The Comprehensive Evaluation Of The Treatment Of Prolift System And Laparoscopic Sacrocolpopexy In Servere Pelvic Organ Prolapse Surgery

Background and Objective:The Pelvic Organ Prolapse(POP) is one kind of The Pelvic Floor Dysfunction(PFD).With the development of society and the problem of population aging,the proportion of it is augment year by year,which caused serious influence on the healthy and quality of the life of the middle and aged women.The treatment of Servere Pelvic Organ Prolapse is surgery mostly,in recent years,the specialists at home and abroad have initiated varied operations,and the Prolift System and Sacrocolpopexy are frequently used in our hospital,in addition,the Laparoscopy is more and more skilled and perfect,it was used to the operation more frequently.The main purpose of this study is to contrast the clinical data of Prolift System and Laparoscopic Sacrocolpopexy in treatment of Servere Pelvic Organ Prolapse,to evaluate the advantages, disadvantages and indication of them.Materials and Methods:Forty-six patients who have undergone surgery to treat uterine prolapse with Pelvic Organ Prolapse Quantitive (POP-Q) Ⅲ～Ⅳ degrees at The First Affiliated Hospital of ZhengZhou University between March2011and May2012are analyzed in this study.Twenty-thire of them have undergone Prolift System (Group P), the others (23) have Laparoscopic Sacrocolpopexy (Group L). The data of general information, operation, perioperative,economics cost and efficacy in two groups are compared and analyzed respectively.Postoperative follow-up visits are arranged at one month, six months and one year after surgery.The POP-Q is objective assessment,and The Pelvic Floor Dysfunction Inventory (PFDI-20), Pelvic Floor Impact Questionaire (PFIQ-7), Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire Short Form(PISQ-12) are choosed to assess the effection of the operation to the quality of life and the quality of sexual life.Results:1.General information:Except the age and the period of menopause (P<0.05), there is no significant differences in the general information (P>0.05), the age of group L is younger;2.The index of operation, perioperation and complication:The operation time of group P is short of group L (P<0.05), there is no significant differencesin the index ofperioperation (P>0.05),Post-operatively,one case with acute urine retention,one case developed small bowel obstruction, the total rate of the complication is8.7%; in group L only one case with the puncture point pain in group P,the total rate of the complication is4.3%.3.Cure rate,satisfaction of patient, complication in the follow-up period:3.1The operation efficacy is based on the POP-Q,0degree is deemed to be the objective cure rate,and the summation of0dgree and I degree is deemed to be the subjective cure rate. In the two groups, both the objective and subjective cure rate of Group Pare100%; about Group L,both the objective and subjective cure rate at six months after the operation are100%, and the subjective cure rate at one year after operation is100%, the objective cure rate is95.65%.3.2In group P, scores of PFIQ-7,PFDI-20at six months and one year after the operation compared with the preoperative scores are significantly different (P<0.01), but the scores of PISQ-12at one year after operation(P>0.05);as to group L,scores of PFIQ-7,PFDI-20at six months and one year after the operation and PISQ-12at one year after operation compared with the preoperative scores are significantly different (P<0.01);the compation of the score of PFDI-20,PFIQ-7at six months and one year after the operation that is made between two groups is no significationly different(P>0.05);3.3There are3cases and lease (13.0%、4.3%) occurred sexual dysfunction in group P and group L respectively, the difference is no significant (P>0.05);4. Economic cost:The main difference of the economic cost is the mesh. The price of Gynecare Prolift is￥14463, which is higher than Gynercare Laparoscopic Sacrocolpopexy, the price of latter is￥3990. But the price of ultrasound knife which is used to incision posterior peritoneum in the latter is￥6000.Conclusions:1. Prolift System and Laparoscopic Sacrocolpopexy are all the effective treatment for severe POP. The short-term rate is high, but the long-term effect still need further follow-up and study;2. Prolift System relatively simple, it is fit for the old woman who do not need sexual life, but the cost is expensive; the cost of Laparoscopic Sacrocolpopexy is cheep and it is appropriate for more younger who need the sexual life, however the operation is complicate.