Clinical Observation Of Three Kinds Of Uterine Preserving Surgical Treatments For Pelvic Organ Prolapse

Objective:To observe the clinical effects of three uterine-preserving procedures in the treatment of moderate to severe pelvic floor organ prolapse.Methods:A retrospective analysis of 145 patients with moderate to severe pelvic floor organ prolapse who underwent surgical treatment in the gynecology department of 4hospitals including Jiangxi Provincial People’s Hospital from January 1,2017 to December 31,2018,and required the preservation of the uterus.They were divided into 3 groups according to different surgical procedures.: 65 cases in group A(transvaginal bilateral sacrospinous ligament suspension,BSSLF),48 cases in group B(transvaginal unilateral sacrospinous ligament suspension,USSLF),32 cases in group C(laparoscopic sacral fixation),LSC),compare the perioperative indicators of each group(operation time,intraoperative blood loss,postoperative anus exhaust,postoperative morbidity,surgical consumables cost,postoperative pain duration);follow-up 6 months,12 Month and 24 months,compare the POP-Q indicator point C score,prolapse score,pelvic floor dysfunction questionnaire short form score(PFDI-20),and sexual life satisfaction questionnaire(PISQ-12).Results:The operation time of groups A and B was shorter than that of group C,and the difference was statistically significant(P<0.05).Group A was equivalent to group B,and the difference was not statistically significant(P>0.05);both groups A and B had anal exhaust time Shorter than group C,the difference is statistically significant(P<0.05),group A is equivalent to group B,and the difference is not statistically significant(P>0.05);the postoperative disease rate of group C is higher than that of group A and B,and the difference is Statistically significant(P<0.05),group A is equivalent to group B,and the difference is not statistically significant(P>0.05);the duration of postoperative pain in group C is shorter than that of groups A and B,and the difference is statistically significant(P< 0.05),group A is equivalent to group B,and the difference is not statistically significant(P>0.05);the cost of surgical consumables in group C is significantly higher than that of groups A and B,and the difference is statistically significant(P<0.05),group A and group B Equivalent,no statistical significance(P>0.05).Compared with before,the C-point measurement values of the 3 groups were significantly improved at 6 months after the operation,and the difference was statistically significant(P < 0.05);the recurrence rate and C-point measurement values at 6 months after the operation were compared,there was no statistical difference between the groups Scientific significance(P>0.05);the recurrence rate of group B was higher than that of groups A and C at 12 months and24 months after surgery,the difference was statistically significant(P<0.05),and the difference between group A and C was not statistically significant(P>0.05);12months and 24 months postoperatively in groups A and C,the measured value of point C improved significantly than in group B,the difference was statistically significant(P<0.05),there was no difference between group A and group C Statistically significant(P>0.05).Compared with the former,the quality of life and quality of sexual life of the 3 groups were significantly improved at 6 months after the operation,and the difference was statistically significant(P<0.05);there was no difference in the scores of PFDI-20 and PISQ-12 at 6m after the operation.Statistically significant(P>0.05);12 months and 24 months after operation,the quality of life in group B had a greater impact than that in groups A and C,and the difference was statistically significant(P<0.05).The difference between group A and group C was No statistically significant(P>0.05);the quality of sex in group B was worse than that of groups A and C at 12 months and 24 months after surgery,and the difference was statistically significant(P<0.05),and the difference between group A and group C was No statistical significance(P>0.05).Conclusion:SSLF is a common and effective surgical procedure for the clinical treatment of pelvic organ prolapse.It has the advantages of low-cost operation,technically easy application,and short operation time.Compared with USSLF,the recurrence rate after BSSLF is lower,and the postoperative quality of life and sexual satisfaction are higher.The postoperative effect of BSSLF is similar to that of LSC,and its operation time is short,the trauma is small,the postoperative morbidity is low,and the cost of consumables is low.It is worthy of clinical promotion.