Bathla Sonal, Verghese George, Kalla Vinod, Sharma T C, Dam Subrat, Agarwal Nirmala, Balani Sweta, Dhamija Priti Arora, Agarwal Deepa, Kumar Praveen
Department of Obstetrics and Gynecology, Sant Parmanand Hospital, New Delhi, India.
Department of Anesthesiology, Sant Parmanand Hospital, New Delhi, India.
J Midlife Health. 2014 Jul;5(3):139-42. doi: 10.4103/0976-7800.141215.
The aim was to study the epidemiological factors responsible for pelvic organ prolapse (POP) in poor women of the remote village Shillai, do their POP quantification staging, to study the variety of surgeries conducted in mobile surgical camps in this area.
Retrospective analysis of surgeries conducted in five mobile surgical camps in Shillai, Himachal Pradesh from 2009 to 2013, under "Project Prolapse".
A total number of surgeries conducted in five camps from 2009 to 2013 were 490 including 192 gynecological surgeries. Eighty-two percent of gynecological surgery was conducted for POP. Poor nutritional status (mean weight 41.1 kg), multiparty (mean 3.5), early marriage (mean age 18.2 years), unassisted home deliveries (100%), premature bearing down (23.8%), early postpartum resumption of strenuous activity (54.7%) and smoking (33%) contribute to the high incidence of POP. Anterior compartment prolapse was seen in 99% of patients undergoing surgery while posterior compartment prolapse was seen in 4% of patients. Vaginal hysterectomy with anterior repair with culdoplasty was the most common procedure performed (73.4%), and vault suspension was done in 3.6% subjects. The complication rate was negligible.
Uterovaginal prolapse is not only socially embarrassing and disabling; its surgical treatment is complex and costly too. The free mobile surgical camps under Project Prolapse in Shillai, Himachal Pradesh has provided relief to old neglected, disabled women suffering from prolapse in this remote village. Parallel counseling of women and dais for safe hospital delivery and training subordinates in prolapse surgery may help in addressing the problem of POP in this area in the long run.
研究喜马偕尔邦希莱偏远村庄贫困女性盆腔器官脱垂（POP）的流行病学因素，对其POP进行量化分期，并研究该地区流动手术营地所实施的各类手术。
对2009年至2013年在喜马偕尔邦希莱“脱垂项目”下的五个流动手术营地所实施的手术进行回顾性分析。
2009年至2013年在五个营地共进行了490例手术，其中包括192例妇科手术。82%的妇科手术是针对POP进行的。营养状况差（平均体重41.1千克）、多产（平均3.5次）、早婚（平均年龄18.2岁）、在家无助产分娩（100%）、过早用力（23.8%）、产后过早恢复剧烈活动（54.7%）以及吸烟（33%）导致了POP的高发病率。99%接受手术的患者存在前盆腔脱垂，而4%的患者存在后盆腔脱垂。阴道子宫切除术加前壁修补及后穹窿成形术是最常实施的手术（73.4%），3.6%的患者进行了穹窿悬吊术。并发症发生率可忽略不计。
子宫阴道脱垂不仅在社会上令人尴尬且导致功能障碍；其手术治疗也复杂且昂贵。喜马偕尔邦希莱“脱垂项目”下的免费流动手术营地为这个偏远村庄中患有脱垂的被忽视老年残疾女性带来了缓解。长期来看，对妇女和助产士进行安全住院分娩的平行咨询以及脱垂手术下级培训可能有助于解决该地区的POP问题。
