The Clinical Research On The Effect Of Uterus Conservation In Pelvic Reconstructive Surgery To Treat POP

Objective: By researching the use of alternative materials while retaining thepreoperative, intraoperative, postoperative conditions of surgical treatment of pelvic organprolapse uterus group and the hysterectomy group, the article compares the conditions of thetwo groups of patients during surgery, postoperative recovery and treatment of pelvicorganprolapse, then evaluate he effect of using alternative materials while retaining the uterusreconstructive pelvic surgery, reflects the minimally invasive reconstructive pelvic surgery,provide a theoretical basis for the pelvic clinicians toorgan prolapse patients to select the besttechnique.Method: This study selected the patients of the General Hospital of Ningxia Medicalgynecology between January2009and January2013, which includes193cases of the newreconstructive pelvic surgery in organ prolapse (except for vaginal vault prolapse). Accordingto the patients’ offvertical extent and experience of the surgeon,71cases of underwent theProlift pelvic reconstructive surgery,122patients underwent Gynemesh mesh pelvicreconstructive surgery.193patients with preoperative gynecologic examination,gynecological B ultrasound, endometrial curettage pathology, cervical cytology were benignlesions, but the patients wo have removed the uterus should be included in the hysterectomygroup (concomitant hysterectomy group, CH group), which line Prolift pelvic reconstructionsurgery18cases for the CH1group, the line Gynemesh mesh pelvic reconstruction surgery in53cases for the CH2group; the normal inclusion reserved in uterus group (uteruspreservation group, UP group),40cases of line Prolift pelvic reconstructive surgery for UP1group, the line Gynemesh mesh pelvic reconstruction surgery in82cases for the UP2group. Comparing the CH1group and UP1group, CH2group and the UP2group of patients withgeneral information, and follow-up of perioperative conditions respectively and analyzesthem statistically.Results: The general materials of the CH1group, U1P group, CH2group and the theUP2group have no statistical difference (P>0.05). The operative time, blood loss, and theaverage length of stay, the antibiotics time and catheter use time of the UP1groups and theUP2group are significantly less than the the CH1and CH2group, these have statisticallymeaning (P <0.05). The effect of retaining pelvic organ prolapse uterus hysterectomy improveare similar, but because the pelvic tissue trauma, patients recover quickly of retaining theuterine, achieved the effect of minimally invasive. The CH1group follow-up rate is100%,and the average follow-up time (11.5±0.4) months, cases of recurrence (5.5%), two casesappeared mesh exposure (11.1%); the UP1group follow-up rate is95%, with an averagefollow-up time (9.8±0.6) months after recurrence-free (0%) patients had mesh exposure(2.5%),1patient had postoperative voiding dysfunction (2.5%); CH2group follow-up rate of95.3%, with an average follow-up time (10.9±0.6) months, cases of recurrence (1.8%), nomesh exposure (0%);95.1%of the the UP2group of follow-up rate, the average follow-uptime (10.8±0.7) months after recurrence (0%),5cases of mesh exposure (6.1%) patients hadpostoperative wound hemorrhage (1.2%).Conclusion:1.The operation of alternative materials pelvic floor reconstructive surgeryneeds to regulate the training and grasp the surgical indications strictly, that is able to achievethe security, reliability, and rapid postoperative recovery, fewer complications. The recenttreatment effect is satisfactory, but the long-term efficacy to be further observing andfollowing-up.2. The use of alternative materials while preserving the uterus reconstructivepelvic surgery have strengthened the cervix around the ring and uterine relaxation around theligaments and fascia, which has a certain significance to maintaining the integrity andstability of the structure of the pelvic floor. The short-term efficacy is similar to the hysterectomy group, the advantages are shorter operative time, less bleeding, less trauma andfaster recovery, which is good to reduce the middle-aged women perioperative risk,meanwhile, it retains the original form of the vagina which is longer than vaginalhysterectomy, and can help to improve sexual quality of the younger patients. Achievingfunctional recovery of the pelvic floor and vaginal anatomical reconstruction of pelvic organprolapse, but it still needs further follow-up to observe long-term efficacy and long-termcomplications.