Clinical Study Of TVM Total Pelvic Floor Reconstruction Surgery In Treating Female Pelvic Organ Prolapse

ObjectiveTo investigate the clinical significance of transvaginal mesh(TVM)(Prolift) floor repair system and transvaginal hysterectomy(TVH)plus repair of vaginal anterior and posterior wall on the treatment of pelvic organ prolapse(POP).MethodsThe curative effect and complication of prolift total pelvic floor reconstruction surgery or TVH was analyzed retrospectively in40women with POP who have undergone operation at Shandong Provincial Hospital from February2006to June2014.The patients were divided into two groups. In the study group,3received TVH+ptolift floor reconstruction surgery as study group1and17received single prolift floor reconstruction surgery as study2. In the control group,20were received routine TVH+repair of anterior and posterior wall of the vagina. The clinical outcome of each patient was assessed after operation by regular follow-up.Results(1) There were no significant difference between study group and the control group in the aspects such as Age, menopausal status, body mass index, mode of delivery, pregnancy, parity, POP-Q indexing and the indwelling catheter time (P> 0.05).(2) There were significant differences between study group2and the control group in the aspects such as operation time, blood loss during the operation and mean in-hospital time. After operation, the operation time was significantly shorter, the blood loss and the mean in-hospital time was significantly reduced(P<0.05). There were no significant difference between study group1and the control group.(3)Clinical evaluation after operation The POP-Q stage after of all patients being out-hospital was0or Ⅰ.The subjective satisfaction were reached100%according to Prolapse Quality of Life.(4) Follow-up After a mean follow-up of one year, the rate of follow-up for the control group and the study group was95%and100%, respectively. POP-Q Ⅱ degree and sub-degree Ⅱ degree judged as relapse. There was one case of recurrence in the control group which recurrence rate was5%and the study group was without recurrence (P>0.05).Conclusion(1) The routine TVH+repair of anterior and posterior wall of the vagina and prolift floor reconstruction surgery are both safe and effective methods in the treatment of POP.(2) As a new method of surgical, the prolift floor reconstruction surgery was more safe, less invasive, fewer complications and better able to repair the defect, to reconstruction of the pelvic floor structure and restore the pelvic floor function, and with lower recurrence rate.The short-term effect are stability, but the Long-term effect needs further follow-up observation.