Clinical Observation Of Modified Uterosacral Spinous Ligament Fixation In The Treatment Of Pelvic Organ Prolapse

Objective:Female pelvic organ prolapse(pelvic organ prolapse POP)is one of the common gynecological diseases of middle-aged and elderly women.Its severity and extensiveness have caused psychological damage and self-confidence destruction to them,and clinical treatment is difficult.This article aims to analyze the clinical efficacy of modified uterine-preserving vaginal sacrospinous ligament fixation(MVSSLF)in the treatment of POP and its advantages and disadvantages compared with traditional vaginal hysterectomy assisted vaginal anterior and posterior wall repair in the treatment of female POP.Therefore,it is hoped that it can provide help for the clinic to find a better surgical method for the treatment of female POP.Methods:By collating and collecting the general information of 68 cases of severe(grade Ⅲ-Ⅳ)pelvic organ prolapse patients who visited the Department of Gynecology at the First Affiliated Hospital of Bengbu Medical College from January 2018 to June 2020,statistical analysis was conducted.Among them,33 patients underwent a modified sacrospinous ligament fixation with uterine preservation procedure as the study group(Group A),while the other 35 POP patients underwent traditional vaginal hysterectomy with anterior and posterior vaginal wall repair as the control group(Group B).Compare the perioperative variables between two groups of patients:intraoperative blood loss,surgical time,average duration of indwelling urinary catheter and average length of hospital stay for both groups of patients after surgery.At the same time,the pelvic floor dysfunction questionnaire-20(PFDI-20)was used to follow up the pelvic floor function recovery of patients before operation,3 months,6 months and 12 months after operation,and the sexual life quality questionnaire-12(PISQ-12)followed up the sexual life quality of patients before operation,6 months and 12 months after operation,and collected the quantitative staging of pelvic organ prolapse(Pelvic organ prolapse quantitation,POP-Q)before operation,6 months and 12 months after operation Statistical analysis was performed on the scores of the questionnaire and the value of each indicator point by using SPSS22.0 software.Results:1.General information such as childbearing age,age at operation,body mass index,pregnancy,and parity of the two groups of patients were selected,and the results of statistical analysis were not statistically significant(P>0.05).2.Statistical analysis of the perioperative conditions of the two groups of patients:the blood loss during the operation in group A was less than that in group B,and the difference was statistically significant(P<0.01);the average time of indwelling catheter and hospitalization time of patients in group A All were shorter than group B,and the differences were statistically significant(P<0.01);there was no significant difference in the average operation time between the two groups(P>0.05).3.There were statistically significant differences in the position values of POP-Q indicator points between the two groups compared with preoperative values(P<0.05),and there were no statistically significant differences between the groups and within the groups at 6 and 12 months after operation(P>0.05)).It is suggested that both surgical methods are effective in the treatment of middle pelvic organ prolapse.4.Statistical analysis of PFDI-20 questionnaire scores of patients in the two groups before operation,3 months,6 months,and 12 months after operation:There was no significant statistical difference before operation(P>0.05);the PFDI-20 questionnaire scores of the two groups at 3 months,6 months,and 12 months after operation were statistically significant compared with those before operation(P<0.05).And there was no statistically significant difference within the group(P>0.05);The PISQ-12 questionnaire scores of the two groups of patients were significantly different from those before operation(P<0.05).The PISQ-12 questionnaire scores of patients in group A were higher than those in group B at 6 and 12 months after operation,and the 4 difference was statistically significant.Significant(P<0.05),the scores of PISQ-12 questionnaire in each group after operation were not statistically significant(P>0.05).This suggests that both surgical methods can effectively improve pelvic floor function and sexual life in women with POP,but the quality of sexual life after surgical treatment in group A is significantly better than that in group B.Conclusion:Both the modified uterovaginal sacrospinous ligament fixation and traditional vaginal hysterectomy assisted anterior and posterior vaginal wall repair for female pelvic organ prolapse were both effective.Postoperative pelvic dysfunction was significantly improved compared with before treatment.Short-term(within 1 year)follow-up showed no obvious recurrence.The amount of blood loss during the operation in group A was less than that in group B.The average duration of indwelling catheter and hospital stay in group A was shorter than that in group B.The uterus is preserved in most patients,which also improves the quality of postoperative sexual life for patients,which will satisfy the patient’s demands for surgical treatment to the greatest extent,and this surgical method is worthy of clinical promotion.