目的:女性盆腔器官脱垂(POP)的高患病率需要关注并不断评估治疗方案。骶棘韧带固定术(SSLF)对根尖脱垂有好处,高功效,和低成本。我们的目的是比较SSLF中阴道前后入路与解剖结构的关系,并将它们与体重指数(BMI)相关联。
方法:新鲜女性尸体经阴道前后入路固定骶棘韧带,使用CAPIO®SLIM设备(波士顿科学,纳蒂克,MA,美国)。从固定点到阴部动脉的距离,阴部神经,测量臀下动脉。
结果:我们评估了11具尸体,平均年龄为70.1±9.9岁,平均BMI为22.4±4.6kg/m2。从后SSLF到坐骨脊柱的平均距离,阴部动脉,阴部神经,臀下动脉为21.18±2.22mm,17.9±7.3mm,19.2±6.8mm,和18.9±6.9mm。相对于前SSLF的相同测量值为19.7±2.7mm,18.6±6.7mm,19.2±6.9mm,和18.3±6.7毫米。统计分析显示两种方法中的距离之间没有差异。从固定点到阴部动脉和神经的距离与BMI成正比。
结论:在阴道前后入路中获得的测量结果没有差异。发现BMI与阴部动脉和阴部神经的距离之间存在直接相关性。
The high prevalence of pelvic organ prolapse (POP) in women requires attention and constant review of treatment options. Sacrospinous ligament fixation (SSLF) for apical prolapse has benefits, high efficacy, and low cost. Our objective is to compare anterior and posterior vaginal approach in SSLF in relation to anatomical structures and to correlate them with body mass index (BMI).
Sacrospinous ligament fixation was performed in fresh female cadavers via anterior and posterior vaginal approaches, using the CAPIO®SLIM device (Boston Scientific, Natick, MA, USA). The distances from the point of fixation to the pudendal artery, pudendal nerve, and inferior gluteal artery were measured.
We evaluated 11 cadavers with a mean age of 70.1 ± 9.9 years and mean BMI 22.4 ± 4.6 kg/m2. The mean distance from the posterior SSLF to the ischial spine, pudendal artery, pudendal nerve, and inferior gluteal artery were 21.18 ± 2.22 mm, 17.9 ± 7.3 mm, 19.2 ± 6.8 mm, and 18.9 ± 6.9 mm respectively. The same measurements relative to the anterior SSLF were 19.7 ± 2.7 mm, 18.6 ± 6.7 mm, 19.2 ± 6.9 mm, and 18.3 ± 6.7 mm. Statistical analysis showed no difference between the distances in the two approaches. The distances from the fixation point to the pudendal artery and nerve were directly proportional to the BMI.
There was no difference in the measurements obtained in the anterior and posterior vaginal approaches. A direct correlation between BMI and the distances to the pudendal artery and pudendal nerve was found.