Transcription of 第67回⽇本産科婦⼈科学会学術講演会 ... - UMIN
1 67 .. 26 4 22 .. 20 59 Samuelsson EC,1999. 50 , US Hendrix SL,2004. 50 US Olsen AL,1997.. US Olsen AL,1997. 1 Sammuelson EC et al. Am J Obstet Gynecol 1999;180:299-305. 2 Hendrix SL et al. Am J Obstet Gynecol 2002;186:1160-1166. 3 Olsen AL et al Obstet Gynecol 1997;89:501. 1997;89:501-506. 506.. QOL .. Sub Speciality .. Delancey JOL: AM J Obstet Gynecol 1992: 1717.. DeLancey .. DeLancey .. Level 1.. Level . Level .. DeLancey .. Level . Level .. Level 2.. DeLancey .. Level 3. , . Level3 .. POP-Q . POP-Q .. +3Aa +9Ba +9C. 9tvl +3Ap +9Bp +9D. POP-Q Stage . POP-Q .. 59 2 . +3Aa + +5C. 6gh 3pb 7tvl -2Ap 0Bp +2D. POP Q Stage . POP-Q Stage .. 60-90 .. N ti Tissue Native Ti R i . Repair . Tension-free Tension free Vaginal Mesh Mesh, TVM . Laparoscopic Sacrocolpopexy, LSC .. Native tissue repair .. M. Manchester . h t .. McCall . Shull . Inmon.
2 Native Tissue Repair . McCall .. 20-40%. 60% .. Olsen et al : Obstet Gynecol 1997. Sh ll ett al:l Am Shull A J Obstet Ob t t Gynecol G l 1992. Holley et al: South Med J 1995. Samuel et al: Am J Obstet Gynecol 1999. Shull et al: Am J Obstet Gynecol 2000. Weber Et L: Int Urogynecol J Pelvic Floor Dysfunc 2001. Native Tissue Repair .. Tension-free Tension free Vaginal Mesh (TVM) .. TVM Study Group . Tension-free .. Site specific . TVM Technique . FDA Public Health Notification Serious S i C. Complications li ti associated i t d with ith Transvaginal Placement of Surgical Mesh in Repair of POP and SUI. 2008 2011 FDA .. Erosion through vaginal epithelium Infection Pain Urinary problems Recurrence of Prolapse and/or Incontinence Bowel Bladder Bowel, Bladder, Blood Vessel perforation during insertion Erosion QOL .. overall health of the patients, the mesh material, the size and shape of the mesh, surgical technique used used, concomitant procedures ( (e g hysterectomy), hysterectomy) possibly estrogen status.
3 Stage .. --------------- .. ----- .. ---------------- .. 1960 .. Laparoscopoic Sacrocolopexy, LSC .. 28 4 1 .. CQ : .. LSC .. Native . Tissue Repair .. IC.
