Objective To investigate the clinical efficacy of transvaginal sacrospinous ligament suspension under laparoscopic surveillance in patients with pelvic organ prolapse.Methods A total of 29 patients with middle pelvic organ prolapse who were admitted to the Department of Gynecology of the First Affiliated Hospital of Xinxiang Medical University from October 2019 to October 2023 were selected as the research subjects.The patients were divided into the control group(n=15)and the observation group(n=14)according to the surgical method.Patients in the control group underwent sacrospinous ligament suspension,and patients in the observation group underwent transvaginal sacrospinous ligament suspension under laparoscopic surveillance.The operation duration,intraoperative bleeding,anal exhaust time,postoperative urinary catheter indwelling time and postoperative hospital stay were recorded in the two groups.The patients were observed for vaginal mass prolapse within 3 days after surgery,vaginal bleeding after vaginal tamponade gauze removal,postoperative pain,hematoma,infection,and urinary retention after urinary catheter removal.The distance of the position of the indication points Aa,Ap,Ba,Bp and C from the hymen edge was calculated by pelvic organ prolapse quantification(POP-Q)staging method and the total vaginal length(TVL)was recorded before,1 month and 3 months after the surgery,respectively.Before and 3 months after the surgery,the pelvic organ prolapse/urinary incontinence sexual life questionnaire-12(PISQ-12)was used to evaluate the quali-ty of sexual life of patients.Results Patients in the two groups underwent surgery successfully,and there was no ureter,intes-tinal canal,bladder,blood vessel and nerve injury,intestinal obstruction or thrombosis.The operation duration,anal exhaust time and postoperative hospital stay of patients in the observation group were significantly shorter than those of the control group,and the intraoperative bleeding was significantly lower than that of the control group(P＜0.05);there was no signifi-cant difference in the postoperative urinary catheter indwelling time between the two groups(P＞0.05).The patients in the two groups recovered smoothly after surgery,their vital signs were stable,there was no vaginal mass prolapse within 3 days after surgery,and there was no obvious vaginal bleeding after removing the vaginal tamponade gauze.The incidence of postoperative com-plications was 26.67％(4/15)in the control group and 14.29％(2/14)in the observation group,and there was no significant difference in the incidence of postoperative complications between the two groups(x2=0.676,P＞0.05).There was no significant difference in the preoperative location of indication points Aa,Ap,Ba,Bp,and C and TVL measurements between the two groups(P＞0.05).The measured values of Aa,Ap,Ba,Bp and C at 1 month and 3 months after surgery significantly decreased and the TVL significantly increased compared with the preoperative values(P＜0.05).At 1 month and 3 months after surgery,the measured value of the indication point C in the observation group was significantly lower than that of the control group,and the TVL was significantly higher than that of the control group(P＜0.05).At 1 and 3 months after surgery,there were no significant differences in the indication points Aa,Ap,Ba and Bp between the observation group and the control group(P＞0.05).There was no significant difference in the PISQ-12 score between the observation group and the control group before and 3 months after surgery(t=-0.104,0.537;P＞0.05),and the PISQ-12 score in the two groups was significantly higher than that before surgery at 3 months after surgery(t=13.254,13.015;P＜0.05).Conclusion Transvaginal sacrospinous ligament suspension under laparoscopic surveillance,with the advantages of small surgical trauma,less intraoperative bleeding and fast postoperative recovery,is a relatively simple and minimally invasive surgical method for the treatment of pelvic organ prolapse.
pelvic organ prolapselaparoscopetransvaginal sacrospinous ligament suspensionefficacy
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