Clinical Study Of Three Different Surgeries For The Treatment Of Severe Pelvic Organ Prolapse

Objective:To investigate clinical significance and application of vaginal sacrospinous ligament fixation(VSSLF) in treatment of severe pelvic organ prolapse(POP) by comparing the effectiveness,quality of postoperative sexual life,life satisfaction for POP recurrence with the following two surgical procedures: total pelvic floor reconstruction and total vaginal hysterectomy with anterior-posterior colporrhaphy.Methods:Totally 90 patients with severe POP underwent surgeries in the study,30patients(group A) were treated by VSSLF,30(group B) were treated by total pelvic floor reconstruction,and 30 patients(group C) were treated by total vaginal hysterectomy with anterior-posterior colporrhaphy. Both of the indices about intraoperation of Length of operation,amount of blood loss and operational complications, and postoperation of morbidity after operation,length of hospital stay and complications of hospital stay were collected and analyzed.Also the indices of length of vaginal,the POP-Q stage of three points,forward complications,recurrence rate,satisfaction of sexual life and index of life quality improvement of the three groups at 3,6,12,24 months were collected and analyzed.Results:The Length of operation and amount of blood loss,in group A,were less than those in group B and group C(P<0.05).No morbidity operational complications happened in three groups;No statistical difference was observed among the 3 groups in terms of morbidity after operation and length of hospital stay(P>0.05);cost operation in group A was similar to that in group C(P>0.05),but lower than that in group B(P<0.05);The length of vaginal in group A was longer than that in group B and group C,three after operation(P<0.05); The POP-Q stage of three points,in three groups,had been improved obviously,three months later(P<0.05),the point C is higher in group A than that in group B and group C(P<0.05); The satisfaction ofsexual life and the index of life quality improvement, two years after operation,in group A were no less than that in group B(P>0.05)and higher than in group C(P<0.05); also The cure rare,two years after operation,in group A was no less than that in group B(P>0.05)but higher than in group C(P<0.05).Conclusions:Compared with the total vaginal hysterectomy with anterior-posterior colporrhaphy, VSSLF is a surgery,which could keep the uters,with shorter operation time and less of damage,amount of blood loss and influence to sexual life. Compared with the total pelvic floor reconstruction,it is a surgery with lower cost operation and less complications. therefore, VSSLF is a minimally invasive surgery with less cost of operation and safety,and it can regain integrity of anatomical structure and functions of pelvic floor,which is worthy to be popularized in clinic.