The therapeutic effect of extraperitoneal tension-free uterine suspension in the treatment of pelvic organ prolapse

doi:10.3877/cma.j.issn.1674-392X.2024.03.016

Abstract

Abstract:

Objective

To explore the clinical curative effect of laparoscopic extraperitoneal tension-free uterine suspension(LETUS) and laparoscopic vaginal sacral colpopexy (LVSC) in the treatment of pelvic organ prolapse (POP).

Methods

A total of 92 patients with POP in the Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were enrolled and divided into an observation group (n=46) and a control group (n=46) between January 1, 2022 and June 1, 2023 by random number table method. The control group was treated with LVSC, while the observation group was treated with LETUS. The surgical indexes, pelvic organ prolapse quantitation (POP-Q) indexes, pelvic floor function, pelvic floor muscle strength and complications were compared between the two groups before and after surgery.

Results

The intraoperative blood loss, operation time and hospitalization time in the observation group were lower than those in the control group [(50.23±8.74) ml vs (82.06±13.52) ml, (206.81±30.96) min vs (272.49±42.07) min, (5.72±0.84) d vs (7.06±1.09) d; P<0.001]. At 6 months after surgery, C, Aa, Ap, Ba and Bp were improved in both groups (P<0.05), but there was no significant difference between the two groups (P>0.05). At 6 months after surgery, the PFIQ-7 score was lower in the observation group than the control group, and the PISQ-12 score was higher in the observation group than the control group [(16.26±3.93) points vs (25.60±4.45) points, (38.94±4.42) points vs (34.51±4.03) points; P<0.001]. At 6 months after surgery, muscle potential, static tension and dynamic tension were higher in the observation group than the control group [(15.01±2.26) μV vs (12.43±1.87) μV, (159.30±22.08) g/cm² vs (137.84±24.31) g/cm², (234.26±29.62) g/cm² vs (202.31±26.98) g/cm²; P<0.001]. The incidence of complications in observation group was lower than that in control group (P=0.044).

Conclusion

The curative effect of both LETUS and LVSC is good in POP. However, the former can shorten postoperative recovery time, improve pelvic floor function, enhance pelvic floor muscle strength and reduce complications.

Key words: Pelvic organ prolapse, Laparoscope, Extraperitoneal tension-free uterine suspensionn, Vaginal sacral colpopexy, Clinical curative effect

Hong Tang, Qi Zhou, Xiaoling Ouyang, Yongfeng Wang, Yu Hua, Xiaobai Hao, Linxia Li. The therapeutic effect of extraperitoneal tension-free uterine suspension in the treatment of pelvic organ prolapse[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(03): 315-319.

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References 21

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组别	例数	年龄(岁)	孕次	产次	体重指数(kg/m²)	病程(年)
观察组	46	54.28±6.75	3.02±0.81	1.63±0.39	22.89±1.41	4.83±0.90
对照组	46	53.63±7.06	2.85±0.76	1.58±0.42	23.12±1.37	4.54±0.78
t值		0.451	1.038	0.592	0.793	1.651
P值		0.653	0.302	0.556	0.430	0.102

组别	例数	年龄(岁)	孕次	产次	体重指数(kg/m²)	病程(年)
观察组	46	54.28±6.75	3.02±0.81	1.63±0.39	22.89±1.41	4.83±0.90
对照组	46	53.63±7.06	2.85±0.76	1.58±0.42	23.12±1.37	4.54±0.78
t值		0.451	1.038	0.592	0.793	1.651
P值		0.653	0.302	0.556	0.430	0.102

组别	例数	前盆腔脱垂程度			中盆腔脱垂程度			后盆腔脱垂程度
组别	例数	Ⅱ期	Ⅲ期	Ⅳ期	Ⅱ期	Ⅲ期	Ⅳ期	Ⅱ期	Ⅲ期
观察组	46	22(47.83)	21(45.65)	3(6.52)	25(54.35)	16(34.78)	5(10.87)	29(63.04)	17(36.96)
对照组	46	24(52.17)	18(39.13)	4(8.70)	21(45.65)	18(39.13)	7(15.22)	26(56.52)	20(43.48)
χ²值		0.461			0.799			0.407
P值		0.794			0.671			0.524

组别	例数	前盆腔脱垂程度			中盆腔脱垂程度			后盆腔脱垂程度
组别	例数	Ⅱ期	Ⅲ期	Ⅳ期	Ⅱ期	Ⅲ期	Ⅳ期	Ⅱ期	Ⅲ期
观察组	46	22(47.83)	21(45.65)	3(6.52)	25(54.35)	16(34.78)	5(10.87)	29(63.04)	17(36.96)
对照组	46	24(52.17)	18(39.13)	4(8.70)	21(45.65)	18(39.13)	7(15.22)	26(56.52)	20(43.48)
χ²值		0.461			0.799			0.407
P值		0.794			0.671			0.524

组别	例数	术中出血量(ml)	手术时间(min)	排气时间(d)	住院时间(d)
观察组	46	50.23±8.74	206.81±30.96	1.48±0.39	5.72±0.84
对照组	46	82.06±13.52	272.49±42.07	1.61±0.42	7.06±1.09
t值		13.410	8.528	1.538	6.604
P值		<0.001	<0.001	0.128	<0.001

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