The Efficacy Analysis Of Traditional Surgery And Pelvic Reconstructive Surgery In Treatment Of Pelvic Organ Prolapse

Objective:To analysis and compare the efficacy between traditional surgery and pelvicreconstructive surgery in treatment of pelvic organ prolapse.Methods:From January2010to January2014,139patients who underwent surgery because ofpelvic organ prolapse were studied. They were divided into two groups:77patients whounderwent traditional surgery without synthetic mesh were known as Non-mesh group(including35cases of Manchester surgery,42cases of trans vaginal total hysterectomyplus colporrhaphia anterior-posterior);62patients who underwent pelvic reconstructivesurgery with synthetic mesh were known as Mesh group (including25cases of Prolift,22cases of Avaulta and15cases of Prosima). The operating time, intra-operative blood loss,operation expenses, and hospital stay were compared as the general situation of the surgery.The POP-Q score changes between preoperative and postoperative were compared asobjective efficacy. The patients were followed up by phone calls and e-mails, the medianfollow-up time of Non-mesh group was (25.00±14.29) months after the surgery, and themedian follow-up time of Mesh group was (24.35±10.78) months after the surgery. Thedifference of follow-up time between the two groups had no statistical significance(P>0.05). By using pelvic floor distress inventory short form (PFDI-20) and pelvic floorimpact questionnaire short form (PFIQ-7), the patients’ subjective efficacy and influencesof life quality were evaluated and compared.Results:(1) The operation time of Mesh group (62.47±27.83) min were less than Non-meshgroup (87.40±25.66) min, the difference was statistically significant (P <0.01). And theintra-operative blood loss of Mesh group (37.98±16.16) ml were less than Non-mesh group(57.27±35.16) ml, the difference was statistically significant (P <0.01).The operation expenses of Non-mesh group (11794.77±2990.38) RMB were less than the Mesh group(19425.23±7596.38) RMB, the difference was statistically significant (P <0.01).(2) The difference of preoperative POP-Q score between the two groups had nostatistical significance (P>0.05). The return rate of Mesh group was98.39%, and thereturn rate of Non-mesh group was93.51%. The difference of postoperative POP-Q scorebetween the two groups had no statistical significance (P>0.05). The difference of POP-Qscore between preoperative and postoperative was statistically significant (P <0.01).(3)When the patients were followed up, the PFDI-20scores of Mesh-group werereduced from (69.72±19.04) to (11.36±6.10) and the PFIQ-7scores were reduced from(75.90±19.19) to (14.75±6.83); The PFDI-20scores of Non-mesh group reduced from(67.79±17.88) to (17.84±6.22), the PFIQ-7scores reduced from (75.55±17.85) to(23.66±11.85). The differences of the scores between preoperative and follow-up werestatistically significant (P <0.01). The follow-up scores of PFIQ-7、POPIQ-7、UIQ-7、PFDI-20and its subscales in the Non-mesh group were higher than the Mesh group, thedifferences were statistically significant(P <0.05). The score of CRAIQ-7was higher thanthe Mesh group, but it had no statistical significance (P>0.05).Conclusion:Traditional surgery and pelvic reconstructive surgery are both effective treatments ofPOP, the efficacy of their recent anatomy reset is similar, but the patients’ furthersubjective efficacy of pelvic reconstructive surgery is better than traditional surgery.Theexpenses of pelvic reconstructive surgery with synthetic mesh are so expensive that thepatients should have a good economic base.