Effect of transvaginal total hysterectomy combined with anterior vaginal wall repair in the treatment of uterine prolapse

doi:10.3877/cma.j.issn.1674-392X.2023.02.019

Abstract

Abstract:

Objective

To analyze the curative effect of transvaginal total hysterectomy combined with anterior vaginal wall repair in the treatment of uterine prolapse and its effect on pelvic floor function, urodynamics and complication rate.

Methods

A total of 68 patients with uterine prolapse admitted in Wuhu Fifth People's Hospital from January 2019 to June 2021 were selected. According to the surgical method, 68 patients were divided into control group and observation group, with 34 patients in each group. The control group was treated with anterior vaginal wall repair, and the observation group was treated with transvaginal total hysterectomy combined with anterior vaginal wall repair. The clinical efficacy, urodynamics, surgical indicators, pelvic floor function and complications were compared between the two groups.

Results

(1) The treatment effect of the observation group was significantly better than that of the control group (P<0.05); (2) After treatment, the post-voiding residual volume (PVR) and the maximum urine flow velocity (Qmax) of the observation group were significantly lower than those of the control group (P<0.05); (3) The surgical indexes (operation time, intraoperative blood loss and hospital stay) in the observation group were significantly lower than those in the control group (P<0.05); (4) After treatment, the scores of PFIQ-7 and PFDI-20 in the observation group were lower than those in the control group (P<0.05); (5) The incidence of complications in the observation group (8.82%) was significantly lower than that in the control group (29.41%) (P<0.05).

Conclusion

For patients with uterine prolapse, transvaginal total hysterectomy combined with anterior vaginal wall repair can significantly improve the urodynamics and pelvic floor function, with good surgical efficacy and safety.

Key words: Transvaginal total hysterectomy, Anterior vaginal wall repair, Uterine prolapse, Pelvic floor function, Urodynamics, Complications

Xiaojie Xu, ping Yu. Effect of transvaginal total hysterectomy combined with anterior vaginal wall repair in the treatment of uterine prolapse[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(02): 209-212.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhshfbwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-392X.2023.02.019

https://zhshfbwkzz.cma-cmc.com.cn/EN/Y2023/V17/I02/209

Figures/Tables 5

References 17

[1]	王之通, 蒋健, 吴雨, 等. 从胶原代谢环节探讨补中益气汤对子宫脱垂中气下陷证患者盆底结缔组织的影响[J]. 中成药, 2021, 43(2): 492-496.
[2]	Sohail M, Uddin H, Nauman-ul-Islam M. Prevalence and therapeutic measures of postpartum uterine diseases in achai cattle at livestock research & development station Surezai, Peshawar[J]. J Dairy Vet Anim Res, 2018, 7(4): 150-152.
[3]	秦昌富, 陈杰, 申英末, 等. 基于中国疝病注册登记随访系统的腹外疝治疗现状分析与流行病学研究[J]. 中华消化外科杂志, 2021, 20(7): 785-789.
[4]	Sun YH, Kan WC, Wu MP, et al. Application of single-incision transvaginal mesh in a woman undergoing peritoneal dialysis and suffering from refractory advanced stage pelvic organ prolapse[J]. Gynecol Minim Invasive Ther, 2017, 6(2): 63-65.
[5]	王佳佳. 阴道前后壁修补术联合阴式子宫全切术治疗中重度子宫脱垂的疗效[J/OL]. 中华疝和腹壁外科杂志(电子版), 2020, 14(1): 64-70.
[6]	印慧琴. 阴式骶棘韧带悬吊术+阴道前后壁修补术联合阴式子宫切除术治疗子宫脱垂的疗效观察[J]. 医学临床研究, 2018, 35(5): 949-951.
[7]	王洋. 经阴道子宫切除联合阴道前后壁修补术对盆腔器官脱垂患者生活质量及盆底功能的影响[J]. 医学临床研究, 2018, 35(1): 150-152.
[8]	Sun C, Ren XY, Gao Y, et al. Clinical Efficacy and Safety of Major Uterine Wall Reconstruction of the Uterus Combined with LNG-IUS for the Treatment of Severe Adenomyosis[J]. Gebuetshilfe Frauenheikd, 2020, 80(3):300-306..
[9]	贾群玲, 王华斌, 王俊. 两种不同手术方式治疗对中重度子宫脱垂患者的影响[J]. 中国妇产科临床杂志, 2019, 10(1): 67-68.
[10]	Elad L, Mona T, Polina S, et al. Long-term outcome(5-10 years) after non absorbable mesh insertion compared to partially absorbable mesh insertion for anterior vaginal wall prolapse repair[J]. International Braz J Urol, 2019, 45(6): 11-12.
[11]	李晓, 沈明坤. 盐酸右美托咪定在阴式子宫切除术中的应用效果[J]. 贵州医药, 2018, 42(11): 1361-1362.
[12]	Cella D, Smith AR, Griffith JW, et al. A new outcome measure for LUTS: symptoms of lower urinary tract dysfunction research network symptom index-29(LURN SI-29) questionnaire[J]. Neurourol Urodyn, 2019, 38(6): 1751-1759.
[13]	Killinger KA, Henrichsen JL, Han E, et al. Symptom and quality of life improvements after pelvic floor physical therapy in a clinical population of women with pelvic pain and other symptoms[J]. Female Pelvic Med Reconstr Surg, 2019, 3(6): 171-179.
[14]	王英, 简燕琳, 李成利. 阴道盆底重建术联合TVT-O治疗子宫脱垂疗效及对盆底功能,尿动力学影响[J]. 中国计划生育学杂志, 2021, 29(9): 1873-1876.
[15]	朱朝霞, 蒋莉莉, 张安乐, 等. 阴式子宫切除术联合阴道前后壁修补术对子宫脱垂合并阴道壁膨出患者术后疼痛及复发的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2020, 14(5): 532-535.
[16]	韩一栩, 刘玉珠, 陈琨. 阴式全子宫切除及阴道前后壁修补手术对子宫脱垂患者性生活质量的影响分析[J]. 中国性科学, 2018, 27(4): 56-59.
[17]	佛新艳, 李萍, 秦娜. 经阴道子宫切除联合阴道前后壁修补术对盆腔器官脱垂患者生活质量及盆底功能的影响[J]. 临床和实验医学杂志, 2019, 18(16): 1778-1781.

组别	例数	疗效显著	有效	无效	总有效率
对照组	34	13(38.24)	8(23.52)	13(38.24)	21(61.76)
观察组	34	16(47.06)	13(38.24)	5(14.71)	29(85.29)
χ²					4.84
P					0.03

组别	例数	疗效显著	有效	无效	总有效率
对照组	34	13(38.24)	8(23.52)	13(38.24)	21(61.76)
观察组	34	16(47.06)	13(38.24)	5(14.71)	29(85.29)
χ²					4.84
P					0.03

组别	例数	PVR(ml)		Qmax(ml/s)
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	34	3.70±0.29	2.88±0.17^*	30.22±5.22	21.55±3.22^*
观察组	34	3.68±0.23	2.58±0.27^*	29.22±5.67	19.55±3.19^*
t		0.32	5.48	0.76	2.57
P		0.75	0.00	0.45	0.01

组别	例数	PVR(ml)		Qmax(ml/s)
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	34	3.70±0.29	2.88±0.17^*	30.22±5.22	21.55±3.22^*
观察组	34	3.68±0.23	2.58±0.27^*	29.22±5.67	19.55±3.19^*
t		0.32	5.48	0.76	2.57
P		0.75	0.00	0.45	0.01

组别	例数	手术时间(min)	术中出血量(ml)	住院时间(d)
对照组	34	75.68± 8.88	393.88±10.17	12.22±2.52
观察组	34	70.01±12.29	379.58±13.27	9.43±3.67
t		2.13	4.99	3.65
P		0.03	0.00	0.00

Please choose a citation manager

Content to export