Status Of Pelvic Organ Prolapse Surgery And Analysis Of Postoperative Influencing Factors

Objective:To investigate the surgical changes,recurrences and related factors that affect the postoperative recurrence of patients undergoing surgical treatment for pelvic organ prolapse disease(POP)in NingXia Hospital in the past10 years(2010-2019).Methods:A total of 1,218 patients with pelvic organ prolapse disease(POP)who underwent surgery in our hospital from 2010 to 2019 years were collected.According to the time of operation,the patients were divided into 550 case in group A(2010-2014)and 668 case in group B(2015-2019);Collect general information about the two groups of patients,the operation situation,whether the recurrence after surgery and the factors that may occur,etc.,then compare the preoperative disease stage,operation type distribution,development trend,postoperative recurrence rate of the two groups of patients,finallyanalysis of NingXia general hospital patients'surgery,change trends,recurrence,etc.At the same time,all patients were followed up by telephone,and 836 patients with complete data were divided into relapse group and non-relapse group according to the presence or absence of recurrence.Analyze the related factors that affect patients'recurrence after operation.Results:1.Comparison of the surgical distribution of the two groups:A total of 550 patients(45.2%)in group A and 668(54.8%)in group B were collected.The number of patients in group A was higher than that in group B;Group:270(49.10%)cases of vaginal mesh repair,120(21.80%)cases of vaginal hysterectomy and anterior and posterior vaginal wall repair,107(19.5%)cases of high uterosacral ligament Suspension(HUS),40 cases(7.3%)of Manchester repair,13(2.4%)cases of uterine(vaginal)patella fixation;group B surgical distribution:326(48.80%)cases of vaginal mesh repair,vaginal hysterectomy Surgery+vaginal anterior and posterior wall repair 134(20.1%)cases,high uterosacral ligament Suspensiont(HUS)89(13.3%)cases,Manchester repair 43(6.40%)cases,Sacrak colpopexy 76(11.4%)example.Vaginal mesh repair and vaginal anterior and posterior vaginal wall repair were performed in both groups(X2=41.34,P<0.01).Group B of uterine(vaginal)patella fixation was higher than group A(X2=41.34,P<0.01).2.Comparison of postoperative recurrence between the two groups of patients:(1)836 patients(68.6%%)were followed up in 1218 patients with complete data,among which 336 patients were effectively followed in group A,37 patients(11.6%)relapsed,group B There were 499 effective follow-ups and 30 relapses(7.2%).The recurrence rate in group A was higher than that in group B(X~2=6.81,P<0.01).3.Analysis of factors influencing postoperative recurrence of the two groups of patients:1)Age factor:recurrence rates of?50 years old,51-65 years old,>65years old are:8.5%,5.5%,11.6%,of which>65 years old The recurrence rate was the highest(X2=7.76,P<0.05).2)Body mass index(BMI):The recurrence rates for normal,obese,and overweight were:4.7%,7.3%,and 16.6%,respectively,and the relapse rate was highest in the obese group(X2=22.54,P<0.01).3)The recurrence rates of preoperative disease stage below II degree and III degree were6.4%and 10.1%respectively,and there was no difference between the two groups(X2=3.95,P>0.05)4)The recurrence rates of the uterine-preserving group and the non-uterine-preserving group were 8.4%and 7.6%,respectively,and there was no difference between the two groups(X2=0.19,P>0.05).5)Among different operation methods:the recurrence rate of vaginal mesh repair is the highest,and the recurrence rate of Sacrak colpopexy is the lowest,respectively 11.1%and1.6%(X2=13.53,P<0.01).Conclusions:1.(1)The rate of pelvic organ prolapse surgery(POP)surgery in our hospital has been increasing in the past 10 years.The main surgical distributions are vaginal mesh repair,vaginal hysterectomy and anterior and posterior vaginal wall repair,Sacrak colpopexy showed an upward trend.(2)The recurrence rate after POP surgery in our hospital has shown a downward trend in recent years.The recurrence rate of vaginal mesh repair is the highest,and the recurrence rate of Sacrak colpopexy is the lowest.2.Patient age,body mass index,and surgical method are related factors that affect the postoperative recurrence of POP patients,and the degree of disease before surgery and whether the uterus is retained have nothing to do with the postoperative recurrence of POP patients.