질둥근천장탈출 환자에게 복강경을 이용한 엉치뼈 질고정술

Abstract

Laparoscopic Sacral Colpopexy for the Patients with Vaginal Vault Prolapse

Won Seok Ki Advisor : Prof. Sang Joon Choi M.D., Ph.D. Department of Medicine, Graduate School of Chosun University

Objective: Vaginal vault prolapse is a rare disease, which occurs in 0.1% due to a weakened structure supporting the vagina after hysterectomy. The purpose of this study was to examine the utility of laparoscopy, using prolene mesh, to treat the patients with vaginal vault prolapse after hysterectomy. Methods: The subjects of this study were 10 patients with vaginal vault prolapse who had laparoscopic sacral colpopexy with prolene mesh in the Dept. of Obstetrics and Gynecology of Chosun University from October 2000 to March 2005. The surgical indications in all patients were vaginal vault prolapse. Results: The mean age of patients was 59.9year (48-75year)old and mean past delivery history was 3.1 times(2-4 times) via vaginal delivery. When visiting the hospital, three patients were classified as stage III pelvic organ prolapse and seven patients were stage IV by POP-Q system. All showed vaginal vault prolapse, cystocele and rectocele. All of 10 patients had no specific features in the pelvic examination. The mean operation time was 113.5 minutes(60-180 minutes) and posterior colporrhaphy was also performed in all patients. All of patients discharged on fourth to tenth postoperative days, without complication. The follow-up was performed at 1 week, 1 month, and 3-months interval after discharging hospital. During the follow-up, nobody relapsed. Conclusion: We conclude that laparoscopic sacral colpopexy with Prolene mesh is effective method to treat for the patients with vaginal vault prolapse after hysterectomy.

Key words : Laparoscopy, Vault prolapse, Sacral colpopexy