evaluate the management of POP associated with U1. Methods： A total of 329 patients who underwent total pelvic reconstruction between June 2009 and February 2015 at a single institution were identified. These patients were divided into two groups （Group A [Prolift reconstruction]： n = 190 and Group B [modified total pelvic reconstruction]： n = 139）. Data regarding surgical procedures and patient demographic variables were recorded. Chi-square and Student＇s t-tests were used for two independent samples. Results： A total of 115 patients presented with UI preoperatively. The average follow-up time was 46.5 months, with 20 patients lost to tbllow-up （6.1%）. The cure rates of stress UI （SUI）, urgency UI （UUI）, and mixed UI （MUI） were 51% （30/59）, 80% （16/20）, and 48% （14/29）, respectively. The cure rate of UUI after total pelvic reconstruction （80% [16/20]） was higher than that of SUI （50.8% [30/59], χ2 = 5.219, P = 0.03）, and the cure rate of MUl （48%, 14/29） was the lowest. The cure rate of patients with UI symptoms postoperatively was lower than that of those with symptoms preoperatively （9.1% [28/309] vs. 16.2% [50/309], χ2 = 7.101, P = 0.01）. There was no difference in the incidence of Ul postoperatively between Groups A and B （P 〉 0.05）. The cure rate of SUl in patients undergoing tension-free vaginal tape-ohturator was not higher than that in those who did not undergo the procedure （42.9% [6/14] vs. 53.3% [24/45], χ2 = 0.469, P = 0.49）. There were no differences in the cure rate for POP or U1 between these two types of reconstructions （P 〉 0.05）. Conclusions： No correlation between the incidence of UI and POP was identified. The results suggest that UI treatment should be performed after POP su

关键词： pelvic organ prolapse Recurrence Urinary Incontinence

Tension-free Polypropylene Mesh-related Surgical Repair for pelvic organ prolapse has a Good Anatomic Success Rate but a High Risk of Complications

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Chinese Medical Journal 2015年第3期128卷 295-300页

作者： Lei Zhang Lan Zhu Juan Chen Tao Xu Jing-He Lang Department of Gynecology and Obstetrics Peking Union Medical College Hospital Peking Union Medical College Chinese Academy of Medical Sciences Beijing 100730 China Department of Epidemiology and Statistics Institute of Basic Medical Sciences Chinese Academy of Medical Sciences and School of Basic Medicine Peking Union Medical College Beijing 100730 China

Background： Food and Drug Administration announcements have highlighted the standard rate of mesh-related complications. We aimed to report the short-term results and complications of tension-free polypropylene mesh （PROSIMATM） surgical repair of pelvic organ prolapse （POP） using the standard category （C）, timing （T）, and site （S） classification system. Methods： A prospective cohort study of 48 patients who underwent PROS1MATM mesh kit-related surgical repairs were followed for two years at Peking Union Medical College Hospital. Recurrence was defined as symptomatic POP quantification （POP-Q） Stage II or higher （leading edge ≥ -1 cm）. The Patient Global Impression of Change Questionnaire, the Chinese version of the pelvic Floor Impact Questionnaire short-form-7 and POP/Urinary Incontinence Sexual Questionnaire short-form- 12 were used to evaluate the self-perception and sexual function of each patient. Mesh-related complications conformed to the International Urogynecological Association/International Continence Society joint terminology. The paired-sample t-test, one-way analysis of variance, Fisher＇s exact test, Kaplan-Meier survival analysis and log-rank test were used to analyze data. Results： All patients were followed up for ≥12 months; 30 （62.5%） patients completed the 24 months study. We observed a 93.8% （45/48） positive anatomical outcome rate at 12 months and 90.0% （27/30） at 24 months. Recurrence most frequently involved the anterior compartment （P 〈 0.05）. pelvic symptoms improved significantly from baseline （P 〈 0.05）, although the patients＇ impressions of change and sexual function were not satisfying. Vaginal complication was the main complication observed （35.4%, 17/48）. The survival analysis did not identify any relationship between vaginal complication and anatomical recurrent prolapse （POP-Q 〉 Stage II）（P = 0.653）. Conclusions： Tension-free polypropylene mesh （PROSIMA^TM）-related surgical repair of POP has better short-term anatomical outcomes at the apical and posterior compartments, but a lo

关键词： pelvic organ prolapse Postoperative Complication PROSIMATM Mesh Kit Quality of Life

A 14-year multi-institutional collaborative study of Chinese pelvic floor surgical procedures related to pelvic organ prolapse

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Chinese Medical Journal 2021年第2期134卷 200-205页

作者： Zhi-Jing Sun Xiu-Qi Wang Jing-He Lang Tao Xu Yong-Xian Lu Ke-Qin Hua Jin-Song Han Huai-Fang Li Xiao-Wen Tong Ping Wang Jian-Liu Wang Xin Yang Xiang-Hua Huang Pei-Shu Liu Yan-Feng Song Hang-Mei Jin Jing-Yan Xie Lu-Wen Wang Qing-Kai Wu Jian Gong Yan Wang Li-Qun Wang Zhao-Ai Li Hui-Cheng Xu Zhi-Jun Xia Li-Na Gu Qing Liu Lan Zhu Department of Obstetrics and Gynecology Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing 100730China Department of Obstetrics and Gynecology Graduate School of Peking Union Medical CollegeChinese Academy of Medical SciencesBeijing 100730China Department of Epidemiology and Biostatistics Institute of Basic Medical SciencesChinese Academy of Medical Sciences and School of Basic MedicinePeking Union Medical CollegeBeijing 100730China Department of Obstetrics and Gynecology The Fourth Medical CenterChinese PLA General HospitalBeijing 100048China Department of Gynecology Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200433China Department of Obstetrics and Gynecology Peking University Third HospitalBeijing 100083China department of Obstetrics and Gynecology Tongji HospitalTongji UniversityShanghai 200065China Department of Obstetrics and Gynecology West China Second HospitalSichuan UniversityKey Laboratory of Birth Defects and Related Diseases of Women and ChildrenMinistry of EducationChengduSichuan 061110China Department of Obstetrics and Gynecology Peking University People’s HospitalBeijing 100044China Department of Obstetrics and Gynecology The Second Hospital of Hebei Medical UniversityShijiazhuangHebei 075100China Department of Obstetrics and Gynecology Qilu Hospital of Shandong UniversityJinanShandong 250002China Department of Obstetrics and Gynecology 900 Hospital of the Joint Logistics TeamFuzhouFujian 350025China Department of Obstetrics and Gynecology Women’s HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang 310000China Department of Obstetrics and Gynecology Nanjing First HospitalNanjing Medical UniversityNanjingJiangsu 210006China Department of Obstetrics and Gynecology The Third Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450000China Department of Obstetrics and Gynecology Shanghai Jiao Tong University Sixth HospitalShanghai 200300China Department of Gyn

Background:It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time.The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse(POP)over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011.Methods:A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1,2004 and September 30,2018 were included from 22 tertiary academic medical centers.The data were reported voluntarily and obtained from a database.We compared the proportion of each procedure in the 7 years before and 7 years after September 30,2011.The data were analyzed by performing Z test(one-sided).Results:The number of different procedures during October 1,2011-September 30,2018 was more than twice that during October 1,2004-September 30,2011.Regarding pelvic floor surgeries related to POP,the rate of synthetic mesh procedures increased from 38.1%(5298/13,906)during October 1,2004-September 30,2011 to 46.0%(14,107/30,688)during October 1,2011-September 30,2018,whereas the rate of non-mesh procedures decreased from 61.9%(8608/13,906)to 54.0%(16,581/30,688)(Z=15.53,P<0.001).Regarding synthetic mesh surgeries related to POP,the rates of transvaginal placement of surgical mesh(TVM)procedures decreased from 94.1%(4983/5298)to 82.2%(11,603/14,107)(Z=20.79,P<0.001),but the rate of laparoscopic sacrocolpopexy(LSC)procedures increased from 5.9%(315/5298)to 17.8%(2504/14,107).Conclusions:The rate of synthetic mesh procedures increased while that of non-mesh procedures decreased significantly.The rate of TVM procedures decreased while the rate of LSC procedures increased significantly.Trial registration number:NCT03620565,https://register.***.gov.

关键词： Laparoscopic sacrocolpopexy pelvic organ prolapse Synthetic mesh Transvaginal placement of surgical mesh