The Curative Effect Study Of Polypropylene Mesh In Female Pelvic Floor Dysfunction Surgery

Objective:Female pelvic floor dysfunction is also called pelvic floor relaxation or pelvic floor support system defects, mainly including urinary incontinence and pelvic organ prolapse is a common disease of department of gynaecology.At present commonly using traditional Chinese medicine and surgery. Although surgical treatment can improve symptoms, but there are inevitable complications, caused many inconvenience to patients. Polypropylene mesh implantation in recent years, treatment of female pelvic floor dysfunction disease has become the research hot spot. This research through to applicating of polypropylene mesh to observe the clinical short and long-term curative effect and complications of the surgical treatment of female pelvic floor dysfunction (PFD) main of pelvic organ prolapse and stress urinary incontinence with the, and to discuss the safety of the operation and postoperative quality of life and to observe the syndrome differentiation of traditional Chinese medicine.To further explore the syndrome differentiation of pelvic floor dysfunction and the prevention and treatment measures of surgery-related and mesh-related complications.Avoid the risks of mesh added of pelvic floor reconstruction, and achieve individualized treatment of pelvic floor reconstruction, to contribute to further improvement of the operation quality and clinicians’ level. Pelvic floor dysfunction disease created with surgery and traditional Chinese medicine will improve the quality of surgery and clinical efficacy. Polypropylene mesh implant treatment of female pelvic floor dysfunction disease provided the scientific basis and feasibility.Methods:1. Case of choice:In this study, collect29cases of Prolift pelvic floor reconstruction and sacral fixation,141cases of tension-free vaginal tape-obturator treatment from January2007to May2012.2. Observe the indicators:To observe patients’ perioperative period, follow-up of post-operative complications and comparison of the quality of life before and after surgery were retrospectively analyzed, also to observe the Chinese medicine dialectical and classification3. Statistical analysis: On the basis of SPSS18.0statistical analysis software.In this study, patients’ perioperative period, follow-up of post-operative complications and comparison of the quality of life before and after surgery were retrospectively analyzed. Statistical analysis the main syndrome types of female SUI and POP diseases.Results:Collect data form January2007to May2012,141patients with SUI underwent TVT-O treatment,11of them are cases of TVT-O combined vaginal mesh reconstruct pelvic treatment,29cases of Prolift pelvic floor reconstruction and sacral fixation.In this study, patients’perioperative period, follow-up of post-operative complications and comparison of the quality of life before and after surgery were retrospectively analyzed.1、A total of POP patients successfully completed the surgeries, completed the postoperative follow-up8to42months, mesh added reconstructive pelvic surgery showed no recurrence, objective cure rates were100%, compared to the traditional surgical rates of76.7%. PFDI-20score of Prolift group, preoperative, six months after the operation and the last follow-up were average of(95.36±35.22)、(29.64±27.56)、(24.17±22.81)points. I-QOL score were (92.56±8.79)、(92.19±7.87)、(88.75±11.76) points. PFDI-20score of Sacral fixation group, preoperative, six months after the operation and the last follow-up were average of (86.59±8.33)、(89.76±40.02)、(15.63±11.84) points. I-QOL score were (83.79±23.65)、(89.68±18.16)、(93.56±7.13) points. The most common complication of Prolift pelvic floor reconstruction surgery was mesh erosion; however, the sacral fixation were lumbar and sacral pain, mesh erosion was not found.2、A total of141patients successfully completed their surgeries,130patients with a simple TVT-O treatment,mean operative time (47.01±18.82) min, average blood loss (64.38±99.62) ml, mean catheterization (2.67±0.90) d, the average length of stay (4.73±2.14) d.101cases completed the postoperative follow-up, quality of life improved significantly, IIQ-7score from preoperative an average of (15.74±3.87) to postoperative (1.63±2.66) points; UDI-6score from an average of (10.51±3.70) to (1.63±2.66) points.73patients (72.3%) with postoperative urinary incontinence, which subjective symptom were completely cured, and significant improvement in11cases (10.9%), ineffectiveness in6cases (5.9%); pad useing of13patients (12.9%); affect the sexual life postoperatively in8patients (7.9%).11cases of pelvic organ prolapse underwent TVT-O combined transvaginal mesh reconstruct pelvic treatment, mean operative time (74.5±24.66) min, mean blood loss (86.36±30.75) ml, mean catheterization (3.45±1.37) d, average length of stay (4.91±1.04) d.10cases completed the postoperative follow-up, quality of life improved significantly, IIQ-7score from preoperative an average of (16.10+3.18) to postoperative (1.60±3.20)points; UDI-6score from an average of (11.30±3.62) to (1.40±2.55) points.7patients (70%) with postoperative urinary incontinence, which subjective symptom were completely cured, and significant improvement in2cases (20%), ineffectiveness in1cases (10%); pad useing of1patients (10%); affect the sexual life postoperatively in3patients (30%).3、The main syndrome type of POP patients was syndrome of sinking of Qi due to spleen deficiency; SUI patients were swaged Spleen and kidney Yang deficiency.Conclusion:1、Prolift pelvic floor reconstruction and sacral fixation had high postoperative objective cure rate and low recurrence rate, better than the traditional operation.2、Pations of POP underwent Prolift pelvic floor reconstruction and sacral fixation, quality of postoperative life was significantly improved, but symptoms of urinine incontinence had no significant improvement.The two operations had no significant differences between quality of life and lower urinary tract symptoms.3、Prolift pelvic floor reconstruction does not require operating TVT-O surgery simultaneously to prevent stress urinary incontinence.4、TVT-O and patch using in the treatment of SUI and pelvic floor reconstruction, is not only easy to operate, but also has clinically high security, low recurrence rate, and significantly improved patients’quality of life. However, patch complications can not be ignored and need further discussion.5、TVT-O combined transvaginal mesh reconstruct pelvic treatment, without increasing complications.6、Surgery combined with traditional Chinese medicine treat with pelvic floor dysfunction, reducing the disease progress, also improving the postoperative curative effect.