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Study on ischiospinous ligament fixation in treatment of stage Ⅲ pelvic organ prolapse

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Author:
No author available
Journal Title:
Chinese Journal of Obstetrics and Gynecology
Issue:
7
DOI:
10.3760/cma.j.issn.0529-567x.2012.07.004
Key Word:
妇科外科手术;治疗结果;盆腔器官脱垂;Gynecologic surgical procedures;Treatment outcome;Pelvic organ prolapse

Abstract: Objective To evaluate the safety and efficacy of ischiospinous ligament fixation in treatment of stage Ⅲ pelvic organ prolapse (POP).Methods Between March 2007 and December 2009,65 patients with stage Ⅲ POP who underwent ischiospinous ligament fixation in Peking Union Medical College Hospital were enrolled in this study.Among 21 cases complicated with stress urinary incontinence (SUI) underwent transobturator tension-free vaginal tape (TVT-O) concomitantly.Clinical parameter associated with perioperation,objective and subjective successful rate and complication were recorded.Results The mean operating time was (71 ±22) min and the mean blood loss was (93 ±40) ml.No intraoperative blood transfusion and viscera injury cases were observed.All patients were able to recover spontaneous micturition.Two cases experienced pelvic hematoma with diameter of 7 cm,after conservative treatment,they all recovered later.The objective success rate was 100% at 6 weeks follow-up by POP-Q scoring.And 46.2% (30/65) were followed up at range of 1 -3 years,recurrence rate were 10% (3/30),and however,no operation were needed.At median of 20 months,all patients were followed up by telephone,the subjective successful rate was 95.4% (62/65).At 6 weeks after operation,6.2% (4/65) patients suffered from lower back pain and right thigh pain,visual analogue scale of pain was at range of 3 to 5,which relieved gradually after treatment and disappeared totally within 2 years.The rate of suture exposure was 10% (3/30),the new urinary incontinence 4.6% (3/65),and the new dyspareunia 12.5% (3/24).Conclusions Ischiospinous ligament fixation is a safe and efficacious management.

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