The Analysis Of Anxiety,depression And Quality Of Life Before And After Operation In 113 POP Patients

Objective:1.To understand the preoperative anxiety and depression of patients with moderate to severe pelvic organ prolapse;2.To explore the changes of anxiety,depression and quality of life in pelvic organ prolapse patients before and after surgical treatment;3.Provide references for the timely psychological treatment and intervention of pelvic organ prolapse patients after surgical treatment in the future.Method:It prospective analyzes 113 patients with pelvic organ prolapse who are treated with surgery from February 2017 to August 2019 in the first affiliated hospital of kunming medical university.There are some inventories,as The POP-Q scores,the Hamilton Anxiety Scale and the Hamilton Depression Scale,the patient global impression of improvement,the pelvic floor distress inventory short form 20,which including the pelvic organ prolapse distress inventory 6,the colorectal-anal distress inventory 8 and the urinary distress inventory 6,being performed and compared before and after operation.Also to calculate the minimal clinically important differences of each scale.Results:1.All patients with pelvic organ prolapse successfully complete the surgery,and 99.12%(112/113)patients show have an improvement compared with those before surgery with the patient global impression of improvement.2.The value of the POP-Q scores after surgery are significantly improved compared with those before surgery,and the difference is statistically significant(P<0.05).3.PFDI-20 score:the MCID value of PFDI-20 is 81.70,POPDI-6 was 24.79,CARI-8 is 8.69,and UDI-6 is 34.50.The scores of patients 3 months and 6 months after the surgery are lower than that before the surgery(P<0.05),and the change value of the score is higher than it's MCID,and the change has clinical significance.Among which,the score of subscales pelvic organ prolapse distress inventory 6 and urinary distress inventory 6 are reduce more obviously than the colorectal-anal distress inventory 8.4.HAMA score:The MCID value of HAMA is 3.91.The preoperative HAMA scores shows that,5%(6/113)patients have severe anxiety,26%(29/113)patients have moderate anxiety and 60%(68/113)patients have mild anxiety.Postoperative anxiety symptoms are improved being compared with those before surgery,and the difference is statistically significant(P<0.05),and the score variation is greater than it's MCID,the change has clinical significance.However,compare with the anxiety symptoms in the 3 months after surgery,it is significantly worse in the 6 months after surgery,and the difference is statistically significant(P<0.05).5.HAMD score:The MCID value of HAMD is 2.25.There are 38%(43/113)patients have mild depression before surgery,when 3 months after surgery,there are 15%(17/113)patients.And 16%(18/113)patients have mild depression at 6 months after surgery.The HAMD scores after surgery is statistically significant compared with that before surgery(P<0.05),the score variation is more over its MCID,and the change has clinical significance.Also the HAMD score at 3 months after surgery is not statistically significant compare with that at 6 months after surgery(P>0.05).Conclusions:1.Patients with moderate to severe pelvic organ prolapse have different degrees of anxiety and depression before surgery.Most of the patients have anxiety symptoms,mainly patients have mild to moderate anxiety,and some patients have mild depression.After the objective cure through surgical treatment,the anxiety and depression symptoms of moderate to severe pelvic organ prolapse patients are improved;2.With the extension of postoperative time,pelvic organ prolapse patients with surgery may have new anxiety problems;3.Symptoms caused by prolapse and symptoms of lower urinary tract in patients with moderate to severe pelvic organ prolapse have a greater impact on their quality of life;4.After the objective cure of surgical treatment,the patients' quality of life is improved.