RESUMO
OBJECTIVE: To investigate the effectiveness and safety of laparoscopic CY Liu non-mesh pelvic floor repair surgery in treatment of pelvic organ prolapse(POP).METHODS: From February 2016 to September 2017,a total of 83 patients with POP were treated in Zhejiang Province People's Hospital,and they were included in this retrospective study.The clinical data were retrospectively analyzed;the POP-Q scores were used as the objective evaluation indicators for POP.Analyze the changes of POP-Q indicator points after surgery,and observe surgery related data and complications.Evaluate the postoperative symptom improvement and subjective satisfaction rate of the patients using pelvic floor impact questionnaire short form(PFIQ-7).RESULTS: All surgeries of the included 83 patients were successfully finished laparoscopically.The average follow-up time was(18.88±3.82)months,but there were 8 cases of loss of follow-up.During the follow-up,the total anatomical success rate of laparoscopic CY Liu non-mesh pelvic floor repair surgery was 97.33%(73/75).The differences in POP-Q scores and PFIQ-7 scores were statistically significant before and after the surgery(P<0.05).Subjective satisfaction rate was 96.00%(72/75)after surgery.CONCLUSION: Laparoscopic CY Liu non-mesh pelvic floor repair surgery is effective in the management of Ⅱ-Ⅳ pelvic organ prolapse.There's no need for mesh,and the recurrence rate is low in short-term follow-up,which is worth paying attention to.
RESUMO
Objective To discuss the clinical value of the suture of sacral ligament and pubovaginalis fascia plus sacrospinous ligament fixation in the treatment of moderate and severe pelvic organ prolapse ( POP) . Methods Thirty-two cases with moderate or severe POP,who were treated by the suture of sacral ligament and pubovaginalis fascia besides sacrospinous ligament fixation,were retrospectively analyzed. Results The locations of POP in the 32 patients were mainly in the anterior and middle pelvis cavity. The degree of uterine prolapse was not less than POP-Q Ⅲ phase. The anterior and/or posterior vaginal walls were also prolapsed. The patients were treated by the transvaginal panhysterectomy,vaginal wall neoplasty,sacrospinous ligament fixation and the suture of sacral ligament and pubovaginalis fascia. Those with stress incontinence were also treated with urethral posterior ligament plication. The operation time was 60~120 min,and the hemorrhage vol-ume was 100~300 mL. There were no severe complications or recurrence in all patients. Conclusion The suture of sacral ligament and pubovaginalis fascia could greatly reduce the hazard rate of the recurrence of anterior pelvic organ defects in POP patients treated by sacrospi-nous ligament fixation. The suture operation could strengthen the anterior pelvis cavity,and was proven to be simple,secure and effective. Therefore,the operation is valuable to be used in clinical application.