| Objective:The clinical efficacy and safety of the treatment of severe pelvic organ prolapse(pelvic organ prolapse,POP)in elderly female patients with colpocleisis were followed up.Method:Methods from December 2009 to December 2016,the clinical data of 43 elderly patients with severe POP who were treated with colpocleisis in Hebei People's Hospital were retrospectively analyzed.Through access to medical records,records of patients with anesthesia,the operation time,bleeding volume during surgery and postoperative hospitalization days,the operation and the postoperative complications;before and after operation were performed on patients with POP-Q(pelvic organ prolapse quantitation,POP-Q)classification,and pelvic floor dysfunction symptoms the questionnaire(pelvic floor distress Inventory-Short Form 20,PFDI-20),pelvic floor dysfunction questionnaire(life impact questionnaire life for pelvic floor disorders,PFIQ-7)and patients with subjective satisfaction and regret ratio,make a comparison,records of patients with pelvic organ prolapse symptoms and impact on life.Result:1.Operation related conditions:(1)the amount of bleeding during the operation: the amount of bleeding was 50(80)ml during the operation,of which the amount of bleeding was greater than that of the 500 ml in 2 cases.(2)the operation time: 43 cases of patients with the average operation time was104.9 ? 27.4min,of colpocleisis and vaginal hysterectomy and single /bilateral adnexectomy,prolong the operation time,the difference was statistically significant(P<0.05).(3)postoperative complications: 3 cases of postoperative morbidity,relief after symptomatic and antibiotic treatment,2cases with postoperative mild pelvic distention,all of which were relieved at 2months after operation.(4)the recurrence rate: 1 cases of patients withpreoperative IV prolapse after 2 month prolapse recurrence,POP-Q score III,again for closed surgery;5 patients with stress urinary incontinence patients in1 patients after 16 months of stress urinary incontinence(Stress urinary incontinence,SUI),were treated with Transobturator Vaginal Tape Inside-out,TVT-O,improved after treatment;(5)patients with stress urinary incontinence after surgery in 2 cases(4.7%);2 cases of patients with frequent urination(4.7%);3 cases of patients with urinary urgency(7%);no patients experienced difficult defecation and incontinence after surgery.2.POP-Q score: preoperative POP-Q score was IV degree prolapse in 23 patients,III degree prolapse in 20 patients,except for 1 patients with IV prolapse before surgery,the prolapse recurred to III degree,the remaining 42 cases POP-Q scores were 0 degrees.3.subjective symptoms and questionnaire results: postoperative pelvic floor distention and urethral and intestinal pelvic organ prolapse symptoms were significantly improved compared with those before operation,the difference was statistically significant(P<0.05).There was no significant difference in the symptoms of stress urinary incontinence between the patients before and after operation(P > 0.05).The scores of PFDI-20 and PFIQ-7 were compared before and after operation.The total score and each subscale score showed that the POP symptoms and the influence on life were significantly improved after operation,and the differences were statistically significant(P<0.05).To the last follow-up after operation,the objective cure rate of all patients was 97.7%,and the subjective cure rate was 97.7%.Conclusion:Colpocleisis is a classic surgical procedure for the treatment of severe pelvic cavity organ prolapse in elderly women without vaginal life requirement.It has the advantages of safety,effectiveness and low recurrence rate.It can obviously improve the symptoms of patients with pelvic organ prolapse,effectively alleviate the symptoms of urethra and intestinal discomfort,and significantly improve the quality of life of the patients. |
PDF Full Text Request