| Objective Pelvic floor dysfunction appears after the C2 radical hysterectomy and pelvic lymph node resection in many early stage cervical cancer patients. The investigation and questionnaire were to discuss the effectiveness of pelvic floor rehabilitation in patients with pelvic floor dysfunction after the surgery. Meanwhile the comparison of transperineal ultrasound parameters before and after therapy demonstrated the significance of the pelvic floor rehabilitation. A new way to improve the quality of life for cervical cancer patients after surgery may be found.Methods 140 patients with pelvic floor dysfunction at 3 months after surgery were randomly chosed according to the setting standard in our hospital from 2013-10-01 to 2014-10-01.60 cases were treated with pelvic floor rehabilitation,80 cases were observed. 5 months after surgery, pelvic muscle strength and efficiency of both groups were collected to prove the advantage of pelvic floor rehabilitation. The comparison of transperineal ultrasound parameters of both groups before and after therapy demonstrated the significance of the pelvic floor rehabilitation.Results Both groups of patients were successfully followed. Group A was followed up of 6 to 12 months after surgery, an average of 10.50 months; Group B were followed up for 6 to 12 months after surgery, an average of 10.2 months.1 Pelvic floor rehabilitation can significantly improve the muscle strength score. 3 months after surgery, for patients of group A, Ⅰ Class muscle strength score, Ⅱ muscle strength score was 2.3±0.8, 1.8±1.5 respectively. For patients of group B, Ⅰ muscle strength score, Ⅱ Class muscle strength score was 2.1±0.7, 1.7±1.7 respectively. 5 months after surgery, for patients of group A, Ⅰ muscle strength score, Ⅱ muscle strength score was 4.0±0.4, 4.5±0.5 respectively. For patients of group B, Ⅰ muscle strength score,Ⅱ muscle strength score was 3.1±0.7, 3.7±1.3 respectively. Both groups had no significant difference(P<0.05) in Ⅰ muscle strength score, Ⅱ muscle strength score at 3 months after surgery. 5 months after surgery, the score was higher in group A, there was significant difference(P<0.05) in group A and B.2 Pelvic floor rehabilitation can significantly improve the pelvic floor dysfunction. A questionnaire was carried out to estimate the pelvic floor function. There is 5 patients with sexual dysfunction, 27 patients with SUI,18 patients with uroschesis,10 patients with constipation in group A. After the treatment, 55 patients were improved and the effectiveness is 91.6%. There is 5 patients with sexual dysfunction, 37 patients with SUI,25 patients with uroschesis,13 patients with constipation in group B. After the treatment, The effectiveness is 71.3% according to the questionnaire. Both groups had significant difference(P<0.05) in score and effectiveness.3 Images at rest, maximum Valsalva maneuver, pelvic muscle contraction were acquire respectively at the median sagittal plane. By the comparison between groups, BSD, UA, ARA had no significant difference(P>0.05) at 3 months after surgery. In 3 situation after surgery about 5 month, group A was(2.03±0.59)cm,(156.48±15.26)°,(109.28±14.25)°,(1.13±0.71)cm,(145.09±14.52)°,(128.25±19.03)°,(2.40±0.69)cm,(158.18±22.27)°,(85.45±16.65)°. Group B was(2.59±0.76)cm,(138.94±13.26)°,(113.08±17.14)°,(1.64±0.34)cm,(131.72±21.23)°,(135.47±16.21)°,(2.94±0.78)cm,(145.19±20.89)°,(91.56±15.48)°. There was significant difference(P<0.05) in the same situation between groups.4 C2 radical hysterectomy bring physical and psychological harm to patients, during the investigation we found that some patients lose faith in the follow-up treatment, even complaint about surgeon. 5 cases of group A had interrupted treatment once, after patient persuasion they return to group A, Eventually the result is satisfactory after therapy.Conclusion1 Pelvic floor rehabilitation can significantly improve the pelvic floor muscle score comparing to observed treatment, and the pelvic floor function of patients was improved, too. Pelvic floor rehabilitation was safe, noninvasive, efficient.2 The transperineal ultrasound is one of the simplest way to estimate the pelvic floor function quantitatively. Objectively, the transperineal ultrasound confirms the effectiveness of the pelvic floor rehabilitation. |
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