PDF(Pubmed)
Abstract：
BACKGROUND: Pelvic organ prolapse constitutes a prevalent condition associated with a considerable impact on the quality of life. The utilization of transvaginal mesh surgery for managing POP has been a subject of extensive debate. Globally, trends in TVM surgery experienced significant shifts subsequent to warnings issued by the FDA.
METHODS: This study aims to explore temporal patterns in transvaginal mesh surgery in the German healthcare system. A comprehensive analysis was conducted on in-patient data from the German Federal Statistical Office spanning 2006 to 2021. A total of 1,150,811 operations, each associated with specific codes, were incorporated into the study. Linear regression analysis was employed to delineate discernible trends.
RESULTS: The trends in transvaginal mesh surgery within the anterior compartment exhibited relative stability (p = 0.147); however, a significant decline was noted in all other compartments (posterior: p < 0.001, enterocele surgery: p < 0.001). A subtle increasing trend was observed for uterine-preserving transvaginal mesh surgery (p = 0.045).
CONCLUSIONS: Surgical trends over the specified timeframe demonstrate how POP management has evolved globally. Notably, despite observed fluctuations, transvaginal mesh surgery remains a viable option, particularly for specific cases with a high risk of relapse and contraindications to alternative surgical approaches.
METHODS: This study aims to explore temporal patterns in transvaginal mesh surgery in the German healthcare system. A comprehensive analysis was conducted on in-patient data from the German Federal Statistical Office spanning 2006 to 2021. A total of 1,150,811 operations, each associated with specific codes, were incorporated into the study. Linear regression analysis was employed to delineate discernible trends.
RESULTS: The trends in transvaginal mesh surgery within the anterior compartment exhibited relative stability (p = 0.147); however, a significant decline was noted in all other compartments (posterior: p < 0.001, enterocele surgery: p < 0.001). A subtle increasing trend was observed for uterine-preserving transvaginal mesh surgery (p = 0.045).
CONCLUSIONS: Surgical trends over the specified timeframe demonstrate how POP management has evolved globally. Notably, despite observed fluctuations, transvaginal mesh surgery remains a viable option, particularly for specific cases with a high risk of relapse and contraindications to alternative surgical approaches.
摘要：
背景：盆腔器官脱垂是一种普遍存在的疾病，对生活质量有相当大的影响。利用经阴道网状手术来管理POP一直是广泛辩论的主题。全球范围内,在FDA发出警告后,TVM手术的趋势发生了重大变化.
方法：本研究旨在探索德国医疗保健系统中经阴道网状手术的时间模式。对德国联邦统计局2006年至2021年的住院数据进行了全面分析。共开展1,150,811次行动,每个都与特定的代码相关联，被纳入研究。采用线性回归分析来描绘可辨别的趋势。
结果：前室内经阴道网状手术的趋势表现出相对稳定性（p=0.147）；然而，所有其他隔室均显著下降(后部:p<0.001,肠膨出手术:p<0.001).经阴道保留子宫的网片手术观察到细微的增加趋势（p=0.045）。
结论：在指定时间范围内的手术趋势证明了POP管理在全球范围内的发展。值得注意的是,尽管观察到波动，经阴道网状手术仍然是一个可行的选择，特别是对于具有高复发风险和替代手术方法禁忌症的特定病例。
方法：本研究旨在探索德国医疗保健系统中经阴道网状手术的时间模式。对德国联邦统计局2006年至2021年的住院数据进行了全面分析。共开展1,150,811次行动,每个都与特定的代码相关联，被纳入研究。采用线性回归分析来描绘可辨别的趋势。
结果：前室内经阴道网状手术的趋势表现出相对稳定性（p=0.147）；然而，所有其他隔室均显著下降(后部:p<0.001,肠膨出手术:p<0.001).经阴道保留子宫的网片手术观察到细微的增加趋势（p=0.045）。
结论：在指定时间范围内的手术趋势证明了POP管理在全球范围内的发展。值得注意的是,尽管观察到波动，经阴道网状手术仍然是一个可行的选择，特别是对于具有高复发风险和替代手术方法禁忌症的特定病例。
