Comparison Of The Efficacy And Complicati-Ons Of Prolift System And Traditional Hyste-Rectomy In Female With Pelvic Organ Prol-Apse

ObjectiveTo investigate the efficacy and complications of Prolift system and traditionalhysterectomy in female with pelvic organ prolapse．MethodsSeventy-six women who were admitted to our department from June2010to June2013underwent the surgery for pelvic floor prolapse．The patients were divided into twogroups：the whole Prolift mesh replacement was performed in forty-one cases (GroupA),and transvaginal hysterectomy and colporrhaphia anterior-posterior was performed inthirty-five cases (Group B). All patients were at the stage of III-IV，classified by theinternational pelvic organ prolapse staging system(POP-Q). Patients were followed up at6～36months (with the mean time of18months) post-operation． The data inperi-operation and follow-up results in both groups were compared and analyzedrespectively.Results(1) The average operation time of Group A was84.88min while the Group B was105.40min in contrast.The average hemoglobin loss of of Group A was15.51g/L duringthe surgery while the Group B was20.78g/L.There were4patients suffered from ureter、rectum or other surrounding organs injury of Group B, while patients in Group A were allgood.Group A costed less operation time,losted less blood and could be safer than GroupB，as the differences were significant by test(P<0.05).(2) The length of post-operative hospital stay was significantly shorter in GroupA(4.09d) than that of Group B(6.44d).However, the time when gas was expelled、the daysof a patient’s temperature that was higher than37.4℃、the days of in dwelling catheter were not so significantly different. The occurrent cases of abdominal distention、perineumswelling and a new onset catheter were the same between them(P>0.05).(3) Group A had a disadvantage of causing pain which started from1to2months aftersurgery and lasted2to4months, which occurred in6patients and recovered in half a year.Further more, there were2cases of patch erosion in Group A. There were some caseswhere the symptoms of SUI still exsisted after surgery, and where new SUI and bladderoveractivity occurred. However, there were no significant differences between them inthose aspects.The curative ratio was much higher in Group A (95.12%)than that in GroupB(77.14%).Compared with the POP recurrence rated2.24%of Group A, the rate of GroupB was17.14%and was higher significantly(P<0.05).The failure ratio was nearly the same.Conclusions(1) Compared with transvaginal hysterectomy and colporrhaphia anteriorposte-rior,the whole Prolift mesh replacement enjoyed less operation time、less blood loss, minerinjury, better efficacy and lower recurrent rate.(2) The whole Prolift mesh replacement had the disadvantages of leading to chronicpain after operation and patch erosion or exposure in a long time.(3) The time when the gastrointestinal and urinary function recovered, and theinfection tendency were not significantly different. The cases where the symptoms of SUIstill exsisted after surgery and the new SUI and bladder overactivity occurred were quitesimilar between them.(4) The pelvic floor surgery with Prolift mesh is convenient、safe and can bring goodmedical effects，but it also has its own disadvantages. The period we play the new surgeryis not long enough to collect great quantities of cases. The new theory and surgery stillneed further study and improvement in the future.