Clinical efficacy of pelvic autologous tissue reconstruction in treating pelvic organ prolapse in 36 patients

Abstract

This study aims to search for a new, economic, convenient, and low recurrence rate operation for the surgical management of pelvic organ prolapse (POP). The clinical value of the operation for treating POP was determined through retrospective case series. The new operation was called, pelvic autologous tissue reconstruction.

Women with symptomatic uterine prolapse, who required surgery, were recruited. A total of 97 women [stage III to IV, according to POP quantification (POP-Q) staging] were collected from January 2010 to December 2016. Among these women, 61 women underwent a traditional operation (TO, vaginal hysterectomy and vaginal anterior and posterior wall repair), while the remaining women underwent pelvic autologous tissue reconstruction.

First, there was no statistically significant difference in intraoperative blood loss, indwelling urethral catheter time, in-hospital time, and the time of passage of gas through the anus between the pelvic autologous reconstruction (PAR) and TO groups ( P > .05). The average operation time in the PAR group was significantly longer than that in the TO group ( P < .05). Second, ultrasonic parameters before and after the operation between the 2 groups were compared. The postoperative rotation angle of the urethra (UR), posterior vesicourethral angle (PVA), and bladder neck descent (BND) significantly decreased in the PAR group ( P < .05). There was no statistically significant difference in UR between before and 12 months after surgery in the TO group ( P > .05). Furthermore, BND increased in the TO group at 12 months after the operation, compared with that at 3 months after the operation ( P < .05). There was no significant difference in PVA and UR before the surgery and at 3 and 12 months after the surgery between the 2 groups ( P > .05). In addition, BND was significantly smaller in the PAR group than in the TO group at 3 and 12 months after the surgery ( P < .05). Third, there was no statistically significant difference in PFIQ-7 and PISG-12 in both groups after surgery.

The stability of the pelvic floor structure was better in the PAR group than in the TO group. Furthermore, PAR is better for preventing the occurrence of pelvic floor prolapse and stress urinary incontinence after surgery.