补片在女性骨盆重建外科中的应用
担心出现与盆底障碍治疗相关的经阴道植入网片并发症?以下是一些注意事项。
来自妙佑医疗国际员工
如果您患有骨盆底疾病,您可能听说过涉及网状物的治疗方法。然而,关于并发症的报道可能会让您感到困惑或犹豫不决,不敢去治疗。了解网状物使用方法以及可能出现的并发症。
什么是外科网片?
外科网片是一种医疗产品,用于在修复虚弱或受损组织时提供额外的支持。大多数外科网片是由合成材料或动物组织制成的。
如何使用外科网片治疗盆底障碍?
外科网片可用于治疗:
- 盆腔器官脱垂(POP)。当支撑盆腔器官的肌肉和韧带力量减弱时,盆腔器官可能会脱落,并在阴道内隆起(盆腔器官脱垂)。为了治疗 POP,可以植入外科网片来加固脆弱的阴道壁。我们可以经腹部使用网片或经阴道不使用网片完成外科手术。使用网片进行阴道外科手术已不再是一种选择。
- 压力性尿失禁(SUI)。压力性尿失禁指的是由于咳嗽、打喷嚏、跑步或举重等会对膀胱施加压力的身体动作或活动引起的尿液不自主排出。可以经阴道植入外科网片尿道吊带,以支撑膀胱颈或者身体中输送尿液的管道(尿道)。这项医疗程序称为尿道中段吊带术或网片吊带术。
使用外科修补网治疗盆底疾病有哪些安全性问题?
使用修补网有其自身的风险和益处。
通过阴道使用外科修补网治疗 POP 与修补网相关并发症的发病率升高有关,这些并发症包括修补网刺穿阴道皮肤、盆腔疼痛和性交疼痛。2019 年,美国食品药品管理局下令经阴道 POP 修复用外科修复网制造商停止在美国销售和分销其产品。如果您已经置入用于 POP 手术修复的经阴道修复网,请继续进行常规护理。如果您出现并发症或症状,请咨询医生。
在寻求利用网片治疗盆腔底疾病之前,我应该问些什么问题?
如果您正在考虑利用外科用网片治疗盆腔底疾病,请确保让医生向您解释所有方案,以及它们可能带来的风险和益处。
July 03, 2022
- Maher C, et al. Transvaginal mesh or grafts compared with native tissue repair for vaginal prolapse. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD012079/full. Accessed May 22, 2017.
- Trabuco EC, et al. Overview of transvaginal placement of mesh for prolapse and stress urinary incontinence. http://www.uptodate.com/home. Accessed May 22, 2017.
- Obstetrical and gynecological devices: Reclassification of surgical mesh for transvaginal pelvic organ prolapse repair. Office of the Federal Register. https://www.federalregister.gov/documents/2016/01/05/2015-33165/obstetrical-and-gynecological-devices-reclassification-of-surgical-mesh-for-transvaginal-pelvic. Accessed May 22, 2017.
- Caveney M, et al. Short-term complications associated with the use of transvaginal mesh in pelvic floor reconstructive surgery: Results from a multi-institutional prospectively maintained dataset. Neurourology and Urodynamics. 2017;9999:1.
- ACOG practice advisory on the FDA's reclassification of mesh for pelvic organ prolapse. The American College of Obstetricians and Gynecologists. http://www.acog.org/About-ACOG/News-Room/Practice-Advisories/ACOG-Practice-Advisory-on-the-FDAs-Reclassification-of-Mesh-for-Pelvic-Organ-Prolapse. Accessed May 22, 2017.
- Surgery for stress urinary incontinence. The American College of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Surgery-for-Stress-Urinary-Incontinence. Accessed May 22, 2017.
- FDA takes action to protect women's health, orders manufacturers of surgical mesh intended for transvaginal repair of pelvic organ prolapse to stop selling all devices. U.S. Food and Drug Administration. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm636114.htm?utm_campaign=2019-04-16%20FDA%20orders%20manufacturers%20of%20surgical%20mesh%20intended%20for%20transvaginal%20repair&utm_medium=email&utm_source=Eloqua. Accessed April 16, 2019.
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