[Short-term therapeutic effect of modified total pelvic floor reconstruction in treatment of severe pelvic organ prolapse].

OBJECTIVE: To evaluate short-term clinical effects of modified total pelvic floor reconstruction surgery in treatment of severe pelvic organ prolapse. METHODS: Thirty-nine cases with severe pelvic organ prolapse including vault prolapse diagnosed by pelvic organ prolapse quantification (POP-Q) system received modified total pelvic floor reconstruction surgery. Clinical parameters associated peri-operative period and 12 months after surgery and complications were analyzed. RESULTS: Median operation time was 70 minutes (30-240 minutes), median blood loss was 100 ml (10-200 ml). Seventy-seven percent (30/39) patients were able to micturate spontaneously in the next morning after surgery with postvoid residual volume less than 100 ml (0-650 ml). No severe intra-operative complications were recorded and the rate of postoperative morbidity was 20% (8/39). Median post-operative hospital stay was 4 days (1-11 days). The patients were followed up at median 24 months (13-29 months). According to POP-Q system evaluation, the successful rate of operation reached 100%. Two cases (5%, 2/39) were recorded as symptomatic recurrence which manifested as posterior wall prolapse within 24 months after operation. During follow-up, 8% (3/39) patients were found to have erosion within 7 months after surgery, and urgent urinary incontinence was observed in 5% (2/39) cases, while constipation occurred in 8% (3/39) cases. The most remarkable complication was dyspareunia (36%, 5/14); while 50% (7/14) experienced better sexual life after surgery. CONCLUSIONS: Modified total pelvic reconstruction is a safe, efficient and micro-invasive surgery in treatment of severe pelvic organ prolapse. However, its influence on post-operative sexual life should be concerned.