Objective: To investigate the changes of inflammatory response, stress response and urodynamic changes after total pelvic floor reconstruction in patients with pelvic organ prolapse. Methods: According to random data ...Objective: To investigate the changes of inflammatory response, stress response and urodynamic changes after total pelvic floor reconstruction in patients with pelvic organ prolapse. Methods: According to random data table method, 80 cases of pelvic organ prolapse were randomly divided into the control group (n=40) and observation group (n=40), patients in the control group were given conventional vaginal hysterectomy plus vaginal wall repair sugery and the observation group received total pelvic floor reconstruction. The levels of the serum inflammatory factor,oxidative stress before and after surgery, and postoperative urodynamic changes were compared. Results: The levels of serum hs-CRP, IL-1β,TNF-α, NE, E and Ins in the two groups before treatment were not statistically significant. Compared with the group before treatment, the levels of hs-CRP, IL-1β, TNF-α, NE, E were significantly increased in both groups after treatment, and the observation group levels were significantly lower than those in the control group after treatment;in terms of urodynamics, the postoperative maximal bladder volume and Qmax were significantly higher in the observation group than in the control group, the postoperative levels of PdetQMax, PdetMax and PVR in the observation group were significantly lower than those in the control group. Conclusion: Compared with vaginal hysterectomy plus vaginal wall repair sugery, total pelvic floor reconstruction can light the patient's inflammation, stress response and improve the patient's urinary function, and the overall effect is better which has important clinical value.展开更多
Objective To evaluate the effectiveness and safety of the entire pelvic floor reconstruction(Prolift) with uterus reserved in the treatment of pelvic floor dysfunction diseases.Methods From March 2008 to January 2009,...Objective To evaluate the effectiveness and safety of the entire pelvic floor reconstruction(Prolift) with uterus reserved in the treatment of pelvic floor dysfunction diseases.Methods From March 2008 to January 2009,74 female cases from our hospital who had different defects in pelvic organ prolapse were treated with the entire reconstructive pelvic surgery,in which 38 had uterus retained(observation group) and 36 cases had hysterectomy(control group).The two groups were compared.The patients with combined stress urinary incontinence had transobturator tension-free vaginal tape(TVT-O technique) at the same time.The results of operations were objectively evaluatedaccording to Pelvic Organ Prolapse Quantification sub-degree method(POP-Q) developed by the International Continence Society.Results For observation group,the average operative time was 50 min,and the average amount of bleeding was 100 mL.For control group,the average operative time was 110 min,and the average amount of bleeding was 200 mL.During the postoperative follow-up(8 ~18 months),in the observation group the structures of patients' pelvic floor were normal;stress urinary incontinence was all cured;related symptoms disappeared or were markedly improved;and no postoperative infection appeared.In control group,two cases had postoperative infection;the patients ' pelvic structures were normal during the postoperative follow-up;the related symptoms disappeared or were significantly improved.After 3 months,POP-Q score was significantly elevated in the two groups.Conclusion Full reconstructive pelvic surgery with uterus retained can complete the whole pelvic floor structure and function of all or part of the reconstruction with fast recovery and clear short-term effect.However,the long-term efficacy remains to be revealed.展开更多
With increasing age,pelvic organ prolapse(POP),due to its high incidence,has become a common disease that seriously affects patients’quality of life and places a heavy economic burden on families and society.Transvag...With increasing age,pelvic organ prolapse(POP),due to its high incidence,has become a common disease that seriously affects patients’quality of life and places a heavy economic burden on families and society.Transvaginal mesh(TVM)is a minimally invasive and effective treatment for POP,although its use remains controversial due to the potential risk of mesh-related complications.The US Foods and Drugs Administration,along with authorities in England,Australia,New Zealand,and other countries,have banned the sale and distribution of commercial TVM kits designed for POP.The TVM procedure remains an option for POP treatment and still appeals to many surgeons and patients today in Asia and most European countries,which suggests that a considerable number of POP patients can benefit from its continued refinement.Here we introduce the Huaxi protocol of the TVM plant for the treatment of POP.展开更多
Pelvic organ prolapse （POP） is non-fatal conditions which can markedly affect a patient’s quality of life. Multiple recently developed pelvic reconstructive surgeries have led to a recent expansion in China. In thi...Pelvic organ prolapse （POP） is non-fatal conditions which can markedly affect a patient’s quality of life. Multiple recently developed pelvic reconstructive surgeries have led to a recent expansion in China. In this study, we would like to discuss various aspects of the evaluation and management of POP and raise the question of what is sufficient evidence for the adoption of innovative treatments for POP.展开更多
目的分析腹腔镜下子宫/阴道骶骨固定术与改良全盆底功能重建术治疗中盆腔缺陷所致的盆腔器官脱垂(pelvic organ prolapse,POP)的疗效比较。方法回顾性收集2008年1月至2012年12月在我院接受腹腔镜下子宫/阴道骶骨固定术(观察组,57例)和...目的分析腹腔镜下子宫/阴道骶骨固定术与改良全盆底功能重建术治疗中盆腔缺陷所致的盆腔器官脱垂(pelvic organ prolapse,POP)的疗效比较。方法回顾性收集2008年1月至2012年12月在我院接受腹腔镜下子宫/阴道骶骨固定术(观察组,57例)和改良全盆底功能重建术(对照组,55例)的患者临床资料。随访利用盆腔器官脱垂定量(pelvic organ prolapse quantification POP-Q)评分法比较患者客观满意度;主观症状改善评分(patient global impression of change,PGI-C)比较主观满意度;比较手术时间和出血量等围手术期参数;术后比较并发症、再次手术率;利用盆底生活质量问卷(pelvic floor distress inventory-short form 20,PFDI-20;pelvic floor impact questionnaire 7,PFIQ-7)比较2组术前、术后生活质量评分。结果所有患者手术都有较好的结局。观察组与对照组相比,减少了出血量、留置尿管时间、术后住院时间。在平均42个月的随访中,主观满意度在观察组为57/57(100%),在对照组为51/55(92.73%)(P>0.05);客观满意度在观察组为45/57(78.95%),在对照组为38/55(69.09%)(P>0.05)。PGI-C评分在观察组显著优于对照组;PFDI-20、PFIQ-7问卷2组评分均较术前显著改善,但2组间并无显著差异;性生活质量问卷(pelvic organ prolapse/urinary incontinence sexual questionnaire-12,PISQ-12)评分在观察组术前及术后均优于对照组(P<0.01)。结论与改良全盆底功能重建术比较,腹腔镜子宫/阴道骶骨固定术可显著减少手术出血量、留置尿管时间和术后住院时间,有较好的主观症状改善。展开更多
文摘Objective: To investigate the changes of inflammatory response, stress response and urodynamic changes after total pelvic floor reconstruction in patients with pelvic organ prolapse. Methods: According to random data table method, 80 cases of pelvic organ prolapse were randomly divided into the control group (n=40) and observation group (n=40), patients in the control group were given conventional vaginal hysterectomy plus vaginal wall repair sugery and the observation group received total pelvic floor reconstruction. The levels of the serum inflammatory factor,oxidative stress before and after surgery, and postoperative urodynamic changes were compared. Results: The levels of serum hs-CRP, IL-1β,TNF-α, NE, E and Ins in the two groups before treatment were not statistically significant. Compared with the group before treatment, the levels of hs-CRP, IL-1β, TNF-α, NE, E were significantly increased in both groups after treatment, and the observation group levels were significantly lower than those in the control group after treatment;in terms of urodynamics, the postoperative maximal bladder volume and Qmax were significantly higher in the observation group than in the control group, the postoperative levels of PdetQMax, PdetMax and PVR in the observation group were significantly lower than those in the control group. Conclusion: Compared with vaginal hysterectomy plus vaginal wall repair sugery, total pelvic floor reconstruction can light the patient's inflammation, stress response and improve the patient's urinary function, and the overall effect is better which has important clinical value.
文摘Objective To evaluate the effectiveness and safety of the entire pelvic floor reconstruction(Prolift) with uterus reserved in the treatment of pelvic floor dysfunction diseases.Methods From March 2008 to January 2009,74 female cases from our hospital who had different defects in pelvic organ prolapse were treated with the entire reconstructive pelvic surgery,in which 38 had uterus retained(observation group) and 36 cases had hysterectomy(control group).The two groups were compared.The patients with combined stress urinary incontinence had transobturator tension-free vaginal tape(TVT-O technique) at the same time.The results of operations were objectively evaluatedaccording to Pelvic Organ Prolapse Quantification sub-degree method(POP-Q) developed by the International Continence Society.Results For observation group,the average operative time was 50 min,and the average amount of bleeding was 100 mL.For control group,the average operative time was 110 min,and the average amount of bleeding was 200 mL.During the postoperative follow-up(8 ~18 months),in the observation group the structures of patients' pelvic floor were normal;stress urinary incontinence was all cured;related symptoms disappeared or were markedly improved;and no postoperative infection appeared.In control group,two cases had postoperative infection;the patients ' pelvic structures were normal during the postoperative follow-up;the related symptoms disappeared or were significantly improved.After 3 months,POP-Q score was significantly elevated in the two groups.Conclusion Full reconstructive pelvic surgery with uterus retained can complete the whole pelvic floor structure and function of all or part of the reconstruction with fast recovery and clear short-term effect.However,the long-term efficacy remains to be revealed.
基金National Key Research and Development Program of China,Grant/Award Numbers:2021YFC2009100,2021YFC2009102Natural Science Foundation of Sichuan Province,Grant/Award Number:2022NSFSC1308。
文摘With increasing age,pelvic organ prolapse(POP),due to its high incidence,has become a common disease that seriously affects patients’quality of life and places a heavy economic burden on families and society.Transvaginal mesh(TVM)is a minimally invasive and effective treatment for POP,although its use remains controversial due to the potential risk of mesh-related complications.The US Foods and Drugs Administration,along with authorities in England,Australia,New Zealand,and other countries,have banned the sale and distribution of commercial TVM kits designed for POP.The TVM procedure remains an option for POP treatment and still appeals to many surgeons and patients today in Asia and most European countries,which suggests that a considerable number of POP patients can benefit from its continued refinement.Here we introduce the Huaxi protocol of the TVM plant for the treatment of POP.
文摘Pelvic organ prolapse （POP） is non-fatal conditions which can markedly affect a patient’s quality of life. Multiple recently developed pelvic reconstructive surgeries have led to a recent expansion in China. In this study, we would like to discuss various aspects of the evaluation and management of POP and raise the question of what is sufficient evidence for the adoption of innovative treatments for POP.
文摘目的分析腹腔镜下子宫/阴道骶骨固定术与改良全盆底功能重建术治疗中盆腔缺陷所致的盆腔器官脱垂(pelvic organ prolapse,POP)的疗效比较。方法回顾性收集2008年1月至2012年12月在我院接受腹腔镜下子宫/阴道骶骨固定术(观察组,57例)和改良全盆底功能重建术(对照组,55例)的患者临床资料。随访利用盆腔器官脱垂定量(pelvic organ prolapse quantification POP-Q)评分法比较患者客观满意度;主观症状改善评分(patient global impression of change,PGI-C)比较主观满意度;比较手术时间和出血量等围手术期参数;术后比较并发症、再次手术率;利用盆底生活质量问卷(pelvic floor distress inventory-short form 20,PFDI-20;pelvic floor impact questionnaire 7,PFIQ-7)比较2组术前、术后生活质量评分。结果所有患者手术都有较好的结局。观察组与对照组相比,减少了出血量、留置尿管时间、术后住院时间。在平均42个月的随访中,主观满意度在观察组为57/57(100%),在对照组为51/55(92.73%)(P>0.05);客观满意度在观察组为45/57(78.95%),在对照组为38/55(69.09%)(P>0.05)。PGI-C评分在观察组显著优于对照组;PFDI-20、PFIQ-7问卷2组评分均较术前显著改善,但2组间并无显著差异;性生活质量问卷(pelvic organ prolapse/urinary incontinence sexual questionnaire-12,PISQ-12)评分在观察组术前及术后均优于对照组(P<0.01)。结论与改良全盆底功能重建术比较,腹腔镜子宫/阴道骶骨固定术可显著减少手术出血量、留置尿管时间和术后住院时间,有较好的主观症状改善。
