| Objective: To discuss the clinical effect and postoperative improvement of quality of life of patients with middle pelvic organ prolapse treated by laparoscopic iliopectineal ligament suspension.Methods: A total of 64 patients with middle pelvic organ prolapse who were admitted to Dalian Women and Children Medical Center(Group)from September 2020 to September 2021 were enrolled.According to the order of visits,random numbers were assigned,with odd numbers set as 33 cases in the experimental group(i.e.,laparoscopic iliopubineal ligament suspension group)and even numbers set as 31 cases in the control group(i.e.,laparoscopic vaginopexy group).The study indexes mainly included general information,perioperative period and postoperative long-term complications.General information included age,BMI,gestational time,menopause,complications,history of pelvic surgery,course of disease,and other surgical procedures performed during the operation.Perioperative comparisons included perioperative surgery-related indicators(including length of hospital stay,duration of operation,duration of indenture catheterization,residual urine volume,intraoperative blood loss)and perioperative complications(including vascular,urinary or intestinal damage,pubic or sacral osteomyelitis,and difficulty in stools).The comparison of postoperative long-term complications included gynecological examination(i.e.,POP-Q score),the patient’s complaints of discomfort(i.e.,pelvic pain,new SUI,mesh exposure,apical prolapse,urinary tract infection,and stool difficulty),and questionnaires(i.e.,pelvic floor disease Symptom Questionaire 20(PFDI-20),sex life questionnaire(PISQ-12),and pelvic floor disease life Quality Impact Questionnaire Short Form-7(PFIQ-7).Results: 1.General data: The comparison of general information between the two groups of patients showed no statistically significant difference in overall data between the two groups(P>0.05),indicating a certain grouping value between the two groups.2.Perioperative period: There was no statistically significant difference in intraoperative bleeding,indwelling catheterization time,residual urine volume,and hospital stay between the two groups(P>0.05),while in the control group,the surgical procedure time was longer than in the experimental group(229.35 ± 34.61 points vs 194.06 ± 56.8 points,P<0.05),and the incidence of difficulty in bowel movements was significantly higher than in the experimental group(P<0.05).There were no perioperative complications in both groups,and there was no statistically significant difference in the incidence of complications(P>0.05).3.Postoperative long-term complications: 3.1 Gynecological examination: There was no statistically significant difference in POP-Q indicators between the two groups at preoperative,postoperative 3 months,6 months,and 12 months(P>0.05).There was a statistically significant difference(P<0.05)in the comparison of POP-Q indicator points(Aa,Ap,Ba,Bp,c)between the two groups at 3,6,and 12 months after surgery and before surgery,and the anatomical reduction returned to normal after surgery.3.2 Chief complaints of discomfort: there was no significant difference in the incidence of postoperative pelvic pain,new SUI,mesh exposure,tip prolapse,and urinary system infection(P>0.05),but the incidence of difficulty in defecation in the control group was significantly higher(16.1% vs 0,P<0.05).3.3 Questionnaire survey: Comparison of subjective quality of life scores between two groups before surgery and at 3,6,and 12 months after surgery:(Since the PISQ-12 questionnaire requires patients to inquire about their sexual activity in the past six months,PFDI-20 and PFIQ-7 start from 3 months after surgery.)There was no statistically significant difference in the scores of PFDI-20,PISQ-12,and PFIQ-7 between the two groups before surgery,at 3,6,and 12 months after surgery(P>0.05),while there was no statistically significant difference in the PFDI-20,PISQ-12 scores between the two groups at 3,6,and 12 months after surgery(P>0.05)The intra group comparison of PFIQ-7 scores was significantly lower than before surgery,and the difference between the two was statistically significant(P<0.05).Conclusions: Compared with laparoscopic vaginopexy,laparoscopic iliopectineal ligament suspension can achieve good anatomical reduction,short operation time,relatively simple and safe operation,and significantly reduce the incidence of stool difficulties,so it can be a new choice for the treatment of middle pelvic organ prolapse. |
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