Avtor/Urednik     Lužnik, Marijan
Naslov     Mrežna krpa za korekcijo velike rektokele: prve izkušnje
Prevedeni naslov     Mesh patch for correction of large rectorele: first experience
Tip     članek
Vir     Zdrav Vestn
Vol. in št.     Letnik 71, št. 1
Leto izdaje     2002
Obseg     str. 23-6
Jezik     slo
Abstrakt     Background. The purpose of this article is to show anatomical and functional results of surgical repair with mesh patch of large rectocele. Methods. From July 2000 to February 2001 five surgical repairs of large rectocele with mesh patch were performed at the Department of Gynecology and Obstetrics of General Hospital Slovenj Gradec. The pre- and postoperative evaluation of vaginal status was made by the Pelvic Organ Prolapse Quantitation (POP-Q) system. Posterior vaginal prolapses, with the stage III by POP-Q were defined as large rectonceles. The pre and postoperative functional status was made by questionnaire of accompanying symptoms (pelvic pain, tenesmus, difficult defecation, incontinence of gas and liquid stool) and of sexual function. Mesh patch (Prolene) of appropriate size was used as a plug for defect in rectovaginal septum. The procedure was either the second or the first correction of the posterior vaginal prolapse, it was unconnected or connected with other gynecological surgical repair, for instance with hysterectomy or with TVT (Tension free Vaginal Tape). Results. Posterior vaginal prolapse was abolished by that surgicale procedure and in all five cases the vaginal status was valued as stage 0 by POP-Q. The anorectal symptoms disappeared and the sexual function was unimpeded. Conclusions. Regarding to first short-term results the mesh patch for correction of large defect in static of posterior vaginal wall and for the relief of its symptoms proved to be successful. At the same time this innovative surgical procedure makes it possible to preserve appropriate volume of vagina for unimpeded sexual function.
Izvleček     Izhodišča. Namen članka je prikazati anatomske in funkcionalne rezultate operativne korekcije velike rektokele z uporabo mrežne krpe. Metode. Od julija 2000 do februarja 2002 smo na Ginekološko-porodniškem oddelku Splošne bolnišnice Slovenj Gradec opravili pet korekcij velike rektokele z uporabo mrežne krpe. Pred- in pooperativni nožnični status smo opisali s standarizirano oceno POP-Q (Pelvic Organ Prolapse Quantitation). Kot veliko rektokelo smo opredelili zdrs zadnje stene nožnice, ki se je ujemal s POP-Q stopnjo III. Z vprašalnikom o spremljajočih simptomih (pelvična bolečina, tenezmi, otežena defekacija, nehotno uhajanje vetrov in blata) in o spolni dejavnosti smo ocenili funkcionalno stanje pred operacijo in po njej. Mrežno krpo (Prolene) primerne velikosti smo uporabili kot "zaplato" za okvaro v rektovaginalnem septumu. Operacija je bila ali ponovna ali prva korekcija zdrsa zadnje nožnične stene, lahko samostojna ali združena z drugo ginekološko operacijo, kot na primer s histerektomijo ali s TVT (Tension free Vaginal Tape). Rezultati. Zdrs zadnje nožnične stene smo pri vseh operirankah v celoti odpravili tako, da je bila statika nožnice po operaciji ocenjena s stopnjo O po standardizirani POP-Q. Odpravljeni so bili anorektalni simptomi. Koitiranje je bilo neovirano. Zaključki. Glede na prve kratkoročne rezultate je uporaba mrežne krpe koristna pri korekciji velike motnje v statiki zadnje nožnične stene in odpravi simptomov, ki jo je ta motnja povzročala. Hkrati ta izvirna operativna metoda omogoča, da ohranimo primeren volumen nožnice za neovirane spolne odnose.
Deskriptorji     RECTOVAGINAL FISTULA
SURGICAL MESH
TREATMENT OUTCOME