Chinese Journal of Clinical Anatomy ›› 2021, Vol. 39 ›› Issue (5): 613-618.doi: 10.13418/j.issn.1001-165x.2021.05.021

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Study on the effect of modified laparoscopic uterosacral fixation on the treatment of moderate and severe metroptosis

Ai Xiaoyan, Zhu Yirong, Ke Cancan, Yu Yujie   

  1. Department of Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang 330006, China
  • Received:2020-05-19 Online:2021-09-25 Published:2021-09-30

Abstract: Objective To explore the clinical effect and the effect on the quality of life of patients with pelvic organ prolapse quantitive examination POP-Q Ⅱ/Ⅲmetroptosis treated by modified laparoscopic uterosacral fixation (MLUC). Methods Sixty cases of moderate and severe metroptosis admitted in our hospital from May 2017 to January 2019 were selected as the study object. The patients were randomly divided into two groups: a conventional group and an improved group, 30 cases each. The conventional group was treated with laparoscopic uterosacral fixation (LUC), and the improved group was treated with MLUC. The clinical indexes, objective cure rate, clinical complications, recurrence rate, quality of life and sexual function improvement were compared between the two groups. Results The operation time, intraoperative bleeding volume, catheter retention time and hospitalization time of the improved group were all less than those of the conventional group (P<0.001). Aa, Ba, D, Ap and Bp of the two groups at six months after operation significantly improved compared with those before operation (P<0.001). There was no obvious change in TVL of the conventional group (P>0.05), but TVL of the improved group was significantly less than that of the conventional group (P<0.05).There was no significant difference in the objective cure rate (93.33% in the improved group: 90.00% in the conventional group), recurrence rate (13.33% in the improved group: 16.67% in the conventional group) between the two groups (P>0.05). The incidence of clinical complications in the improved group (6.67%) was lower than that in the conventional group (26.67%),(P<0.05). Six months after operation, the quality of life and sexual function of the two groups significantly improved (P<0.001). The PFDI -20, UDI-6, POPDI -6, CRADI-8 and the score of sexual pain in the improved group were lower than those in the conventional group, and the scores of libido, sexual arousal, orgasm, vaginal lubrication and sexual satisfaction were higher than those in the conventional group (P<0.05).    Conclusions    LUC is a safe and effective treatment for patients with moderate and severe metroptosis. Compared with conventional LUC, MLUC is simpler, with less bleeding shorter operation time and hospital stay, lower postoperative complications, and better improvement effect on the patients’ quality of life, which is worthy of further promotion and application.

Key words: Modified laparoscopic Uterosacral fixation; Middle pelvic defect; Clinical effect, Complication; Quality of life

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