| Objective:By comparing the clinical therapeutical effect of laparoscopic abdominal wall suspension and laparoscopic sacrocolpopexy in the treatment of uterine prolapse,explore the safety and efficacy of the two surgical methods.Methods:From September 2016 to September 2018 in Affiliated Hospital of Qinghai University department of gynaecology and diagnosed for moderate severe uterine prolapse patients were divided into two groups,20 patients were treated with laparoscopic abdominal wall suspension as group A,the other patients were treated with LSC as group B.We recorded and compared the pelvic prolapse degree,pelvic floor function and quality of life,perioperative period index(including operative time,intraoperative bleeding volume,postoperative exhaust time,postoperative hospital stay,the residual urine volume of the bladder)from the preoperative,3 months and 6 months after operation in both grops.SPSS23.0 software was used for statistical analysis and the statistical results were statistically significant when P<0.05.Results:(1)After surgery,Two groups of patients with pelvic organ prolapse than preoperative were significantly improved(P<0.05),the difference betwen the two groups was not statistically significant(P>0.05).(2)The time of operation and the amount of bleeding during operation in group A were shorter than those in group B(P<0.05),but the intraoperative bleeding,hospitalization days and bladder residual urine between the two groups were no significant difference(P>0.05).(3)In both groups,the PISQ-12 score in 6 months after operation was significantly higher than that before operation(P<0.05),and the improvement of PISQ-12 score in group B was better than that in group A(P<0.05).(4)The scores of PFDI-20 and PFIQ-7 in both groups decreased significantly in 6 months after operation(P<0.05),but there was no significant difference between both groups(P>0.05).(5)There was no difference in postoperative recurrence and complications between both groups(P>0.05).Conclusion:(1)Laparoscopic abdominal wall suspension and LSC have better clinical efficacy,high short-term cure rate,few perioperative complications in the treatment of uterine prolapse.However,LSC is superior to laparoscopic abdominal wall suspension in improving the quality of sexual life of the patients.(2)LSC has the disadvantages of complicated operation,longer operation time and more bleeding during the operation so that LSC has high requirements for operators in suturing,knotting and anterior sacral separation by laparoscopic.But laparoscopic abdominal wall suspension has such merits as shorter operation time,fewer traumas,less intraoperative bleeding and easier operation.Therefore,laparoscopic abdominal wall suspension is easier to popularize and apply.(3)Compared with laparoscopic abdominal wall suspension,laparoscopic sacral vaginal fixation which using expensive mesh has higher hospitalization expenses and requirements for economic capacity.(4)For the uterine prolapse patients,the basic condition should be comprehensively evaluated before operation,reasonable operation way should be chosen,and individual treatment should be reflected as far as possible.Such as,for sexually active,tolerable longer time surgery,better physical fitness and economic conditions,should be preferentially given priority to the choice of LSC.But for the older and infirm,less general condition,heavy economic burden,should choose to use Laparoscopic abdominal wall suspension.(5)The sample size of this study is small and the follow-up time is shorter.So that we need to expand sample size and extend follow-up time to observe the long-term curative effect,complications and postoperative recurrence of both methods. |
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