The safety and effectiveness of treating the cervical enlongaton combined with POP by the modified fixation of cervix and sacral ligment with mesh laparoscopically

Abstract

Objective To explore the safety and effectiveness of modified fixation of cervix and sacral ligment with mesh laparoscopiclly to deal with the cervical enlongation combined with pelvic organ prolapse(POP). Methods The clinical data of 14 cases of cervical enlongation combined with POP, Apr 2014 to Apr. 2016, was analyzed retrospectively. Operation time, blood loss and postoperative complications and therapeutic effect were observed. The patients were followed up every 3 months including the quality of life(Qolity of life quwstionnaire 36 short form, QOL-36-SF), quality of sexual life(pelvic organ prolapse/urinary incontinence sexual function questionnaire, P-ISQ) and the vaginal examination results. Results The 14 female patients were 59-78 years old(average 67.5 years), were diagnosed as cervical enlongation combined with POP. The POP degree was marked by POP-Q systerm. Two were POP-Q Ⅱ, 7 were POP-Q Ⅲ and 5 were POP-Q Ⅳ. All patients were cured with mesh by modified fixing the cercix to sacral ligament laparoscopically. The operation time was (180±24)min, blood loss was(70±12)ml. Complications were not observed and all patients went home (3.8±0.6) days after the surgery. During the following-up, All the patients recovered well and twelve of them had intercourse 3 months after the surgery. The score of QOL-36-SF in physiological dimensions was (52.8±6.7) preoperatively and (60.7±9.1) postoperatively. The difference was statistically significant(P<0.05); the score of QOL-36-SF in psychological dimensions was (46.7±7.6) preoperatively and (70.2±8.5) postoperatively, The difference was statistically significant(P<0.05). Eleven patients have sexual life before and after the surgery. The score of P-ISQ was (61.2±35.5) preoperatively and (78.2±37.6) and postoperatively. The difference was statistically significant(P<0.05). The results of vaginal examination were normal. Conclusions The modified fixing the cervix to sacral ligment with mesh laparoscopically is a safe and effective method to cure the cervical enlongation combined with POP. Key words: Cervical enlongation; Pelvic organ prolapse; Laparoscope; Fixation of cervix and sacral ligment; Y mesh