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

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Author:
CHEN Juan(Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China)
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)
SHI Hong-hui(Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China)
SUN Zhi-jing(Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China)
GONG Xiao-ming(Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China)
Journal Title:
Chinese Journal of Obstetrics and Gynecology
Issue:
Volume 47, Issue 07, 2012
DOI:
10.3760/cma.j.issn.0529-567x.2012.07.004
Key Word:
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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