| Objective:Based on the study of the prolapse implementation of pelvic organ prolapse repair and synchronicity stress incontinence after the operation for patients with stress urinary incontinence of pelvic organ,and through the symptoms and physical examination combined with questionnaire,this study discusses the efficacy and safety of prolapse repair the synchronicity of stress urinary incontinence surgery,provide new operation scheme for clinical treatment.Methods:Select 29 patients treated with stress urinary incontinence and pelvic organ prolapse patients need surgery,quantitative score by pelvic organ prolapse(POP-Q)dividing method of diagnosis of pelvic organ prolapse,and through the history,physical examination and ICS incontinence questionnaire touting a diagnosis of stress urinary incontinence from the hospital affiliated Taishan Medical College between January 2013 and December 2013,the surgical treatment of 32 patients,completed in laparoscopic surgery,intrao-perative use of carbon dioxide pneumoperitoneum pressure,basin fascia defects parts under pressure because of local defect,fracture,can form a obvious weak sag,observe their positions and size range and the sags parts accurately fix,observe preoperative and intraoperative Aa point,the change of the Ba point.The patients were followed up 3 months,6 months and 1 year after surgery,and then were followed up once a year.with pelvic discomfort questionnaire summary table(PFDI-20),urine incontinence scale UDI-6,incontinence affects questionnaire touting IIQ-7 Chinese version of Jane and pelvic organ prolapse-incontinence sexual life questionnaire summary table(PISQ-12)score,evaluating the effect of subjective,and opponent after preoperative,Aa,Ba point position changes,the symptoms of urinary incontinence,the circumstance such as ICS questionnaire scores and complications were analyzed.Results:1.The institute of 29 patients,preoperative grading according to pelvic organ prolapse(POP-Q)dividing method of diagnosis of pelvic organ prolapse,and through the history,physical examination and ICS incontinence questionnaire touting diagnosed with stress urinary incontinence,32 cases of patients with laparoscopic pelvic prosthesis under stress urinary incontinence surgery,intraoperative judging defect parts,defect degree,postoperative patients Aa,Ba point position changes,the symptoms of urinary incontinence,ICS questionnaire scores and complications,and so on were analyzed,and the data for paired samples t test,the results(P> 0.05),there was no statistically significant difference,namely through laparoscopic pelvic prosthesis under stress urinary incontinence surgery at the same time,intraoperative judging defect parts,defect levels,and defect repair parts,laparoscopic fascia within the basin of defect judgment and repair more intuitive,It can more accurately judge the defect parts and accurately repaired,effective treatment and prevention of stress urinary incontinence.2.In 29 patients in this study,except for other gynecological operations under laparoscopy,the operative time of 29 patients with perivaginal fascia repair was 25-37 min,with an average(27.1±2.3)min.Intraoperative blood loss was 5-15 ml,with an average of 9.7-1.7 ml.There was one case of bladder injury during the operation.No bladder fistula was found after one needle was given.After 3 days,25 patients with temperature is maintained at 36.5 to 38.4 ?,4 cases of patients with temperature is maintained at 38.5 to 38.9 ?,normal after symptomatic treatment.The postoperative time of urethral tube extraction was 3-14 days,with an average of 5 days.2 patients were treated with urethral catheter again after 3 days of extraction for urinary excretion disorder.3.The 29 patients in our study,each indicator point location(Aa,Ba,C,Ap and Bp)after 6 weeks,6 months,1 year and 2 years POP-Q compared with preoperative has the obvious rise,all basic normal anatomical position,respectively.4.The postoperative symptom scores were significantly lower than those in the 29 patients in this study,and the differences were statistically significant(P<0.05).The lower the symptom score of patients with longer operation time,the lower follow-up symptom score was lower than the initial follow-up,3 months after surgery,6 months,12 months of UDI-6,IIQ-7 Chinese simplified version and pisq-12 score were significantly lower than before surgery,respectively,and the difference was statistically significant(P<0.05).3 months after surgery,6 months,12 months of UDI-6,IIQ-7 Chinese simplified version,and PISQ-12 score showed no significant change,and the difference was not statistically significant(P>0.05).Conclusion:Petros integral theory of clinical evaluation ways judgment within the basin of fascia defects parts with laparoscopic pressure test judgment of defect parts,has guiding significance for can of defect parts.Laparoscopic basin fascia in pressure test can more accurately determine the size of the defect and defect found at that site,to repair the defect part of the judgment,the recent effect is obvious,and has less postoperative complications. |
PDF Full Text Request