The Observation Of Morphological Changes Of Pelvic Floor Structure After Pelvic Floor Reconstruction By MRI

Objectives:The research on the application of repair patch in female pelvic floor reconstruction III-IV degree pelvic organ prolapse underwent preoperative postoperative pelvic MRI, objective evaluation of pelvic floor tissue anatomical changes and postoperative reduction, combined with postoperative quality of life function of subjective score, postoperative POP-Q score changes,reached on postoperative patients with pelvic organ prolapse curative effect make subjective and objective comprehensive evaluation, explore patch implantation pelvic reconstructive surgery applications Avaulta Solo pelvic floor repair system after pelvic floor structure of the anatomical and functional changes, evaluate the safety and efficacy of the surgical plan.Methods:Select 35 patients with Level III-IV pelvic organ prolapse, who were taken in the gynaecology department of the people’s hospital of shenzhen city from October 2013 to Janyary 2015 and was treated with pelvic floor revascularization operation and completed the follow-up investigation,as experimental group. Take 15 benign tumor patients without pelvic organ prolapse, as the controlling group. By comparing the following clinical evaluation index of the 35 patients themselves’ before and after the surgery and between the experimental group and controlling group: the preoperative, postoperative pelvic mri examination and related indicators, pelvic floor dysfunction questionnaire(PFIQ- 7),(PFDI- 20), and sexual questionnaire(PISQ- 12), to evaluate the effectiveness and safety of treating pelvic organ prolapse with the pelvic floor revascularization operation.Results:1. The numbers of LHS、ICA and LPA in experimental group after the operation all got smaller than before the operation(P<0.05), but the number of ICT and PRT didn’t show significant change(P>0.05)。2. By MR scanning the pelvic, under resting and valsava status, significant differences on the Levator ani hiatus size(A), the average thickness of the Puborectalis thickness(C), Levator plate angle(γ°)、Iliococcygeus thickness、the length of H-line、M-line,the highest abdominal pressure of LPA, LHS and the M line of the POP patients, was detected, P<0.05. No significant difference was detected on all indicator in the controlling group.3. The POP-Q indicators of the III-IV degree pelvic organ prolapse patients changed significantly after the operation. Each anatomic operation point improved comparing with beforethe operation, especially in front and middle pelvic cavity anatomic operation points,the difference had statistical significance(P<0.01);postoperative compared between two groups,no significant statistical significance(P>0.05).Conclusions:1. Comparison pop patients before operation and the control group in the resting state and Valsava state MRI measurement index, it is discovered that pop patients with anal provided muscle fissure area increases, puborectalis muscle was significantly impaired, the iliococcygeus muscle rupture sparse and anatomical structure of pelvic floor changed obviously.2. Pop patients after operation in the resting state, the PRT, ICA compared with the preoperative without significant changes, other indexes were compared with preoperative improve; Valsava PRT is still no obvious change, the rest of the index were compared with the preoperative improvement3. The POP-Q score of each anatomic indicator after pelvic floor reconstruction was improved compared with preoperative, and it was obvious that the anatomic site of the pelvic floor was significantly4. After pelvic floor reconstruction, the patients often had some improvement of urinary and defecation, and the quality of life improved.