Comparison On Clinical Effctivess Of Anterior Pelvic Reconstruction Combined With Colporrhaphia Posterior And Total Pelvic Reconstruction

Female pelvic organ prolapse is a kind of common disease that serious influence the daliy life of the patients.The surgical is one of the method to the severe POP.So far,there were diverse operations.Each has its advantages and disadvantages.In recent 10 years,total pelvic reconstruction has been widely used in patients with severe POP,espacially in the anterior and posterior vaginal walls.Objective:In this paper,the clinical efficacy of anterior pelvic reconstruction combined with colporrhaphia posterior and total pelvic reconstruction in the treatment of patient with pelvic organ prolapse was compared to evaluate its efficacy and safety.Methods:Fifty patients who had taken operations in the department of gynecology of the Chengde Medical College Affiliated Hospital bacause of severe POP from February 2014 to February 2017.The anterior pelvic reconstruction combined with colporrhaphia posterior were performed in thirty cases(Group A),and total pelvic reconstruction was performed in twenty cases(Group B).All patients were classified by the international pelvic organ proalpse staging system(POP-Q)at the stage ?~?.There were no significant differences between two groups in general data(P>0.05).Patient were followd at 3-months,6-months and 12-months after the operation.Less than stage ?prolapse at all vaginal sites as scored by the international pelvic organ proalpse staging system(POP-Q)were defined as the objective success.The pelvic floor impact questionnaire-short 7 were used to assess preoperative and postoperative quality of life,the higher the score,the greater the impact on the quality of one's life.The quality of one's sexual life was evaluated by pelvic organ prolapse/urinary incontinence sexual questionnaire(PISQ-12)before and after surgery,and the more the score,the better the quality of sexual life.The patient global impression of improvement questionnaire was used to evaluate patient's subjective satisfaction.The safety and financial burden of the surgery were evaluated by blood loss,operation time,mean hospitalization days,mesh exposure,pelvic floor prolapse recurrence,dyspareunia ect.It was considered to be statistically significant that P<0.05.Results:1.The objective cure rate and subjective satisfaction of the two groups in 3-months,6-months and 12-months after operation did not differ between the two groups(P>0.05).2.There was no significant difference between the two groups of pre-operation PFIQ-7 questionnaire scores and pre-operation PISQ-12 questionnaire scores.The score of postoperation PFIQ-7 questionnaire was gradually reduced,the postoperation score of PISQ-12 was gradually increase.There was no significant difference between the two groups in the PFIQ-7questionnaire and PISQ-12 questionnaire(P>0.05).3.The mean time of operation,blood loss and average indwelling catheter of anterior pelvic reconstruction combined with colporrhaphia posterior were less than total pelvic reconstruction,and the difference was statistically significant(P<0.05).4.There was no significance for the incidence of postoperative network exposure,POP recurrence and dyspareunia of the two groups(P>0.05).Conclusion:The anterior pelvic reconstruction combined with colporrhaphia posterior is comparable total pelvic reconstruction.However,the average operation time,blood loss and average indwelling catheter time and hospitalization cost of the anterior pelvic reconstruction combined with colporrhaphia posterior were less than total pelvic reconstruction,which was worth the clinical promotion.