Analysis Of The Effect Of Laparoscopic Round Ligament Suspension And Vagina Hysterectomy In The Treatment Of Postmenopausal Uterine Prolapse

Objective To evaluate the effect of laparoscopic round ligament suspension and Vagina Hysterectomy in the treatment of postmenopausal uterine prolapse.Methods From January 1,2016 to December 31,2017,74 cases of postmenopausal uterine prolapse were divided into experimental group and control group by Surgical procedure,each group of 37 cases,control group underwent Vagina Hysterectomy,experimental group underwent Vagina Hysterectomy and laparoscopic round ligament suspension.POP-Q(Pelvic Organ Prolapse Quantification),Pelvic Floor Distress Inventory Short Form(PFDI-20),Pelvic Floor Impact Questionnaire Short Form(PFIQ-7)and Pelvic Organ Prolapse /Urinary Incontinence Sexual Function Questionnaire Short Form(PISQ-12)were recorded and compared between the two groups.Results There was no difference between the two groups in the proportion of preoperative disease symptoms,age,number of births,BMI,complications and disease severity(P > 0.05).According to the POP-Q staging of pelvic organ prolapse,the control group were 5 patients with stage Ⅱprolapse,16 patients with stage Ⅲ prolapse,1 patient with stage Ⅳ prolapse.All the 22 patients were treated by vaginal hysterectomy 、cystocele repair,three of them who with posterior vaginal prolapse also treated by rectocele repair。 According to the POP-Q staging of pelvic organ prolapse,the experimental group were 2 patients with stageⅡprolapse,18 patients with stage Ⅲ prolapse,with no stage Ⅳcases.All of then were treated by laparoscopic round ligament suspension+ vaginal hysterectomy +cystocele repair,three of them who with posterior vaginal prolapse also treated by rectocele repair。The operation time and anesthesia recovery time of the experimental group were longer than those of the control group(P<0.05).There was no difference in blood transfusion,infection and pelvic pain between the two groups.But for patients over 70 years old,the proportion of pelvic pain in the experimental group was higher than the control group.One month after operation,two kinds of operation can effectively cure pelvic organ prolapse.,no difference in the improvement of pelvic indication points between the two groups(P > 0.05).The pelvic indicator points in the experimental group were better than that in the control group one year after the operation..The quality of life and sex rehabilitation inervention in each group were significantly improved(P=0.00)after the operation,and the experimental group was higher than the control group in the quality of life.But there was no difference between the two groups in the sex rehabilitation(before the operation P=0.08,after the operation P=0.05).Conclusion Laparoscopic vaginal stump suspension and vaginal hysterectomy can effectively treat the uterine prolapse after menopause,and has certain efficacy in preventing the recurrence of pelvic organ prolapse,and can significantly improve the life and quality of life of patients,but for the elderly patients with surgical decisions need to be careful.