A New Surgical Method For Pelvic Organ Prolapse

Objective:To explore the efficacy of the modified ischial spinous fascia fixation in treatment of pelvic organ prolapse.Methods:Modified ischial spinous fascial fixation is an improved operation based on vaginal hysterectomy,which opens the vaginal bladder space,fixes the vaginal stump on the ischial spinous fascia,and changes the suture method to tie in the vagina.56 cases of the POP-Q stage II-IV with pelvic prolapse underwent vaginal hysterectomy and modified ischial spine fascial fixation in our hospital from September 2016 to July 2018.Perioperative parameters such as admission,operation time,estimated intraoperative bleeding volume,days of retaining urinary catheter after operation,days of hospitalization after operation,total cost of hospitalization and urinary retention after operation were recorded and followed up.The changes of Aa,AP,C,Ba and Bp points were evaluated by POP-Q staging before and after operation,so as to evaluate the clinical therapeutic effect of modified sciatic spine fascial fixation.Results:The 56 cases were aged 45-73 years,with an average age of 59.29±6.60 years,average body weight is 58.70±5.83 kg,average pregnancy is 4.43±1.80 times,delivery is 2.84±1.17,average stay hosital time is 5.80±1.79 days,average hospitalization cost is 11625.09±1855.81 yuan,operation average time is 132.07±27.75 min,the average bleeding volume of this operation is 156.94±74.29 ml.During the operation,there was no injury to the urinary catheter,bladder,rectum and other organs.Postoperative POP-Q staging at 6 months,12 months and 18 months showed an increase in the locations of the indicative points compared with those before operation.There were significant differences in the locations of Aa point,Ba point,Ap point,Bp point and C point.Recurrence is defined as any point ≥ 0,accompanied by vaginal mass.During the follow-up of 56 cases,there were 3 cases of recurrence,all of them were anterior vaginal wall prolapse grade II,with a recurrence rate of 5.36%.Conclusions:Modified ischial spine fascial fixation operation is minimally invasive,safe,it can alleviate prolapse symptoms,restore pelvic anatomical structure,without external mesh and other auxiliary materials.It has fewer complications and higher cure rate.It can improve the quality of life of patients.The short-term clinical effect is affirmative.