阴道骶韧带悬吊术预防子宫全切术后盆底功能障碍的效果评价

 目的 评价骶韧带悬吊术在预防腹式子宫全切术后盆底功能障碍的效果。方法 选择2012-01至2013-06住院的符合子宫全切术指征的良性疾病且子宫体积≥12孕周患者84例,随机分为两组,每组42例。单纯组为单纯腹式子宫全切术,联合组为腹式子宫全切术加骶韧带悬吊术。比较术后6、12个月阴道长度以及脏器脱垂及其程度、压力性尿失禁等情况。结果 术后6、12个月联合组阴道长度分别为(7.72±1.76)cm、(8.13±1.46)cm,均长于单纯组(6.91±1.40)cm、(6.74±1.74)cm。术后12个月联合组发生压力性尿失禁者1例,单纯组8例,两组存在统计学差异(P=0.029)。术后12个月联合组患者发生膀胱膨出者2例,单纯组9例,两组存在统计学差异(P=0.048)。结论 阴道骶韧带悬吊术可预防腹式子宫全切术后的盆底功能障碍。

Efficacy of vaginal uterosacral ligament suspension for preventing postoperative pelvic floor dysfunction after hysterectomy

Objective To evaluate the effect of sacral ligament suspension on the prevention of pelvic floor dysfunction after total abdominal hysterectomy. Methods Eighty-four cervical cancer patients in the hospital from January 2012 to June 2013 undergoing total hysterectomy were enrolled into this study and divided into abdominal hysterectomy group (control group) and abdominal hysterectomy plus uterosacral ligament suspension surgery (combined group). We compared the postoperative vaginal length, sexual satisfaction, organ prolapse and degree, and stress urinary incontinence after 6 and 12 months. Results 6 and 12 months after the operation, in total abdominal hysterectomy with sacral suspensory ligament group, vaginal lengths were (7.72±1.76)cm ,(8.13±1.46)cm, longer than in total abdominal hysterectomy group(6.91±1.40)cm,(6.74±1.74)cm. 12 months after surgery, in combination group of patients, stress urinary incontinence occurred in 1 case, in simple group 8 cases, with a significant difference (P=0.029). 12 months after surgery, in combination group of patients, bladder bulging occurred in 2 cases, in simple group of 9 cases, with a significant difference (P=0.048). Conclusions Vaginal uterosacral ligament suspension can prevent pelvic floor dysfunction after abdominal hysterectomy.