Analysis of the effect of different surgical methods in the treatment of uterine prolapse in the reproductive period / 中国综合临床

ABSTRACT

Objective:To investigate the therapeutic clinical effect of laparoscopic high uterosacral ligament suspension (LHUS) combined with cervical amputation and vaginal sacrospinal ligament fixation (SSLF) in the treatment of prolapse of uterus in childbearing period.Methods:From October 2011 to December 2016, the clinical data of 78 patients with uterine prolapse above grade Ⅱ treated in Department of Gynecology, Jizhong Energy Fengfeng Group Hospital were retrospectively analyzed.According to different surgical methods, the patients were divided into LHUS group (40 cases) and SSLF group (38 cases). The operation time, intraoperative bleeding volume and hospital stay of the two groups were compared by independent sample t test.Before and 6 months after the operation, the prolapse quality of life questionnaire (P-QOL), pelvic organ prolapse/incontinence sexual function questionnaire-12 (PISQ-12) and pelvic floor distress inventory-short form 20 (PISQ-20) were used.PFDI-20 and pelvic floor impact questionnaire-short 7 (PFIQ-7) were used to evaluate patients′ quality of life, sexual function and pelvic floor function.Paired t test was used to compare the above scores before and 6 months after operation in the same group.Results:There were no significant differences in operation time, intraoperative bleeding volume and hospital stay between the two groups ( t value were 1.593, 1.203 and 0.535, , respectively, all P>0.05). The preoperative P-QOL, PISQ-12, PFDI-20, and PFIQ-7 scores of patients in the LHUS group were (55.4±11.1), (25.1±4.6), (15.0±4.9), (8.9±2.8) points, and (53.7±10.5), (23.9±3.7), (14.1±4.2), (9.2±3.0) in the SSLF group.There was no statistically significant difference in the indexes between the two groups before operation (t value were 0.694, 1.265, 0.869 and 0.457, respectively, all P>0.05). The scores of P-QOL, PISQ-12 at 6 months after operation in LHUS group((87.9±12.0), (39.1±6.1)) and SSLF group((81.3±11.7), (35.6±4.0)) were significantly higher than those before operation( t value were 12.574, 11.589, 10.823 and 13.236, respectively, all P<0.001). The scores of P-QOL and PISQ-12 at 6 months after operation in the two groups were higher than those before operation((87.9±12.0), (39.1±6.1)), and the P-QOL score of LHUS group was higher than that of SSLF group 6 months after operation, the difference was statistically significant ( t value were 12.574, 11.589, 10.823 and 13.236, respectively, all P<0.001). At 6 months after operation, PFDI-20 and PFIQ-7 scores in LHUS group((2.1±0.3), (1.3±0.2) points) were significantly lower than before operation ( t value were=16.619 and, 17.123, all P<0.001). The PFDI-20 and PFIQ-7 scores in LIHUS group were lower than those in SSLF group((2.7±0.3), (1.9±0.2)) at 6 months after operation (t values were 10.096 and 13.073, respectively, all P<0.001). Conclusion:LHUS combined with cervical resection in the treatment of prolapsed uterine prolapse can effectively improve the quality of life, sexual function, and pelvic floor function.The effect is better than SSLF, which is worthy of clinical promotion.