Consensus statement Mesh Pelvic organ prolapse Stress urinary incontinence
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摘要

CONTEXT:Surgical nonautologous meshes have been used for several decades to repair abdominal wall herniae. Implantable materials have been adopted for the treatment of female and male stress urinary incontinence (SUI) and female pelvic organ prolapse (POP).
OBJECTIVE:A consensus review of existing data based on published meta-analyses and reviews.
EVIDENCE ACQUISITION:This document summarises the deliberations of a consensus group meeting convened by the European Association of Urology (EAU) and the European Urogynecological Association, to explore the current evidence relating to the use of polypropylene (PP) materials used for the treatment of SUI and POP, with reference to the 2016 EAU guidelines (European Association of Urology 2016), the European Commission's SCENIHR report on the use of surgical meshes (SCENIHR 2015), other available high-quality evidence, guidelines, and national recommendations.
EVIDENCE SYNTHESIS:Current data suggest that the use of nonautologous durable materials in surgery has well-established benefits but significant risks, which are specific to the condition and location they are used for. Various graft-related complications have been described-such as infection, chronic pain including dyspareunia, exposure in the vagina, shrinkage, erosion into other organs of xenografts, synthetic PP tapes (used in SUI), and meshes (used in POP)-which differ from the complications seen with abdominal herniae.
CONCLUSIONS:When considering surgery for SUI, it is essential to evaluate the available options, which may include synthetic midurethral slings (MUSs) using PP tapes, bulking agents, colposuspension, and autologous sling surgery. The use of synthetic MUSs for surgical treatment of SUI in both male and female patients has good efficacy and acceptable morbidity. Synthetic mesh for POP should be used only in complex cases with recurrent prolapse in the same compartment and restricted to those surgeons with appropriate training who are working in multidisciplinary referral centres.
PATIENT SUMMARY:Synthetic slings can be safely used in the surgical treatment of stress incontinence in both male and female patients. Patients need to be aware of the alternative therapy and potential risks and complications of this therapy. Synthetic mesh for treating prolapse should be used only in complex cases with recurrent prolapse in specialist referral centres.

译文

背景: 外科非自体网已被用于修复腹壁疝几十年。植入材料已被用于治疗女性和男性压力性尿失禁 (SUI) 和女性盆腔器官脱垂 (POP)。
目的: 基于已发表的荟萃分析和综述对现有数据进行共识综述。
证据获取: 本文件总结了由欧洲泌尿外科协会 (EAU) 和欧洲泌尿妇科协会召开的协商一致小组会议的审议情况, 为了探索与使用聚丙烯 (PP) 材料处理 SUI 和 POP 相关的当前证据,参考 2016 EAU 指南(欧洲泌尿外科协会 2016),欧盟委员会关于外科手术网使用的 SCENIHR 报告 (SCENIHR 2015),其他可用的高质量证据、指南和国家建议。
证据综合: 目前的数据表明,在手术中使用非自体耐用材料有既定的好处,但风险很大,这是特定于它们使用的条件和位置的。已经描述了各种移植物相关的并发症 -- 如感染、慢性疼痛 (包括性交困难) 、阴道暴露、收缩、异种移植物其他器官的侵蚀, 合成 PP 胶带 (用于 SUI) 和网格 (用于 POP)-这不同于腹疝的并发症。
结论: 当考虑手术治疗 SUI 时,评估可用的选择是必要的,其中可能包括使用 PP 胶带的合成尿道中段吊带 (MUSs) 、填充剂、阴道退休和自体吊带手术。在男性和女性患者的 SUI 手术治疗中使用合成 MUSs 具有良好的疗效和可接受的发病率。用于 POP 的合成网格应仅用于在同一隔室中反复脱垂的复杂病例,并且仅限于在多学科转诊中心工作的受过适当培训的外科医生。
患者总结: 合成吊索可以安全地用于男性和女性患者压力性尿失禁的手术治疗。患者需要了解替代疗法以及该疗法的潜在风险和并发症。用于治疗脱垂的合成网片只能用于在专科转诊中心治疗复发性脱垂的复杂病例。

pelvic organ prolapse

妇产 盆底功能障碍 临床研究术语
概述  :  

盆底支持结构缺陷、损伤或功能障碍造成盆腔器官从正常位置沿阴道下降脱出于阴道内或阴道外称为盆腔器官脱垂(Pelvic Organ Prolaps ,POP),也叫女性盆底功能障碍性疾病(pelvic floor dysfunction, PFD)。盆底肌肉群、筋膜、韧带及其神经构成复杂的盆底支持系统,其互相作用和支持以维持盆腔器官的正常位置。PFD又称盆底缺陷(pelvic floor defects)或盆底支持组织松弛(relaxation of pelvic supports)是各种病因导

pelvic   英 [ˈpelvɪk] 美 [ˈpelvɪk]

释    义   adj. 骨盆的  

同根词   pelvis  n. pelvis 骨盆 pelvimetry [妇产] 骨盆测量;[妇产] 骨盘测量法

例    句   This can cause serious health problems in later life, such as pelvic inflammatory disease.  这可能会在以后的生活导致严重的健康问题,如盆腔炎的。

 

organ   英 [ˈɔːɡən] 美 [ˈɔːrɡən]

释    义   n. 器官;机构;风琴;嗓音;阴茎

n. (Organ)人名;(英)奥根

同根词   organ  

adj. organic [有化] 有机的;组织的;器官的;根本的   

例    句   How work government organ and until who work?  政府机构应该如何工作、为谁工作?

 

prolapse   英 [ˈprəʊlæps] 美 [ˈproʊlæps]

释    义   n.(身体器官的)脱垂,下垂  v. (身体器官、部位)脱垂,下垂

例    句   Prolapse is a complication that can occur in women.  脱垂是一种并发症,可以发生在妇女。

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