Analysis On The Correlated Influencing Factors Of Pelvic Floor Dysfunctional Disease For Postoperative Patients With Cervical Cancer

Objective:To study the functional situation of pelvic floor on the patients with cervical cancer after extensive uterine resection operation and pelvic lymph node dissection (±ostoperative radiotherapy and chemotherapy),and the occurrence rate> the relevant monitoring indicators of postoperative pelvic floor dysfunction of cervical cancer patients,then analyzing the correlated influencing factors.Methods:Cases were 62 patients with total hysterectomy (±excision of uterine adnexa) between January 2013 and January 2015 collected from Department of Gynecology of Shandong Provincial Hospital.Divided into two groups:1.Cervical cancer group 24cases:1)Inclusion Criteria:age<60 years old; cervical cancer patients who received extensive uterine resection and pelvic lymph node resection surgery (±postoperative radiotherapy and chemotherapy); 6-48 months after surgery.2)Exclusion criteria:Preoperative radiotherapy,chemotherapy alone, age>60years old.2.Control group38cases:1)Inclusion Criteria:uterine hysterectomy due to benign at the same period.2) Exclusion criteria:age>60 years. Specific research programs include:collecting the general data of patients; the related situation of cervical cancer treatment; preoperative situation; postoperative situation; Understanding the postoperative pelvic floor function:the urination functions, defecation function, electrical physiological changes of pelvic floor.Results:(1) Before operation,with comparing respectively between the two groups of patients in general satiation (age, weight, age of the first sexual life, pregnancy times, delivery times) and pelvic floor dysfunctional diseases (urinary retention, urinary incontinence, difficulty in defecation, fecal incontinence),the difference was not statistically significant (P>0.05).(2) There were significant differences in operation time, bleeding volume, indwelling catheter time and hospitalization time between the two groups (P<0.05):the operation time of cervical cancer group (191.25±6.6min) was significantly longer than that of the control group (112.30±7.6min); the bleeding volume of the cervical cancer group (231.32±14.1ml) was more than that in the control group (176.24±11.5ml); the indwelling catheter time of cervical cancer group (9.07±6.7d) longer than the control group (2.61 ±1.9d); the hospitalization time of cervical cancer group (14.38±5.3d) was significantly longer than that of control group (6.71±6.3d); but there was no significant difference in the anal exhaust time (P>0.05), which showed that there was no difference in the recovery of gastrointestinal motility between the two groups after operation.(3) After operation, two groups in urinary incontinence, fecal incontinence occurred rate difference has statistical significance (P<0.05), after extensive hysterectomy and pelvic lymph node resection (±radiotherapy and chemotherapy) patients compare with hysterectomy for patients with benign gynecological diseases, more likely to have urinary incontinence, fecal incontinence. Postoperatively, the difference in urinary retention, difficulty in defecation are not statistically significant (P>0.05), the two kinds of operation in causing urinary retention, difficulty in defecation were no significant difference, all can cause those.(4) There was no significant difference (P>0.05) between the two groups in free urine flow rate (the maximum urinary flow rate, the mean urinary flow rate, the micturition time, the peak time); there were significant differences (P<0.05)in the electrophysiological function of the pelvic floor, (the level of Ⅰ、Ⅱ muscle fiber strength and fatigue, the muscle potential).(5) In cervical cancer group. The age, BMI, constipation, and the pregnancy times, the delivery times, perineal lacerations, the extent of surgery, postoperative pathology, the indwelling catheter time, postoperative time, postoperative radiotherapy, menopause, by Fisher exact probability method, with the single factor analysis. Age, constipation, the delivery times, indwelling catheter time, postoperative time, significant difference (P<0.05), were related risk factors of the postoperative PFD. By Binary Logistic regression analysis, constipation, delivery times, indwelling catheter, postoperative time were the independent risk factors (P<0.05).Conclusion:Through retrospective analysis, founding that patients with cervical cancer after radical hysterectomy were more likely to have pelvic floor disorders, the electric physiological function of pelvic floor is relatively poor. For patients with cervical cancer after surgery, long term constipation, excessive delivery times, long postoperative indwelling catheter time, long postoperative time can increase the risk of cervical cancer postoperative patients with pelvic floor disorders.