The Effect Evaluation Of The Modified Pelvic Reconstructive Surgery For Servere Pelvic Organ Prolapse

Objective:To evaluate the efficacy of the modified pelvic reconstructive surgery for servere pelvic organ prolapse.Methods:From Nov.2006 to Oct.2008,207 patients of pelvic organ prolapse quantitative for the uterine prolapseⅢ~Ⅳdegrees with different levels of vaginal prolapse were enrolled into groups by different operation methods:105 patients were treated with modified pelvic reconstructive surgery(the PRS group),102 patients underwent total vaginal hysterectomy and colporrhaphy (the vaginal hysterectomy group),intra-operative blood loss,operating time and post-operative hospital stay were compared, patients were assessed objectively (according to pelvic organ prolapse quantitive examination score) and subjectively(pelvic organ prolapse quality of life score) by following up at 3 months,6 months and 1 year after the operation.Results:(1)No significant differences emerged in demographic and clinical characte- ristics between the PRS group and the vaginal hysterectomy group;(2)Mean intra- operative blood loss,mean operating time and mean post-operative hospital stay was (90.56±46.41)ml,(75.28±21.87)min,(4.6±1.73)d in the PRS group,and(98.84±36.89) ml,(75.55±20.22)min,(5.33±1.35)d in the vaginal hysterectomy group respectively, Mean intra-operative blood loss and mean operating time are less in the PRS group than in the vaginal hysterectomy group,but no significant difference existed (P>0.05),mean postoperative hospital stay is significantly less in the PRS group (P<0.05);(3) the cure rates in the PRS group were respectively 94.12%,95.65% and 92.86% followed up at 3 months,6 months and 1 year after the operation,the vaginal hysterectomy group was 93.88%,88.89%,77.61%,no significant difference existed at 3 months and 6 months after the operation(P>0.05),significant difference existed 1 year after the operation(P<0.05);(4)scores of P-QOL in the two groups at 3 months,6 months and 1 year after the operation compared with the preoperative score were significantly different (P<0.01);between the two groups of comparison,no significant difference existed at 3 months,significant difference existed at 6 months and 1 year after the operation (P<0.05). Conclusions:Modified pelvic reconstructive surgery for treatment of severe pelvic organ prolapse can restore and strengthen the structure and function of pelvic floor support as well as uterine preservation;the surgery is a micro-invasive approach with shorter operating time and postoperative hospital stay, the surgery present good effect on improving the short term quality of life, the long-term effect need further follow- up.