Vaginal Part Of The Closed Treatment Of Elderly Patients With Severe Pelvic Organ Prolapse,12Cases Of Clinical Efficacy

Objective: Clinical observation of patients with severe pelvic organ prolapsesurgery closed12cases of vaginal part, analysis and evaluation of vaginal partialclosure of the clinical subjective and objective efficacy of the treatment of senile severepelvic organ prolapse (POP).Methods: collection Dalian Central Hospital gynecology in hospital in August2010to March2012,12cases of elderly patients with severe pelvic organ prolapsetransvaginal partial closure of the treatment of patients, patients using the InternationalContinence Society in1996(International Continence Society,ICS) announced thatpelvic organ prolapse quantitative method [1](pelvic organ prolapse quantitiveexamination, POP-Q), are III-IV of the average age of75.7±3.1years (71-81years),of which9patients (75%), accompanied by medical complications. Among12patients,9cases of uterine prolapse, prolapse of vaginal stump after hysterectomy two cases, theanterior vaginal wall prolapse, four cases of posterior vaginal wall prolapse three cases.Merge dysuria in12cases (100%), difficulty in defecation in8cases (67%), stressurinary incontinence in7cases (56%).12patients,10cases (83%) the uterus, the linevaginal hysterectomy resection and vaginal part of the closed technique, the remainingtwo cases (17%) uterine transvaginal partial closure technique. After one month and sixmonths follow-up to observe the results of operations to evaluate the clinical subjectiveand objective efficacy.Results:12patients, mean operative time was127.5±61.4min (60-180) min andthe average intraoperative blood loss was116±77.8ml (50-300) ml, Vice injury anddeath in patients with intraoperative.12cases of patients with postoperative residualurine volume (5-250) ml, merge urination, defecation difficulties and stress urinaryincontinence caught improved. One cases of12patients1week after cholecystectomydue to gallstone line, die because they can not tolerate surgery, another11cases of patients1month to outpatient review, the total length of the average vagina, Yin cracklength, respectively.(3.4±1.1)(2.3±0.5) cm, significantly less than before surgery(8.3±0.7)(4.2±0.9) cm, the difference was statistically significant (p <0.05); perinealbody length (3.5±0.9) cm, significantly greater than the preoperative (1.5±1.2) cm,the difference was statistically significant (p <0.05),11cases of postoperative POP-Qstage≤Ⅰ, no recurrences, and objective cure rate of100%. After six months using theInternational the incontinence Advisory Committee incontinence questionnaire(ICI-Q-LF), and according to our habits and the actual situation of self-designedquestionnaire of11patients, including one case less than months after operation,postoperative quality of life significant improvement in subjective satisfaction rate of100%.Conclusion: The vaginal part of the closed treatment of elderly patients withsevere pelvic organ prolapse patients with the main objective success rate, frail elderly,the merger is the more serious complications, can not tolerate a larger surgery, vaginalintercourse requirements of a safeeffective, satisfaction with the good procedure, andshould be widely applied.