Vaginale und minimal-invasive Zugangswege in der Urogynäkologie – immer möglich?

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• 作者：PD Dr. med. U. Pecks ; N. Maass ; C. Schem
• 关键词：SchlüsselwörterProlaps ; Minimal ; invasive Interventionen ; Wundheilung ; Laparoskopie ; Adipositas
• 刊名：Der Gynäkologe
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：49
• 期：12
• 页码：915-920
• 全文大小：
• 刊物主题：Gynecology; Obstetrics/Perinatology; Endocrinology;
• 出版者：Springer Medizin
• ISSN：1433-0393
• 卷排序：49

文摘

Surgical candidates for pelvic organ prolapse (POP) repair are women with symptomatic prolapse who decline or in whom conservative therapy fails. For most if not all procedures standardised minimally invasive techniques using abdominal and vaginal surgical routes have been developed. Minimally invasive surgery is cost efficient and significantly reduces the peri- and postoperative risks. Obliterative procedures (e. g. colpocleisis) are reserved for women who cannot tolerate more extensive surgery or who are not planning future vaginal intercourse. It is the authors’ opinion that with decreasing morbidity of minimally invasive techniques obliterative procedures nowadays are rarely justified. Hence, vaginal or abdominal surgery aim at preservation of function and seem similarly effective. Yet, the choice of surgical route depends upon a variety of factors. Beside the primary operative aim, these include patient’s general health condition, previously performed vaginal or abdominal surgery or concomitant intraabdominal findings as well as the optimal approach for the combination of prolapse sites and the use of meshes. The aim of this article is to summarise major decisions when choosing a primary surgical procedure to repair POP.