Clinical Research Of Prolift And Avaulta System In The Anterior Pelvic Floor Reconstruction

Objectives:Evaluate the clinical effect of Prolift and Avaulta systems in the anterior pelvic floor reconstruction.Methods:Collected patients with a total of 43 cases as the research object during the period of March 2010 to December 2014 who have anterior vaginal wall prolapse with various degree of uterine prolapse.All of this patients were admitted to have gynecological surgery in hospital. 25 cases of this patients taken the anterior pelvic reconstruction with Prolift and 18 cases with Avaulta,while this patients have stress incontinence,TVT-O would be taken simultaneously. Compare two groups of patients with the clinical data, intraoperative and postoperative conditions, complications, follow-up recurrence rate and other indicators, and describe the objective response of the pelvic floor reconstructive surgery. Pelvic organ prolapse Quality of Life Questionnaire(P-QOL) scale was been filled before and after surgery to assess the impact of POP on the quality of life and to subjectively evaluate the efficacy of postoperative review.Results:1. The two groups, general information such as the age, body mass index, delivery times, menopause years, has no statistically significant(P> 0.05).2. Perioperative case comparison results: perioperative blood loss results contrast to the Prolift group(54.23 ± 21.97) ml and Avaulta group(35.56 ± 14.24) ml, the difference was statistically significant(P <0.05).3. Clinical efficacy :the postoperative POP-Q stage improved in the two groups compare with the preoperative, especially Aa, Ba point and C point significantly corrected compared to before the surgery, reproductive tract gh hole length was significantly shorter. Differences were statistically significant(P <0.05).4. Recurrence rate and complication rate: two groups of patients were followed up for 4-12 months and the follow-up rate was 100%. Prolift group of 25 patients had 2 patients recurrent one after 3 months and other after 1 year with anterior vaginal wall prolapse Ⅱ degree, the recurrence rate of 8%; 1 cases appear mesh exposure, 3 months after the surgery,the incidence was 4%, the symptoms improved after trimmed the exposed mesh and use estriol ointment. In Avaulta group,one patient relapsed 1year after the surgery with Cervical extended and posterior vaginal wall prolapse, the recurrence rate was 5.5%. 1 case with the emergence of SUI 1 year after the surgery, the incidence was 5.5%.5. Preoperative P-QOL scale score has no statistically significant difference between the two groups; compare preoperative and postoperative scale score within the groups was statistically significant difference(P <0.01), showed that Prolift and Avaulta pelvic floor reconstruction were significantly improved postoperative quality of life of patients.Conclusion:The anterior pelvic floor reconstruction wiht Prolift and Avaulta mesh has definite short-term effect, but long-term recurrence rate and complications still need further study and expand the sample According to the relevant literature and herein we recognize that two groups of meshes repair systems treat POP with good anatomical recovery effect, and also significantly improve the quality of life of patients. Accumulation of surgical experience of surgeon is an important factor affecting surgical treatment.