Long-term Effect Of Laparoscopic Sacral Colpopexy In The Treatment Of Pelvic Organ Prolapse

Objective: To investigate the long-term clinical efficacy of laparoscopic sacral colpopexy(LSC)in the treatment of pelvic organ prolapse(POP).Methods: A retrospective study was conducted on 106 patients with moderate to severe pelvic organ prolapse treated by LSC at the Second Hospital of Hebei Medical University from October 2008 to October 2016.The changes of the anatomical indication points of POP-Q(pelvic organ prolapse quantitation)were compared before and after operation.Pelvic Floor Distress Inventory-short form(PFDI-20)and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire(PISQ-12)were used to evaluate the impact of surgery on the quality of life and sexual life of patients with pelvic floor dysfunction before and after operation.Meanwhile,the occurrence of surgical complications was observed and try to analyze the cause.Results:1 Anatomical effect: There were statistically significant differences in the anatomical indication points between preoperative and postoperative POP-Q(P<0.05).There were no significantly differents in all time points after operation(P> 0.05).2 Functional effect:The scores of PFDI-20 and PISQ-12 were statistically significant(P <0.05);There was no significant difference in CRADI-8 scores((P> 0.05).3 Complications:(1)Intraoperative complications:1 case suffered from sacral anterior venous injury.(2)Recent complications:3 cases had lower abdomen bulge;6 cases with secretions increased;5 cases with lumbosacral pain,of which 1 case severed with pain and fever returned to hospital for treatment;3 cases was found postoperative urinary retention.(3)Long-term complications: 5 cases suffered from mesh exposure;1 case had erosion of therectum;3 cases severed with sexual dysfunction and pelvic pain;4 cases of postoperative vaginal anterior wall prolapse ? degree,2 cases of posterior vaginal prolapse ? degree;5 cases had new constipation;16 cases had new stress urinary incontinence;2 cases had new urinary incontinence symptoms;1 case had new mixed urinary incontinence symptoms;3 cases had new urinary frequency.Conclusion: LSC is a safe,minimally invasive and less complicated surgical approach to the treatment of pelvic organ prolapse,not only to restore anatomical reduction,but also to meet the physiological needs of patients,improve clinical symptoms and improve the quality of life.