腹腔镜子宫骶韧带高位两段四点悬吊术治疗盆腔器官脱垂合并慢性盆腔痛

Two-segment Four-point Top-of-vaginae Laparoscopic High Sacral Ligament Suspension in the Treatment of Pelvic Organ Prolapse Combined With Chronic Pelvic Pain

目的探讨腹腔镜子宫骶韧带高位两段四点悬吊术治疗盆腔器官脱垂(pelvic organ prolapse,POP)合并慢性盆腔痛(chronic pelvic pain,CPP)的近期疗效。方法回顾性分析2019年1月~2021年1月腹腔镜子宫骶韧带高位两段阴道顶端四点悬吊术治疗POP合并CPP 52例资料。POP-QⅠ度21例,Ⅱ度22例,Ⅲ度9例。CPP轻度16例,中度31例,重度5例。术前及术后3、6、12个月进行POP-Q评分、PFDI-20量表评分及盆底肌肉疼痛评分评估疗效。结果52例术中、术后均无严重并发症发生。术后12个月48例脱垂分度降级,POP客观治愈率88%(46/52);49例PFDI-20量表所有项目评分≤60分,POP主观治愈率94%(49/52);49例盆底肌肉疼痛评分较前下降≥50%,CPP治疗有效率94%(49/52)。结论腹腔镜子宫骶韧带高位两段四点悬吊术对POP合并CPP有良好疗效。

Objective To discuss the short-term efficacy of two-segment four-point top-of-vaginae laparoscopic high sacral ligament suspension in the treatment of pelvic organ prolapse(POP)combined with chronic pelvic pain(CPP).Methods A total of 52 POP patients combined with CPP who underwent two-segment four-point top-of-vaginae laparoscopic high sacral ligament suspension from January 2019 to January 2021 were studied retrospectively.There were 21 cases of POP-QⅠ,22 cases of POP-QⅡ,and 9 cases of POP-QⅢ.The CPP was mild in 16 cases,moderate in 31 cases,and severe in 5 cases.The POP-Q score,PFDI-20 score and pelvic pain score before operation,and at 3 months,6 months,and 12 months after operation were studied to evaluate the curative effect.Results There were no serious complications during and after operation in the 52 patients.At 12 months after operation,48 patients were degraded in prolapse grading and the objective satisfaction of POP was 88%(46/52).Besides,49 patients had PFDI-20 score≤60 in all questions,and the subjective cure rate of POP was 94%(49/52).The pelvic pain score of 49 patients decreased by more than 50%,and the subjective satisfaction of CCP treatment was 94%(49/52).Conclusion Two-segment four-point top-of-vaginae laparoscopic high sacral ligament suspension has a good effect for POP combined with CPP.