Comparison Of Postoperative Pelvic Floor Dysfunction On Different Surgical Procedures Of Hysterectomy

Part 1 Risk factors and analysis of pelvic floor dysfunction post hysterectomyObjective:To explore the risk factors of pelvic floor dysfunction post hysterectomy.Methods:In this study,we selected patients who underwent hysterectomy from January 2012 to January 2017 in our hospital.In the course of intrafascial or extra-fascial hysterectomy,the pelvic floor dysfunction Symptoms and signs of the Han women,completed follow-up requirements,and medical records to obtain a complete patient,follow-up time?6 months.A total of 103 patients were enrolled in the study group.At the same time,100 patients with postoperative pelvic floor dysfunction symptoms and signs were selected as the control group.Results:multi-parity,high BMI or low body weight,with a history of chronic abdominal hypertension,previous history of pelvic surgery,smokers,hysterectomy to accept fascia,large uterine and long time-consuming and high abdominal pressure after surgery(P<0.05),and postoperative pelvic floor muscle exercise and preoperative regular physical exercise may reduce the occurrence of postoperative PFD(P<0.05).And age,gestational age,whether there is chronic complications,premenopausal,surgical approach,preoperative and postoperative anemia status,perioperative blood loss,perioperative infection,preoperative severe pelvic adhesions,after surgery Bedtime and vaginal stump healing time were not correlated(P>0.05).Conclusion:The reason of PFD after hysterectomy is consistent with the risk factorsof PFD after hysterectomy,which is related to the operation of the operation itself,such as prolonged traction,extracranial hysterectomy and so on.Part 2Comparison of postoperative pelvic floor dysfunction on different surgical procedures of hysterectomyObjective:To compare postoperative pelvic floor dysfunction after different surgical procedures of hysterectomy.Methods:A total of 260 patients who underwent hysterectomy in Renmin hospital of Wuhan University from January 2012 to January 2014 were enrolled in the study,divided into 7 groups by different surgical procedures,which are total abdominal hysterectomy(A-TH);total laparoscopic hysterectomy(L-TH);total vaginal hysterectomy(V-TH);abdominal intrafascial hysterectomy(A-CISH);laparoscopic intrafascial hysterectomy(L-CISH),including pelvic examination,POP-Q measurement,test of pelvic muscle strength,filling in pelvic floor distress inventory short form 20 and the female sexual function index questionnaire.Results:Patients of 7 groups have no statistical difference in general information(P>0.05).POP incidence difference after 6 months,A-TH and A-CISH,A-TH and L-CISH was statistically significance(P<0.05).POP-Q grade after 6 months A-TH and a-CISH was statistically different in degree(P<0.05).Abnormal pelvic floor muscle fatigue difference after six months of A-TH and A-CISH,A-TH and L-CISH was statistically significant(P<0.05),after 12 months of L-TH and A-CISH was statistically different(P<0.05),pelvic floor muscle strength after 6 months integrated L-TH and A-CISH,V-TH and A-CISH,V-TH and L-CISH was statistically significant(P<0.05),after 12 months of V-TH and A-CISH difference was statistically significant(P<0.05).Pelvic dynamic pressure after 6 months and after 12 months was no difference between 7 groups(P>0.05).Stress urinary incontinence,abnormal bowel movements after 6 months and 12 months was no significant difference between groups(P>0.05),PFDI-20 total score was not statistically significant(P>0.05).FSFI total score after 6 months and 12 months in the A-TH and A-CISH,L-TH and A-CISH,A-CISH and L-CISH were statistically significant(P<0.05).Conclusions:The influences of different surgical procedures to pelvic floor function was no statistical difference,As to the surgical resection of hysterectomy,the intrafascia hysterectomy compared with extrafascia hysterectomy,the former is more helpful to the protection of the structure and function of the pelvic floor.