A Comparative Clinical Study Of Different Surgical Procedures For The Treatment Of Female Pelvic Organ Prolapse

Objective: To evaluate the recent and long-term efficacy. complications,quality of life of the different surgical treatments of the pelvic organ prolapse.Methods: We performed a retrospect review of all patients who underwent different surgery in our hospital between December 2002 and July 2014, 181 patients with pelvic organ prolapse were reviewed, 79 of whom underwent transvaginal hysterectomy and repair of anterior & posterior vaginal wall, 45 of whom were recieved total pelvic reconstruction and 57 of whom were treated by laparoscopic hysterectomy and colposuspension. The operative parameters including preoperative basic situation,operative time, intraoperativ blood loss, in-dwelling urethral catheter time, postoperative hospital stay, hospitalization expenses, complications and, postoperative quality of life.Results: 1.Three groups of cases of preoperative clinical indicators(including BMI, menopause age, vaginal delivery times, prolapse degree by stage(POP-Q stage) and combination with SUI) there was no statistically significant difference(P>0.05). There was statistically significant difference(P>0.05)between age. 2. Operative time, intraoperativ blood loss,in-dwelling urethral catheter time, postoperative hospital stay, hospitalization expenses difference between three groups was statistically significant(P < 0.05). 3. Recent complications,urinary symptoms,long term bladder disorder, pain and recurrence rate was statistically significant different(P < 0.05).Two cases of group B had organ damage, one had mesh exposure while one organ damage in group C Perioperative disease rate, pain, organ damage, long-term rectal dysfunction in patients of three groups showed no statistical significance(P>0.05).4. Life quality between three groups after 1 year had significant difference(P<0.05). Life quality after 3 years between the group there was no statistical significance(P>0.05).Conclusion: 1.Transvaginal hysterectomy and repair of anterior & posterior vaginal wall, total pelvic reconstruction and laparoscopic hysterectomy and colposuspension are effective surgical methods for pelvic organ prolapse. 2.The highest recurrence rate, better feeling, no mesh exposure, ecomony, safety are advantages of transvaginal hysterectomy and repair of anterior & posterior vaginal wall. 3.Total mesh pelvic floor reconstruction can restore pelvic anatomy better and then achieve the effect of tissue repair of pelvic floor. It’s suitable for the older. Because of the mesh exposure and other complications are serious, it should be strictly and carefully applied into treatment. 4. Laparoscopic hysterectomy and colposuspension has minimal invasion, faster postoperative recover, low recurrence rate, but the long-term efficacy remains to be further prospective comparative study. 5. The three different surgical methods have their own advantages, clinicians should make a comprehensive assessment of the conditions of the patients, weighing the pros and cons and give patients individualized treatment.