Clinical Analysis Of Two Different Surgical Methods For Patients With Moderate To Severe Uterine Prolapse

Background and ObjectivePelvic organ prolapse(POP)refers to the pelvic floor support structure function weakened,missing,and damaged by adjacent organs,such as the uterus,bladder,rectum and other organs.To the abnormal area.It is one of the common gynecological diseases among middle-aged and elderly women.With the continuous development of society,the incidence of POP is increasing year by year,which brings many personal health problems and social psychological pressures.Surgery is an effective means of treating this disease.The purpose of the operation is to try to correct the anatomical defects of pelvic organ prolapse.At present,there are many surgical methods for the treatment of POP in clinical practice,and their respective clinical effects are reported to be inconsistent.For various types of POP surgery,how to individually select surgical methods,recognize the indications,and grasp the contraindications,in order to achieve reduction.Misdiagnosis and mistreatment,reduce the recurrence rate and reduce the serious complications.In this study,96 patients with moderate to severe uterine prolapse in our hospital were retrospectively analyzed.According to different surgical methods,they were divided into laparoscopic high uterine ligament suspension group and transvaginal sacrospinous ligament fixation group.Through the follow-up of the questionnaires PFDI-20,PFIQ-7,PISQ-12,etc.,the clinical evaluation of the surgical efficacy was analyzed to analyze the improvement of patients' quality of life and sexual life quality,and to explore the recurrence rate and advantages and disadvantages of the two different surgical methods.It has important guiding and practical value for the progress of surgical research on pelvic dysfunction diseases.The research results can promote patients' individualized choice,improve the quality of life,sexual life quality and satisfaction of patients with pelvic organ prolapse,and optimize POP surgery.The treatment strategy ultimately achieves the goal of benefiting women's reproductive health.Materials and methods 1.MaterialsFrom July 2016 to September 2017,96 patients with moderate to severe uterine prolapse diagnosed in the gynecological department of the Second Affiliated Hospital of Zhengzhou University were selected.All of them signed an informed consent form and approved by the ethics committee to exclude contraindications.The choice was divided into two groups.Group A: 48 cases of laparoscopic high uterine ligament suspension,and group B: 48 cases of transvaginal sacral ligament fixation.The POP-Q measurement method was used to measure the data of each indication point before operation,1 month,6 months and 1 year after operation,and the treatment effect and recurrence rate of the two groups were analyzed.The patient satisfaction was evaluated by PISQ-12 questionnaire.Quality of life,PFDI-20,PPFIQ-7 questionnaire to assess quality of life,VAS score to assess satisfaction;at the same time collect the patient's age,maternal parity,menopausal age,prolapse age,prolapse index and perioperative data,etc.The evaluation of the clinical short-term and long-term efficacy and advantages and disadvantages of the two surgical methods.2.Statistical methodsStatistical methods such as independent sample t test,paired sample t test,chi-square test,etc.were used to perform statistical analysis using SPSS 21.0 software.The test level was ?=0.05.Results1.There were no significant differences in age,maternal birth,menopausal time,sexual life needs,body mass index,prolapse time,prolapse degree,and preoperative POP-Q indication points(P>0.05).2.The postoperative POP-Q measurement points of the two groups were significantly different from those before operation(P<0.05),but there was no significant difference between group A and group B at 1 month and 6 months after operation(P>0.05),except for the C point of group B,there was no significant difference between the POP-Q measurement points and the postoperative 6 months(P>0.05).3.POP-Q measurement points before and after surgery,the data show that both surgical methods can effectively improve the symptoms of pelvic organ prolapse,in which group A surgery time,intraoperative blood loss and postoperative hospital stay are less than group B(P<0.05);There was no significant difference in bladder residual urine volume and postoperative exhaust time between the two groups(P>0.05).4.The 6-month postoperative quality of life scores of PISQ-12 in group A and group B were significantly higher than those before surgery(P<0.05),but the total score of PISQ-12 in group A was higher than that in group B.(Group A: 43.45±2.81,Group B: 38.25±3.27),the difference was statistically significant(P<0.05).5.There was no significant difference in the quality of life scores between the two groups(P=0.251,0.151)at 6 months after operation in group A and group B.The quality of life score of group A was better than that of group B after 1 year.There were significant differences in the scores of PFDI-20 and PFIQ-7 between the groups(P=0.038,P=0.027).6.The scores of PFDI-20 and PFIQ-7 questionnaires were significantly lower in the two groups after 6 months and 1 year after operation(P<0.05).One group was treated 1 year and 6 months after operation.The difference of PFDI-20 and PFIQ-7 scores was statistically significant(P=00.017,P=0.017).There was no significant difference in PFDI-20 and PFIQ-7 scores between group B and 1 month after operation.(P=0.327,P=0.228).7.There was no significant difference between the patients in group A and group B at 6 months after operation(P=0.250).The subjective satisfaction score of group A was higher than that in group B after 1 year.The difference was statistically significant(P=0.029).Conclusions1.Laparoscopic high uterine ligament suspension and transvaginal sacrospinous ligament fixation can be used as a better surgical treatment for patients with moderate to severe uterine prolapse.The clinical curative effect is reliable,the safety is high,and the complications are few.2.Laparoscopic high uterine ligament suspension and transvaginal sacrospinous ligament fixation can effectively improve the quality of life and quality of life of patients.There is no significant difference between short-term efficacy and post-treatment satisfaction,but the long-term clinical efficacy and long-term Satisfaction is better with laparoscopic high uterine ligament suspension.3.Laparoscopic high uterine ligament suspension is better for improving the quality of sexual life,and has the advantages of short operation time,less intraoperative blood loss,shorter hospital stay and low recurrence rate.It is suitable for large-scale clinical promotion.