Evaluation Of Surgery Effect And Quality Of Life Of128Cases Of Patients With Pelvic Organ Prolapse

Objective: Pelvic organ prolapse(POP)is a common disease that affectwomen's quality of life seriously. Surgery is one of the important means totreat POP in moderate and severe degree. However, there were a variety ofoperation methods in present, and all of them could be divided into traditionaland modern procedures. But the long term effect of quality of life wasuncertain. In present study,128patients with POP who had taken operations inthe department of obstetrics and gynecology of the Second Hospital of HebeiMedical University were followed up, aiming to study the long-term quality oflife and effect of different operations, so as to provide the medical evidence toclinical practice.Methods: Data of191patients with POP who had taken operations in thedepartment of obstetrics and gynecology of the Second Hospital of HebeiMedical University from2001.1to2009.12were retrospectively analyzed(Including3cases who taken second surgery). Data of128patients werefinished, the rate was67%. The mean following up length was31.38months.In the study,72patients underwent traditional surgical techniques and56patients underwent modern surgical techniques. Questionnaire scores ofquality of life of pre-and post-operation were collected and evaluated. Wetook pelvic floor distress inventory-short form20(PFDI-20) to evaluate thequestionnaire scores. PFDI-20is the general method to assess the quality oflife of the POP patients, which includes3individual tables: pelvic organprolapse distress inventory6(POPDI-6), colorectal-anal distress inventory8(CRADI-8) and urinary distress inventory6(UDI-6).Results:1General informationThere were no significant difference between two groups in age, delivery history, body mass index(BMI), days in hospital and the menopausal rate(P>0.05). The mean following up time of the traditional group was42.92months, and the subjective recurrence rate was15.28%; The mean followingup time of the modern group was19.84months, and the subjective recurrencerate was12.24%, the subjective recurrence rates of the two groups did notshow significant difference (P>0.05). The amount of bleeding during operation(the median is100ml) in traditional surgical group was significantly lowerthan that in modern surgical group (the median is200ml)(P<0.05).2Comparing the quality of life of the two groups at pre-operationIn traditional group, the scores of POPDI-6and PFDI-20were lower thanthose in modern group(12.50vs18.78±8.24,20.88vs25.00,P<0.05). The scoresof CRADI-8and UDI-6did not differ between two groups(P>0.05).3Comparing the quality of life of the two groups at post-operationThe scores of POPDI-6,CRADI-8,UDI-6and PFDI-20after operation didnot differ between the two groups(P>0.05).4Comparing the quality of life of the same groups at pre-and post-operationThe scores of POPDI-6CRADI-8PFDI-20of the two groups inpost-operation were obviously improved. However, the scores of UDI-6intraditional group were only improved within5years post-operation, butworsen from the5thyear to the7thyear after operation.5POP-Q stage at pre-and post-operation5.1Anterior pelvic operationThere were11medical records of patients who had taken anteriorcolporrhaphy and8medical records of patients who had taken anterior pelvicreconstruction (including5improved pelvic reconstruction).In the anteriorcolporrhaphy group, the scales of Aa and Ba in post-operation were someimproved comparing with the scales before operation, but the improvement ofthe scale of Ba wasn't significant. However, both the scales of Aa and Ba weresignificantly improved after operation in the anterior pelvic reconstructiongroup.5.2Middle pelvic operation There were9medical records of patients who had taken high uterosacralligament suspension (HUS). After operation, the scale of C point wasobviously improved.5.2Posterior pelvic operationThere were14medical records of patients who had taken posteriorcolporrhaphy. The scales of Ap and Bp after operation were improved thanthose before operation, but both of them were not significantly improved.Conclusions:Both traditional surgical and modern surgical could improve the quality oflife of the patients who were suffering POP, the subjective recurrence rate ofthe patients who underwent traditional surgical wasn't higher than the patientswho underwent modern surgical. The improvement of lower urinary tractsymptoms in the patients who underwent traditional surgical was low in the5thyear after operation. The scales of Ba in modern surgical were better thantraditional surgical in2thyear after operation, but the long effect of the modernsurgical needs longer following up.