Clinical Efficacy of Laparoscopic Non Mesh Vaginal Sacral Fixation in the Treatment of Pelvic Organ Prolapse with Mainly Middle Pelvic Defects
10.13241/j.cnki.pmb.2025.12.006
- VernacularTitle:腹腔镜下非网片阴道骶骨固定术治疗中盆腔缺陷为主的盆腔器官脱垂的临床疗效
- Author:
Liu-ming LI
1
;
Xin-dan WANG
1
;
Ding-yuan ZENG
1
Author Information
1. 广州市妇女儿童医疗中心柳州医院妇科 广西柳州 545005
- Publication Type:Journal Article
- Keywords:
Laparoscopy;
Vaginal sacral fixation surgery;
Pelvic organ prolapse;
Mesh;
Curative effect
- From:
Progress in Modern Biomedicine
2025;25(12):1961-1968
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the clinical efficacy of laparoscopic non mesh vaginal sacral fixation(LSC)in the treatment of pelvic organ prolapse(POP)patients with mainly middle pelvic defects.Methods:55 cases of laparoscopic non mesh LSC patients with POP with mainly middle pelvic defects were selected from August 2019 to February 2023 at Liuzhou Hospital of Guangzhou Women and Children's Medical Center.The surgical condition of POP patients were observed.Patients were followed up after surgery,the position and recurrence of the anterior vaginal wall(Ba)point,posterior vaginal wall(Bp)point,and vaginal apex(C)point in POP patients before and after surgery were observed.The preoperative and postoperative pelvic floor dysfunction questionnaire scores of POP patients treated by laparoscopic non mesh LSC were compared.And the occurrence of short-term and long-term complications in POP patients after surgery were observed.Results:Among the 55 POP patients with laparoscopic non mesh LSC,11 underwent bilateral adnexectomy,3 underwent bilateral salpingectomy,55 underwent anterior vaginal wall repair,28 underwent posterior vaginal wall repair,2 underwent paravaginal repair,and 28 underwent perineal laceration repair.Additionally,2 underwent tension free mid urethral suspension via the pubic posterior vaginal wall,and 3 underwent mid urethral folding.The average duration of the surgery was(197.8±48.7)minutes,and the intraoperative blood loss was 50(30,50)mL.The postoperative indwelling time of the urinary catheter was 2.0(1,3)days,the postoperative residual urine volume was 6(0,11)mL,and the hospital stay was 10(8,12)days.Among the 55 POP patients,all surgeries were successful,with a success rate of 100％.The follow-up period ended in September 2024,with an average follow-up time of(42.14±11.37)months.2 cases were lost to follow-up,and 53 patients were successfully followed up,including 48 outpatient follow-up patients and 5 telephone follow-up patients.Among the 48 outpatient follow-up patients,1 case had a recurrence of the anterior vaginal wall,with a recurrence rate of 2.08％(1/48).The patient did not undergo anterior vaginal wall repair during surgery,and after surgery,the patient felt that there was a mass protruding from the vagina.However,the symptoms improved on their own after rest,and no further surgery was performed.The comparison of Ba points,C points,and Bp points before and after surgery in 48 outpatient follow-up patients showed statistically significant differences(P＜0.05).The comparison of preoperative and postoperative pelvic organ prolapse distress inventory(POPDI),Urogenital distress inventory(UDI),and Pelvic Floor Distress Inventory-short From-20(PFDI-20)scores among 53 POP patients showed statistically significant differences(P＜0.05),there was no statistically significant difference in preoperative and postoperative colorectal-anal distress inventory(CRADI)scores among the 53 POP patients(P＞0.05).There were a total of 11 cases of postoperative complications in 55 POP patients,including 1 case of enteritis,2 cases of urinary tract infections,1 case of bladder injury,1 case of lower back pain,pelvic pain,and difficulty defecation,and 5 cases of newly developed urinary incontinence.The incidence of complications was 20.00％(11/55).The long-term follow-up results of POP patients showed that 4 patients had no sexual activity after surgery,and 49 patients resumed sexual activity after surgery,among them,47 patients reported an improvement in their sexual experience compared to before surgery,accounting for 95.92％(47/49).Two patients were unable to have normal sexual activity due to painful intercourse,accounting for 4.08％(2/49).Conclusion:Laparoscopic non mesh LSC treatment for POP patients with mainly middle pelvic defects has a high success rate,few complications,good short-term and long-term follow-up effects,and can significantly improve pelvic floor dysfunction symptoms.
