Uterosacral Ligament Lord-Vaginal Ring Reconstruction For Pelvic Organ Prolapse

Part OneUterosacral ligament lord-vaginal ring reconstruction in the treatment ofpelvic organ prolapse clinical researchObjective To study the effects of sacral ligament lord-vaginal ringreconstruction in the treatment of POP-Q stage I and the life quality of the patientsafter this reconstruction surgury.Methods60patients with uterus benign lesion and pelvic organ prolapsed(POP-Qstage I) together were chosen randomized, in which30underwent trans-abdominalhysterectomy(TAH) and multi-plane utero-sacral ligament and cardinal ligamentsuspension surgery (suspension group),the other thirty women were just underwentTAH(control group). POP-Q points and the length of the vaginal were measured forevery patient before the surgery,and at postoperative one month,trimester and sixmonths to judge the curative effect,and the quality of life questionnaire of theprolift floor(PFDI-20) were used to investigate the life quality of the patients.Results The disease distribution,POP-Q points and the PFDI-20before thesurgery had no obvious differences in these two groups（P>0.05）. After operationthere were significant improvements in the stage of prolapse. The POP-Q scores forpoints Aa,Ba,Ap,Bp and C of suspension group were significantly further away fromthe hymen at postoperative one month,trimester and six months than compared withthe control group values[Aa:(-2.51±0.49)cm,(-2.41±0.49)cm,(-2.46±0.49)cm vs(-1.97±0.97)cm,(-1.95±0.15)cm,(-1.98±0.15)cm.Ba:(-2.90±0.30)cm,(-2.86±0.34)cm,(-2.88±0.31)cm vs(-2.50±0.41)cm,(-2.41±0.43)cm,(-2.43±0.44)cm.Ap:(-2.40±0.57)cm,(-2.36±0.57)cm,(-2.46±0.58)cm vs(-1.81±0.30)cm,(-1.83±0.30)cm,(-1.86±0.36)cm.Bp:(-2.86±0.31)cm,(-2.90±0.27)cm,(-2.86±0.29)cm vs(-2.36±1.01)cm,(-2.35±1.00)cm,(-2.30±1.01)cm.C(-8.13±0.68)cm,(-8.11±0.75)cm,(-8.18±0.68)cm vs(-7.15±1.27)cm,(-6.90±1.27)cm,(-6.81±1.24)cm,P<0.05].There were significantimprovements on suspension group than the control group on scores of life qualityof life questionnaire of the prolift floor(PFDI-20) at postoperative onemonth,trimester and six months[(35.57±9.87),(33.63±9.66),(32.23±9.42)vs(43.37±5.82),(43.20±5.85),(44.73±6.14), P<0.05].Conclusion Suspension surgery had significantly greater effect at POP-Q stageI and obvious benefit for reducing postoperative bladder, intestinal and pelvicsymptoms, it is a economic and simple operation,is worth of clinical promotion. Part TwoUterosacral ligament Lord-vaginal ring reconstruction in the prevention of pelvicorgan prolapse after hysterectomyObjective To study the clinical effects of sacral ligament Lord-vaginal ringreconstruction in the prevention of pelvic organ prolapse after hysterectomysurgery.Methods50patients with uterus benign lesion were chosen randomized, in which20underwent TAH and Sacral ligament lord-vaginal ring reconstruction surgery(suspension group), the other thirty women were just underwent TAH(control group).POP-Q points and the length of the vaginal were measured for every patient beforethe surgery,and at postoperative one month,trimester and six months to judge thecurative effect,and the quality of life questionnaire of the prolift floor(PFDI-20)were used to To investigate the life quality of the patients.Results The disease distribution, POP-Q points and the PFDI-20before thesurgery had no obvious differences in these two groups（P>0.05）. After operationthere were significant improvements in the stage of prolapse. The POP-Q scores forpoints Ap,Bp and C of suspension group were significantly further away from thehymen at postoperative trimester and six months than compared with the control groupvalues[Ap:（-3.00±0.00）cm，（-2.80±0.41)cm vs (-2.86±0.31)cm,(-2.55±0.49)cm.Bp:(-3.00±0.00)cm,(-2.95±0.22)cm vs (-2.98±0.09)cm,(-2.81±0.36)cm,P<0.05].The two groups had no obvious differences on points Aa，Ba and Cat postoperative one month,trimester and six months[Aa:(-3.00±0.00)cm，（-2.82±0.37） cm，（-2.70±0.47)cm vs(-2.96±0.18)cm,(-2.86±0.34)cm,(-2.76±0.43)cm.Ba:(-3.00±0.00)cm,(-2.97±0.11)cm,(-2.87±0.31)cm vs(-2.98±0.09)cm,(-3.00±0.00)cm,(-2.90±0.30)cm, C(-8.75±0.41)cm,(-8.82± 0.37)cm,(-8.20±0.65)cm vs(-7.98±0.72)cm,(-7.20±2.74)cm,(-6.50±0.97)cm,P>0.05]. There were significant improvement on suspension group than thecontrol group on scores of life quality of life questionnaire of the proliftfloor(PFDI-20) at postoperative one month,but had no diference at trimester andsix months.Conclusion Suspension surgery had significantly greater effect in theprevention of pelvic organ prolapse after hysterectomy and obvious benefit forreducing postoperative bladder, intestinal and pelvic symptoms, it is a economicand simple operation,is worth of clinical promotion.