Department of Obstetrics and Gynecology, Dicle University School of Medicine, Diyarbakır, Turkey.
Niger J Clin Pract. 2022 May;25(5):597-604. doi: 10.4103/njcp.njcp_1449_21.
Treatment of total genital prolapse in elderly patients is still controversial in terms of postoperative objective and subjective results.
The present study aimed to compare the long-term objective and subjective cure rates of sacrospinous ligament fixation and Le Fort operation for treatment of total genital prolapse.
Patients over the age of 60 with stage 3 or 4 pelvic organ prolapse that presented to the Obstetrics and Gynaecology Clinic of the Faculty of Medicine of *** University. The study sample consisted of 17 patients that underwent Le Fort operation and 29 patients that underwent sacrospinous ligament fixation. Data on duration of operation, intraoperative complications, duration of hospital stay, and differences between preoperative and postoperative estimated blood loss, postoperative complications, and relapse in the long term were obtained. Questionnaires exploring quality of life, incontinence, and pelvic floor disorders were applied to the patients.
As subjective cure rates, postoperative patient satisfaction (P = 0.001), regret rate (P = 0.038) and recommendation rate (P = 0.044), as well as postoperative questionnaire results, Pelvic Floor Impact Questionnaire and SF36 were found to be significantly better in the Le Fort group (respectively P = 0.039 and 0.042). As objective cure rates, there was no difference between the two groups in terms of postoperative cystocele, rectocele, and cystorectocele (P = 0.955) and postoperative recurrence of prolapse beyond the hymen (P: 0.893). Duration of operation and duration of hospital stay were found to be significantly shorter in the Le Fort group (respectively P = 0.032 and 0.012).
Le Fort operation could be the intervention of choice in sexually inactive elderly patients with stage 3 or 4 pelvic organ prolapse.
对于老年患者的完全性生殖器脱垂，术后的客观和主观结果仍存在争议。
本研究旨在比较骶骨固定和 Le Fort 手术治疗完全性生殖器脱垂的长期客观和主观治愈率。
来自***大学医学院妇产科诊所的年龄在 60 岁以上、患有 3 或 4 期盆腔器官脱垂的患者。研究样本包括 17 例行 Le Fort 手术的患者和 29 例行骶骨固定术的患者。获取了手术持续时间、术中并发症、住院时间以及术前和术后估计出血量、术后并发症和长期复发的差异等数据。采用问卷调查的方式，对患者的生活质量、尿失禁和盆底功能障碍进行了调查。
作为主观治愈率，术后患者满意度（P = 0.001）、后悔率（P = 0.038）和推荐率（P = 0.044）以及术后问卷调查结果，盆腔器官脱垂/尿失禁性功能问卷和 SF36 评分，Le Fort 组明显更好（分别为 P = 0.039 和 0.042）。作为客观治愈率，两组术后膀胱膨出、直肠膨出和膀胱直肠膨出（P = 0.955）以及处女膜外脱垂复发（P：0.893）无差异。Le Fort 组的手术时间和住院时间明显缩短（分别为 P = 0.032 和 0.012）。
对于无性生活的 3 或 4 期盆腔器官脱垂老年患者，Le Fort 手术可能是一种干预手段。
