| Objective: To observe the clinical curative effect and complications through anterior vaginal wall path sacrospinous ligament suspension surgery in the treatment of pelvic organ prolapse,to explore its safety and effectiveness,and to probe whether it is effective in the treatment of anterior pelvic defects and prevention of postoperative vault prolapse recurrencee.Methods: By improving the traditional surgical path of vaginal sacrospinous ligament fixation,51 cases were analyzed retrospectively from clinical data of patients with pelvic organ prolapse from February 2014 to August 2015 in our hospital,which were underwent anterior vaginal wall path sacrospinous ligament fixation.All the patients with pelvic organ prolapse were stage Ⅱ~Ⅳ.The anterior pelvic defects of 26 patients represent different types(anterior vaginal prolapse、cystocele、urinary retention or stress urinary incontinence).The average age of the patients was 63.60±9.59 years old,average production times:3.10±2.10,average weight 58.32±8.19 kg,the average years of the disease: 3.27±6.88 years,Pelvic floor distress inventory-short form 20(PFDI-20)score was 75.64 ± 18.20.They were followed up for 1 months and 6 months postoperatively.The operative time,amount of bleeding,hospitalization time and catheter indwelling time were observed.After more than 6 months of follow-up,51 cases were compared with before and after surgery.The path of sacrospinous ligament fixation complications,the cure rate and quality of life were observed.We compared the POP-Q score in 1 month and 6 months after the operation of 26 cases with anterior pelvic defects,observing the effective of the surgical prevention of anterior vaginal wall prolapse.There were 30 cases with hysterectomy,15 cases remained uterus.The operation time,bleeding,hospitalization time,catheter indwelling time,the cure rate and enhancement of life quality of two groups were compared.Results: 51 cases with the anterior vaginal wall path sacrospinous ligament suspension were operated successfully.The mean operation time: 75.20 ± 24.31 min,average intraoperative bleeding: 87.65±74.72 ml,the average hospitalization time: 10.00±3.00 days.The mean indwelling catheter time: 3.50±1.30 days.The dates in our report are similar to relevant literature reports of the vaginal sacrospinous ligament suspension.51 cases complete follow-up,short-term follow-up rate was 100.00%,3 cases recurred relapsed within 6 months after operation,the cure rate: 94.12%.POP-Q Aa,Ba,Ap,Bp,C,PFDI-20 of preoperative and postoperative were compared,the differences were significant(P < 0.05).The comparison of Postoperative anterior vaginal wall Aa,Ba,C between 1 month and 6 months after operative was no difference(P > 0.05).Hysterectomy group and retain the uterus surgical time,intraoperative bleeding volume were compared,the difference is statistically significant(P < 0.05),the difference of hospitalization time,indwelling catheter time,cure rate and life quality score was not statistically significant(P > 0.05).Conclusion: The sacrospinous ligament suspension of existing transvaginal sacrospinous ligament suspension through anterior vaginal wall path is a modified operation.Clinical curative effect is reliable,minimally invasive and with less complications.Surgical technique is easy to master;it is a safe,effective operation.In view of the limitations of the traditional operation of transvaginal sacrospinous ligament suspension,the anterior vaginal wall path sacrospinous ligament suspension has advantage in the treatment of combined anterior pelvic defects of pelvic organ prolapse disease.The anterior vaginal wall path sacrospinous ligament suspension can retain the uterus.Hysterectomy does not increase surgical cure rate.The use of mesh of the anterior vaginal wall path sacrospinous ligament suspension surgery can better restore organ anatomical location. |
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