Clinical observation of pelvic floor muscle reconstruction in the treatment of female vaginal laxity combined with stress urinary incontinence
10.3760/cma.j.cn114453-20240617-00158
- VernacularTitle:盆底肌重建法治疗女性阴道松弛伴发压力性尿失禁的效果观察
- Author:
Fengyong LI
1
;
Zhuomin JIA
;
Yilin LI
;
Meichen LIU
;
Yipeng JIN
;
Yansheng XU
Author Information
1. 中国医学科学院北京协和医学院整形外科医院会阴整形与性别重塑科，北京 100144
- Publication Type:Journal Article
- Keywords:
Muscles;
Pelvic floor;
Reconstruction;
Female;
Stress urinary incontinence;
Vaginal laxity
- From:
Chinese Journal of Plastic Surgery
2024;40(12):1283-1288
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the feasibility of pelvic floor muscle reconstruction for women with vaginal laxity accompanied by stress urinary incontinence (SUI).Methods:A prospective cohort clinical study was conducted to collect clinical data from patients with vaginal laxity and SUI admitted to the Urogenital Reconstructive and Gender-affirming Department at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and the Department of Urology, Third Medical Center, Chinese PLA General Hospital, from January 2019 to September 2022. Patients underwent surgical treatment for pelvic floor muscle reconstruction. The cough provocation test and the patient global impression of improvement (PGI-I) scale were utilized as objective and subjective indicators of treatment effecacy, respectively. The urinary incontinence quality of life scale (I-QOL) and the pelvic organ prolapse and urinary incontinence sexual function questionnaire 12(PISQ-12) were used to evaluate the changes in quality of life and sexual funtion. The changes in pelvic floor anatomical structure were evaluated by pelvic floor ultrasound. Data analysis was performed using SPSS version 23.0. The I-QOL and PISQ-12 scores, posterior vesicourethral angle, urethral rotation angle, and bladder neck motion before and after surgery were analyzed using paired t-test, with P<0.05 was considered statistically significant. Results:A total of 36 female patients were included, with an average age of 41.7 years (ranged 24-51 years) and an average body mass index of 23.8 kg/m 2. The average operation time was 76.2 minutes, and the average blood loss was 84.5 milliliters. After 12-27 months of postoperative follow-up, the objective and subjective cure rates were 86.1% (31/36) and 88.9% (32/36), respectively. The sexual function and quality of life of the patients were significantly improved compared with the preoperative results, and postoperative pelvic floor ultrasound results showed significant improvement. The I-QOL and PISQ-12 scores 12 months after surgery were statistically significant compared with those before surgery ( P<0.01). Postoperative pelvic floor ultrasonography revealed statistically significant differences in posterior vesicourethral angle, urethral rotation angle, and bladder neck motion during maximum Valsalva maneuver compared to preoperative data ( P<0.01). Conclusion:Pelvic floor muscle reconstruction is a safe and effective surgical method for patients with vaginal laxity combined with SUI. This procedure can significantly improve sexual quality of life and alleviates SUI symptoms, restores anatomical structure in the female pelvic floor, and enhances overall quality of life.
