Objective To evaluate the feasibility and efficacy of modified pelvic reconstructive surgery for severe pelvic organ prolapse ( POP ) with polypropylene mesh. Methods From November 2008 to May 2010, 120 cases of POP with surgery treatment were enrolled in the study. They were divided into study group ( n = 55 ) treated with modified pelvic reconstructive surgery ( uterus conservation group, UCG group ) and control group ( n =65 ) undergoing total vaginal hysterectomy and colporrhaphy ( hysterectomy group, HG group ). The perioperative information, POP score before and after operation and cure rate of two groups were compared. Results There were no significant differences in mean operation time ( 120. 3 ± 36. 5min vs 135. 7 ± 34. 2min, t = 0. 12,P = 0. 62 ) and intraoperative blood loss ( 78. 9 ±20. 9mL vs 82. 1 ±22. 0ml, t = 1. 39 ,P =0. 71 ) between two groups, but the mean postoperative hospital stay of UCG group was significantly shorter than that of HG group( 5.0±0. 3d vs 7.1±0. 6d,t = 3.92,P<0. 01. The cure rate of two groups after 1-year follow up was significantly different 92.7% vs77.5% ,χ2 =5.97,P=0.02 ). Conclusion Modified pelvic reconstructive surgery for treatment of POP can remain uterus, and it is simple to practice with safety and minimal invasion. The patients recover quickly. UCG is an effective method to treat severe POP.%目的 探讨女性盆腔器官脱垂(POP)应用聚丙烯网片在保留子宫的同时进行盆底重建的可行性和有效性.方法 以2008年11月至2010年5月期间手术治疗的120例女性盆腔器官脱垂患者为研究对象,分为研究组55例行保留子宫的改良式全盆底悬吊术(UCG 组)和对照组65例行传统的阴式子宫全切加阴道前后壁修补术(HG组).比较两组围手术期情况、术前术后POP-Q评分及治愈率.结果 两组平均手术时间(120.3±36.5min vs 135.7±34.2min,t=0.12,P=0.62)及术中出血量(78.9±20.9mL vs 82.1±22.0ml,t=1.39,P=0.71)无统计学意义;UCG组平均术后住院日比HG组短(5.0±0.3d VS 7.1±0.6d,t=3.92,P＜0.01).随访1年后的治愈率,两组间差异有统计学意义(92.7% vs 77.5%,χ2=5.97,P=0.02).结论 与HG组比较,UCG治疗重度POP可保留子宫,手术简单、安全、微创,患者术后恢复快.UCG是治疗重度POP的有效术式.
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