Research On Influencing Factors For Post-operative Recovery After Pelvic Organ Prolapse

Objective The surgical treatment of pelvic organ prolapse is increasingly diversified,and how to choose appropriate surgical procedures is a problem to be solved.The purpose of this study is to compare the advantages and disadvantages of different operation methods and analyze the factors for postoperative recovery of patients suffering from pelvic organ prolapsed by comparing the clinical effects of different operations,which can better assist in guiding treatment.Methods We retrospectively collected the patients undergoing POP surgery in a tertiary hospital from 2009 to 2016.The operation methods includes semi-closed reduction of vagina,laparoscopic vaginal stump suspension,laparoscopic vaginal hysterectomy for preserving uterus,Manchester operation,laparoscopic assisted vaginal hysterectomy and transvaginal hysterectomy + ligament suspension.We analyzed the age,BMI,menopause time,mode of delivery,time of pregnancy and delivery,uterine prolapse grading,operation method,operation time,the length of hospital stay,intraoperative blood loss,the length of hospital stay after operation,complications and other information of different patients and compared the differences in operation time,intraoperative blood loss,the length of hospital stay and the length of hospital stay after operation between different operation methods.We choose the basic conditions of different patients as the arguments and analyzed the factors influencing the postoperative recovery of patients with pelvic organ prolapsed by non conditional Logistic regression model.Results In this study,we systematically analyzed the clinical efficacy of 326 cases of patients undergoing POP surgery in a tertiary hospital.The results display that the operation time of laparoscopic uterine suspension(94.34±27.95)min(t=6.476,P<0.001)was lower than that of vagina suspension(155.22±46.41)min,but was higher than that of vaginal semi-closed surgery(58.38±26.25)min,with significant difference(t=5.128,P=0.005).In the terms of bleeding during operation,the laparoscopic uterine suspension group(43.13±37.01)m L was lower than other groups and the difference was statistically significant(P<0.001).In the time of postoperative hospitalization,the laparoscopic uterine suspension group(4.42±2.29)d was lower than the laparoscopic vagina suspension group(5.46±1.12)d(t=5.191,P<0.001)and the Manchester operation group(6.50±1.30)d(t=9.370,P<0.001),the difference was statistically significant.The result of non conditional logistic regression model shows that age less than 60 years old(OR=0.79,95%CI: 0.543-0.850)and cesarean section(OR=1.17,95%CI:0.842-1.348)is the protective factor of patients with high objective cure rate after pelvic organ prolapse surgery.Conclusion By comparing the results of different operations,we find that the surgery time,blood loss and hospital stay of laparoscopic uterine suspension are superior to other surgical methods.The effect is obvious and exact.In the meantime,age and mode of delivery are important factors affecting the surgical treatment of patients with POP.