Analysis of the influencing factors of new stress urinary incontinence in patients with uterine prolapse after vaginal hysterectomy combined with anterior and posterior vaginal wall repair

Abstract

Objective To explore the related factors of stress urinary incontinence in patients with uterine prolapse after vaginal hysterectomy combined with anterior and posterior vaginal wall repair. Methods From January 2017 to January 2019, we selected 50 patients who were hospitalized in Tianchang hospital Traditional Chinese Medicine for vaginal hysterectomy and the anterior and posterior vaginal walls repair. The patients were excluded from acute urinary incontinence and stress urinary incontinence before operation. All patients were discharged smoothly after operation. The patients were followed up for 2 months. According to the subjective symptoms, physical examination results and urinary incontinence questions of the international urinary incontinence Advisory Committee The international consultation on Incontinence Questionnaire-short form (ici-q-sf) and urodynamic examination were used to diagnose and count the patients with new stress urinary incontinence after operation, and the factors that may cause new stress urinary incontinence after operation were analyzed. Results (1) 15 cases of new stress urinary incontinence were treated by vaginal hysterectomy combined with anterior and posterior vaginal wall repair, of which 5 cases had obvious subjective symptoms, 6 cases had no obvious abnormality in subjective symptoms and physical examination, the diagnosis was confirmed only after completing the questionnaire, and 4 cases were confirmed by urodynamic examination. (2) Univariate analysis showed that the history of diabetes mellitus, BMI, history of giant fetus delivery, and history of pelvic surgery were the related factors influencing the new onset of stress urinary incontinence. (3) With the occurrence of urinary incontinence as a dependent variable (0=not occurred, 1=occurred), four factors with statistical differences in single factor analysis were included in the multivariate logistic regression analysis. The results showed that the history of diabetes mellitus, pelvic surgery and the history of giant fetus delivery were independent risks of new onset stress urinary incontinence after vaginal hysterectomy combined with anterior and posterior vaginal wall repair Factor. Conclusion For the patients with uterine prolapse who have the history of fetal delivery, pelvic surgery and diabetes mellitus, we can strengthen the communication with the patients before the operation, and inform the patients of the risk of new onset of stress urinary incontinence after the operation, and after improving the relevant evaluation, we suggest that the patients should have synchronous anti urinary incontinence operation to improve the prognosis and quality of life. Key words: Uterine prolapse; Vaginal hysterectomy; Repair of anterior and posterior wall of vagina; New stress urinary incontinence