| Objective: To investigate the short-term clinical efficacy of uterus conservationand hysterectomy in pelvic reconstructive surgery.Method:From September2007to September2011,there are63patients in DalianObstetrics and Gynecology Hospital of different defects in women with pelvic organprolapse. According to pelvic organ prolapse POP-Q stage and with the exception ofvaginal vault prolapse, they were III—IV period. According to age, disease severity,with or without complication and the willingness of patients to choose a reasonableoperation mode, respectively apply add mesh with preservation of the uterus (group UC)and hysterectomy (group CH) of the pelvic floor reconstruction operation. Compare thepostoperative treatment efficacy of two groups of patients. During operation periodindex, preoperative POP-Q staging and PFDI-20(pelvic floor distress inventory-shortform20) as the main objective to evaluate the postoperative short-term cure rate ofsubjective and objective.Results:(1)No significant differences emerged in demographic and clinicalcharacteristics between the UC group and CH group (P>0.05).(2)Operating time,operative hemorrhage, in-hospital time post-operation of the two group had significantdifference (P <0.05). Mean operating time of UC group(80.73±29.68minutes) wassignificantly less than CH group (114.03±26.59minutes); mean operative hemorrhageloss was obviously less in UC group (103.94±67.87ml) than in CH group(165.33±71.62ml); mean in-hospital time post-operation was significantly less in UCgroup (7.42±2.18days) vs (8.87±2.22days) in CH group. Retain urine tube days of thetwo group had no significant difference (P>0.05), UC group retain urine tube (5.42±2.14days), CH group retain urine tube (6.30±2.04days).(3)No significantdifferences existed in POP-Q scores of Aa, Ba, C, Ap, Bp, D, gh, pb and tvl betweenCH and UC group preoperative (P>0.05). Various points values in the two groups aftersurgery compared，in addition to tvl，the remaining points was not statisticallysignificant (P>0.05). The CH group vaginal length was shorter after operation than theUC group,the difference was statistically significant (P <0.05).Two groups beforesurgery and after surgery, the POP-Q for each point value compared,in addition to UCgroup of tvl,the differences were statistically significant (P<0.05),but there were nostatistical significance on tvl in group UC(P>0.05).No significant differences existed inpreoperative PFDI-20score between CH group and UC group preoperative (P>0.05),compared with the preoperative, scores of PFDI-20in the two groups after the operation6months and12months were significant differences (P<0.05). While no significantdifferences presented among scores at different postoperative time (P>0.05),whichshows that the two groups had similar result. The mean follow-up time was27months(6-51months). To the end of the follow-up to, subjective cure rate of UC group was93.94%, and objective cure rate90.91%,3cases relapse, the recurrence rate was9.09%,subjective cure rate of CH group was83.33%, and objective cure rate80%,6cases relapse, the recurrence rate was20%. Two groups of each have one case of meshexposed, two groups were no postoperative infection and mesh erosion occurred.Conclusion:1Uterus conservation group has shorter operating times, lessoperative hemorrhage and postoperative rehabilitation faster, that is useful for reducingthe perioperative risks middle-aged and old women.2The pelvic reconstructivesurgery which uterus conservation and hysterectomy is an effective method of treatmentof POP, short-time clinical cure rate is similar between the subjective and objective.3The pelvic reconstructive surgery with uterus conservation is meaningful to maintainpelvic stable structure. It has a definite short-term effect, while its long-term effect、complications and impact on patients’ quality of life needs further long-term follow-upobservation. |
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