- 期刊
Vaginal Vault Prolapse with Enterocele and Stress Incontinence after Vaginal Hysterectomy
陰道式全子宮切除後陰道脫垂併發小腸脫出及尿失禁
摘要
當陰道或子宮的支持組織發生缺陷時，可能就會產生生殖器官的脫垂。陰道或子宮的支持組織發生缺陷的原因可能是分娩、結締組織疾病、腹腔壓力提高或其他醫療疾病引起。輕微的生殖器脫垂可予以保守性治療，重度脫垂則須施行外科治療。我們報導一位子宮切除後發生陰道脫垂、小腸脫出的病人及併有壓力性尿失禁。她接受了陰道薦棘韌帶懸吊術及小腸脫出修補術，並施行經閉鎖孔尿道懸吊術以治療壓力性尿失禁及預防陰道薦棘韌帶懸吊術引起的尿失禁後遺症。術後追蹤發現這些骨盤腔鬆弛的缺陷均獲矯正及改善。當婦女骨盤腔鬆弛的原因有多種時，應需要多種手術的矯正才可恢復正常功能，而不能只施行一種。
並列摘要
Genitourinary prolapse occurs when faults develop in the mechanisms for vaginal and uterine support. The causes may be due to childbirth, connective tissue disease, increased intra-abdominal pressure or iatrogenic causes. Massive genital organ prolapse is usually corrected with surgical treatment while mild genital organ is first treated with conservative treatment. We reported a case of vaginal vault prolapse with enterocele and stress incontinence occurring in a short period after vaginal hysterectomy. This patient was treated with vaginal sacrospinous suspension, McCall operation and transobtutator tape surgery (TOT). Postoperative evaluation one month later showed all the clinical disorders were corrected and improved. It indicates that a mutiple pelvic structures reconstruction is necessary for supporting and allowing normal function of the pelvic organs while mutiple pelvic structural defects concomitantly exist.