Curative Effect Analysis Of Autologous Vaginal Mucosal Flap Suspension For Anterior Vaginal Wall Prolapse

Objective:To compare the efficacy of autologous vaginal mucosal flap suspension and anterior vaginal wall repair for anterior vaginal wall prolapse,so as to provide reference for the selection of surgical procedure in clinical treatment.Methods:A total of 50 anterior vaginal wall prolapse patients admitted to First People's Hospital of Zhangjiagang in Jiangsu Province from January 2014 to June 2015were selected as subjects,who all met the quantitative grading criteria of pelvic organ prolapse implemented by International Continence Society.After informed consents on surgical procedures were obtained,patients were divided into two groups with the method of random number table.Patients of group A underwent transvaginal hysterectomy+autologous vaginal mucosal flap suspension and patients of group B underwent transvaginal hysterectomy+anterior vaginal wall repair.Surgical conditions of patients such as duration of operation,bleeding volume,postoperative hospital stay,duration of indwelling catheter and postoperative complications were recorded.Therapeutic efficacy and the effect of treatment on pelvic floor function were compared between two groups,and 1-year recurrence rate of patients was recorded by follow-up.SPSS19.0 statistical software was used for statistical analysis.Measurement data were expressed as(_x~-±s).The x~2 test was used for enumeration data.Results:1.The duration of operation was(65.2±36.2)min in group A,significantly longer than(40.2±15.6)min in group B(P<0.05).There was no statistically significant difference between two groups in bleeding volume(P>0.05).There were no statistically significant difference between two groups in postoperative first anal exhaust time and postoperative duration of indwelling catheter and average hospital stay(P>0.05).2.A group cure rate was 100.0%,was significantly higher than that of 80.0%in group B(P<0.05).3.The perioperative complications included urinary symptoms,infection,pain and so on.The perioperative total incidence of complications was 16.0%in group A,significantly lower than 36.0%in group B(P<0.05).Other postoperative complications included new onset urinary tract symptoms,new onset urinary incontinence,pain,infection,rectal dysfunction and so on.The incidence of new onset urinary tract symptoms was 8.0%in group A,significantly lower than 32.0%in group B(P<0.05).4.Before treatment,there was no significant difference between two groups in pelvic floor dysfunction score(P>0.05).With treatment,pelvic floor dysfunction was reduced in both two groups(P<0.05),but group A improved significantly better than that of group B(P<0.05).After treatment,postoperative PFIQ-7 was significantly reduced(P<0.05).The PFIQ-7 was 9.5±5.6 in group A,lower than 13.4±6.7 in group B,the difference was statistically significant(P<0.05).5.The recurrence rate was 0%in group A,significantly lower than 20.0%in group B(P<0.05).The proportion of sexual life quality decline was 8.0%in group A,significantly lower than 24.0%in group B(P<0.05).Conclusion:In the treatment of anterior vaginal wall prolapse,autologous vaginal mucosal flap suspension treatment group,relative to the treatment group of anterior vaginal wall repair.Although operating time slightly longer,but does not affect postoperative recovery,and can significantly reduce the postoperative complications and postoperative recurrence rate,this study provides a certain reference significance for the operation in clinical application and popularization.