盆底松驰综合征的病理生理与外科治疗的研究

Pathophysiology and surgical treatment on Relaxed Pelvic Floor Syndrome

OBJECTIVE: To study the pathophysiology of the "Relaxed Pelvic Floor Syndrome (RPFS)" and to assess the value of the "Pelvic Cavity Fixation Operation (PCFO)" for the syndrome. METHOD: 11 patients, who were diagnosed as having RPFS, underwent standardized PCFO. All the patients were followed for a mean time of 19 months (5 - 72 months). RESULT: The main syndromes and signs included difficulty in defecation, inability to empty the rectum properly, fullness of perineum, protrusion of perineum at bearing down, back-inclining uterus, relaxation of the rectum on digital examination. The anorectal dynamics showed that the sequence pressure and rest pressure of the anal cannel were lower and the time of contraction of the anal cannel decreased than that of the normal controls. The rectum sensation was damaged slightly. Defeacography showed that there were relaxing changes in several systems in the pelvic cavity. Operatively, it was easy to see the relaxation of the supporting structure of the colon, rectum, uterus and the lower position of the peritoneal cavity. PCFO has achieved good results. Seven patients were free of symptoms completely and 4 improved. CONCLUSION: The relaxing changes of the supporting tissue of many viscus fefer to several systems are the pathophysiologic of the RPFS. "Pelvic Cavity Fixation Operation" is useful in the treatment of the syndrome.