Observation of the effects of laparoscopic high sacral ligament suspension and transvaginal sacral ligament fixation on pelvic floor function and urodynamics in patients with severe pelvic organ prolapse
Objective To analyze the feasibility of laparoscopic high position hysterosacral ligament suspension and transvaginal sacrospinal ligament fixation as treatment options for patients with severe pelvic organ prolapse,and to ob-serve the impact of the above two surgical methods on clinical related indicators of patients.Methods From May 2021 to May 2022,73 patients with severe pelvic organ prolapse were treated in the Gynecology Department of Hubei Maternal and Child Health Hospital,there clinical data were collected and analyzed retrospectively.They were divided into an observation group of 37 cases and a control group of 36 cases according to different treatment methods.The observation group under-went laparoscopic high sacral ligament suspension surgery,while the control group underwent transvaginal sacral spine lig-ament fixation surgery.Compare perioperative indicators and prognosis between two groups,as well as organ prolapse,quality of life,and changes in urodynamics at different stages.Results The observation group had longer surgical time than the control group,less intraoperative bleeding,shorter removal time of the urinary catheter,and shorter postoperative hospital stay than the control group(t/P=21.641/＜0.001,6.195/＜0.001,15.199/＜0.001,17.575/0.001).The observation group showed lower values in PFIQ-7 scores,and PFDI-20 scores at 6 months after surgery compared to the control group,inclu-ding various POP-Q indicator points,I-QOL scores,maximum bladder volume,and maximum urinary flow rate The average urine flow rate showed higher values compared to the control group(t/P=5.189/＜0.001,22.447/＜0.001,11.051/＜0.001,16.916/＜0.001,31.005/＜0.001,3.477/＜0.001,11.211/＜0.001,3.503/＜0.001,5.728/＜0.001,10.010/＜0.001);The incidence of newly diagnosed stress urinary incontinence,reoperation rate,and incidence of complications in the observation group were lower than those in the control group at 6 months after surgery[χ2(t)/P=5.471/0.019,4.103/0.042,4.364/0.036].Conclusion Laparoscopic high sacral ligament suspension surgery and transvaginal sacral spine ligament fixation surgery can both be effective treatment options for patients with severe postpartum pelvic prolapse.Although the former method takes slightly longer than the latter,it shows better results in improving postoperative pelvic floor function and urodynamics.
Severe pelvic organ prolapseLaparoscopic suspension surgery for high position uterosacral ligamentTransvaginal sacral ligament fixation surgeryPelvic floor functionQuality of life
维普
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