The Effect Of Three Different Types Of Laparoscopic Hysterectomy Surgery On Pelvic Floor Functional

Objective: By comparing laparoscopic hysterectomy in three different operative methods for the influence of the pelvic floor function,discuss Laparoscopic Deltoid Hysterectomy in protecting the clinical value of pelvic floor function aspects.Methods: Retrospectively collected between January 2014 and January2016 in our hospital because of adenomyosis line of 87 patients of laparoscopic surgery.According to different operative methods were divided into three groups.32 patients in LTH group,27 patients in LSH group,28 patients in LDH group.Patients were assessed from the top of vaginal prolapse,bladder and rectum prolapse,stress urinary incontinence,pelvic floor muscle strength,the female sexual.From these five aspects to operative methods in preoperative and postoperative 6 months and postoperative 12 months after this three periods of pelvic floor function effects.Results:1,The top of vaginal prolapse:(1)Preoperative,three groups of patients without the top of vaginal prolapse;(2)Postoperative 6 months,there were no significant difference between the three groups(P>0.05);(3)Postoperative 12 months,there was significant difference between LTH group and LSH group(P < 0.05);There was significant difference between LTH group and LDH group(P < 0.05);There were no significant difference between LSH group and LDH group(P>0.05);(4)Postoperative 6 months and postoperative 12 months three different periods,in the LTH group,there was significant difference between postoperative 6 months and 12 months(P<0.05);In the LSH group,there was no significant difference between postoperative 6 months and 12 months(P>0.05).In the LDH group,there was no significant difference between postoperative 6 months and 12 months(P>0.05).2,Bladder and rectum prolapse:(1)Preoperative,three groups of patients without bladder and rectum prolapse.(2)Postoperative 6 months and Postoperative 12 months,there were no significant difference between the three groups(P>0.05);(3)Postoperative 6 months and postoperative 12 months three different periods,using selfcontrolled study in these three gorups,there were no significant difference(P>0.05).3,Stress urinary incontinence:(1)Preoperative,three groups of patients without stress urinary incontinence;(2)Postoperative 6 months,there were no significant difference between the three groups(P>0.05);(3)Postoperative 12 months,there was significant difference between LTH group and LSH group(P < 0.05);There was significant difference between LTH group and LDH group(P < 0.05);There were no significant difference between LSH group and LDH group(P>0.05);(4)Preoperative postoperative 6 months and postoperative 12 months three different periods,using selfcontrolled study in these three gorups,there were no significant difference(P>0.05).4,Pelvic floor muscle strength:(1)Preoperative,there were no significant difference between the threegroups(P>0.05).(2)Postoperative 6 months,there were no significant difference between the three groups(P>0.05),in the vagina resting pressure,maximal voluntary contraction,I muscle fiber average vaginal pressure and I muscle fiber in the steady shrinkage of 6 seconds time;In II muscle fiber average vaginal pressure and II muscle fiber in the steady shrinkage of 6 seconds,there was significant difference between LTH group and LSH group(P < 0.05);There was significant difference between LTH group and LDH group(P < 0.05);There were no significant difference between LSH group and LDH group(P>0.05);(3)Postoperative 12 months,in the I muscle fiber average vaginal pressure,there were no significant difference between the three groups(P>0.05).In the vagina resting pressure,maximal voluntary contraction,I muscle fiber in the steady shrinkage of 6 seconds time,II muscle fiber average vaginal pressure and II muscle fiber in the steady shrinkage of 6 seconds,there was significant difference between LTH group and LSH group(P<0.05);There was also significant difference between LTH group and LDH group(P<0.05);There were no significant difference between LSH group and LDH group(P>0.05).(4)Preoperative?postoperative 6 months and postoperative 12 months three different periods,in the LTH group,there was significant difference between postoperative 6months and preoperative,postoperative 12 months and preoperative(P < 0.05);But there was no significant difference between postoperative 6months and 12months;In the LSH group,there was no significant difference between postoperative 6 months and 12 months(P >0.05);Using selfcontrolled study in the LSH group and LDH group,there was no significant difference between postoperative 6 months and 12 months(P>0.05).5,The female sexual:(1)Preoperative,there were not statisticant difference between the three groups(P>0.05).(2)Postoperative 6 months?postoperative 12 months,in the sexual desire,arousal,and orgasm,sexual satisfaction,there was significant difference between LTH group and LDH group(P < 0.05);There was significant difference between LSH group and LDH group(P < 0.05);There were no significant difference between LTH group and LSH group(P > 0.05);In vaginal lubrication and sexual pain,there was significant difference between LTH group and LSH group(P < 0.05);There was significant difference between LTH group and LDH group(P < 0.05);There were no significant difference between LSH group and LDH group(P>0.05);(3)Preoperative postoperative 6 months and postoperative 12 months three different periods,in the LTH group,there was significant difference between postoperative 6months and 12 months compareing with the preoperative(P < 0.05);But there was no significant difference between postoperative 6months and 12months;LSH group,in the sexual desire,arousal,and orgasm,sexual satisfaction,there was significant difference between postoperative 6months and 12 months compareing with the preoperative(P < 0.05);But there was no significant difference between postoperative 6months and 12months;On the vaginal lubrication and sexual pain,there were no statistically significant difference postoperative 6months and postoperative 12 months compareing with the preoperative(P > 0.05);Using selfcontrolled study in the LDH group,there was no significant difference between postoperative 6 months and 12 months compareing with the preoperative(P>0.05).Conclusions:(1)After the laparoscopic hysterectomy pelvic floor functionalcharacteristics affected by a certain degree of vaginal prolapse at the top,bladder and rectum prolapse,stress urinary incontinence,pelvic floor muscle function decline and the female sexual life quality.Those should be has draw great attention to doctors and patients.(2)Three different laparoscopic hysterectomy postoperation all have certain negative effect of pelvic floor function,but Laparoscopic Deltoid Hysterectomy for pelvic floor function minimal impact,and does not increase operation difficulty and intraoperative blood loss.(3)In terms of protection of pelvic floor function,Laparoscopic Deltoid Hysterectomy has certain advantage.It is the best surgical method in clinical.