摘要目的:探讨经阴道植入网片盆底重建术远期网片相关并发症的发生情况和治疗结局。方法:对2010年7月至2012年6月间北京协和医院收治的因重度盆腔器官脱垂接受经阴道植入网片的全盆底重建术（Prosima盆底修复系统）共48例患者，术后定期随访，前瞻性观察其中29例（随访率60.4%）接受了至少3年以上随访患者的远期网片相关并发症情况，探讨一般临床特点、分类以及治疗结局。结果:29例患者年龄为（65.1±5.2）岁，随访时间为（71.6±21.2）个月，末次随访时间为术后36~105个月。远期手术成功率为 79.3%（23例）。发生网片暴露累计18例（18/48，37.5%），其中10例（10/18）为远期新发和持续存在。4例（4/18）患者有不适症状，其余均为盆腔检查发现。10例（10/18）患者阴拭子培养结果阳性。1例严重网片并发症为网片侵蚀膀胱。4例（6.9%）患者术后疼痛。根据是否发生过网片暴露分为暴露组（18例）和无暴露组（11例），两组在阴拭子培养阳性结果比例差异具有统计学意义（ P=0.019），术后疼痛的发生率差异无统计学意义（ P=0.566）。 结论:经阴道植入网片盆底重建术（Prosima盆底修复系统）远期网片暴露的发生率不低，多数患者无症状。

abstractsObjective:To investigate the long-term mesh-related complications and treatment outcome of total pelvic reconstruction surgery with tension-free transvaginal mesh (PROSIMA TM pelvic floor repair system). Methods:From July 2010 to June 2012, 48 patients with severe pelvic organ prolapse(POP)who underwent PROSIMA TM were enrolled and treated in Peking Union Medical College Hospital. 29 patients (60.4%) were followed up periodically for at least 3 years to observe the occurrence of long-term mesh-related complications, and the clinical characteristics, classification of complications and treatment outcome of these cases were summarized. Results:The 29 cases with an average age of (65.1±5.2) years were followed up for an average of (71.6±21.2) months. The last follow-up was 36-105 months after treatment. The long-term success rate of the treatment was 79.3% ( n=23). There were 18 cases of mesh exposure (18/48, 37.5%), of which 10 cases (55.6%) were new and persistent. 4 cases (4/18) had symptoms; the rest were found by pelvic examination. Ten patients (10/18) were positive for vaginal swab culture. As for treatment outcome, one case suffered from mesh erosion into the bladder. 4 patients (6.9%) complained of postoperative pain. Twenty-nine patients were divided into the exposure group ( n=18) and the non-exposure group ( n=11) according to mesh exposure occurrence. There was a significant difference in the proportion of positive swab culture results between the two groups ( P=0.019), but no significant difference in the incidence of postoperative pain ( P=0.566). Conclusion:The incidence of long-term mesh exposure in PROSIMA TM is not low, and most of patients with which had no symptoms.