Prospective multi-center study in "Xiehe" pelvic floor reconstruction surgery for severe pelvic organ prolapse

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SUN Zhi-jing(Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China)
MA Le()
ZHU Lan(Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China)
LANG Jing-he(Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China)
HUA Ke-qin()
YANG Xin()
HAN Jin-song()
LIANG Zhi-qing()
HU Li-na()
WANG Jian-liu()
Journal Title:
Volume 46, Issue 08, 2011
Key Word:
Uterine prolapse;Pelvic floor;Gynecologic surgical procedures;Quality of life;Prospective studies

Abstract: Objective To evaluate clinical efficiency and quality-of-life outcomes in treatment of severe pelvic organ prolapse by the "Xiehe" pelvic floor reconstruction surgery. Methods From Jun. 2006 to Dec. 2008, 277 severe pelvic organ prolapse patients with stage Ⅲ to Ⅳ from 8 hospitals in China were enrolled in this prospective study. Pelvic organ prolapse quantitative examination (POP-Q) and anatomic improvement in these patients after surgery were analyzed in this interim study. Comparisons of pelvic floor impact questionnaire-short form 7 (PFIQ-7) and pelvic floor distress inventory-short form 20 (PFDI-20) in these patients before and after surgery was used to evaluate quality of life. Comparison of pelvic organ prolapse-urinary incontinence sexual questionnaire (PISQ) in these patients before and after surgery was used to evaluate quality of sexual life. Results With a median follow-up of 14. 0 months (6 -28 months),twenty-three patients showed recurrent prolapse (8. 3%, 23/277), and anatomical success ( < stage 2 in the treated compartment) was 91.7% (254/277). In this series, mesh exposure or erosion rate was 6. 9% (19/277). The postoperative de novo stress incontinence rate was 6. 5% (18/277). The scores for PFIQ-7 and PFDI-20, and its subscales were significantly improved, the scores of before treatment were lower than those after treatment (P <0. 01 ). And there was no significant difference in the average score of PISQ before and after the surgery (76. 6 ± 15.4 versus 75.5 ± 14. 5 versus 73.6 ± 12. 6, P >0. 05 ), but the rate of de novo dyspareunia was 11% (9/80). Conclusions "Xiehe" pelvic floor reconstruction surgery was safe and efficacy in treatment of pelvic organ prolapse. It could improve quality of life remarkably with less cost when compared with the traditional total pelvic floor reconstruction surgery.

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