To investigate the clinical effect of laparoscopic transvaginal hysterectomy and traditional hysterectomy combined with anterior and posterior vaginal wall repair in elderly patients with severe uterine prolapse complicated with stress urinary incontinence, and to compare the long-term prognosis.

From January 2017 to July 2020, elderly patients with severe uterine prolapse complicated with stress urinary incontinence were prospectively recruited from the gynecological clinic and inpatient department of Taikang Xianlin Drum Tower Hospital. The subjects were divided into control group (n=40) and observation group (n=40) by computer random number table method. The observation group was given laparoscopic transvaginal total hysterectomy combined with simultaneous anterior and posterior vaginal wall repair, and the control group was given traditional total hysterectomy combined with simultaneous anterior and posterior vaginal wall repair. The operation time, blood loss, anal exhaust time, total hospitalization time, total medical expenses, self-perceived pain duration, pain severity 12 h after surgery, and postoperative complications of the two groups were compared. After two years of follow-up, the pelvic organ prolapse rate and the degree of stress urinary incontinence by incontinence impact questionnaire short form (IIQ-7) were compared between the two groups within 2 years after operation.

The operation time, blood loss, anal exhaust time and total hospitalization time of the observation group were lower than those of the control group, and the total medical cost of the observation group was higher than that of the control group (P<0.05). The duration of self-perceived pain and visual analogue scale (VAS) score at 12 h after operation in the observation group were lower than those in the control group (P<0.05). The incidence of postoperative complications in the observation group was lower than that in the control group (P>0.05). The IIQ-7 scores in the observation group were significantly lower than those in the control group within 2 years after operation and the difference was statistically significant (P<0.05). There was no significant difference in the recurrence rate of pelvic organ prolapse between the two groups (P>0.05).

In the surgical treatment of patients with uterine prolapse, the choice of laparoscopic assisted vaginal hysterectomy can effectively improve the effect and safety of surgical operation, shorten the operation time, reduce the blood loss of patients, promote postoperative recovery, reduce the severity of postoperative pain and improve the symptoms of stress urinary incontinence.