Abstract：
OBJECTIVE: The objective was to determine whether the addition of uterosacral ligament plication to pectopexy for pelvic organ prolapse increases anatomical improvement and female sexual functioning.
METHODS: This is a prospective randomised study. Forty patients who underwent laparoscopic pectopexy (LP) and laparoscopic pectopexy with uterosacral ligament plication (LPUSL) were included in the study. A total of 38 patients were evaluated in the study. Patients were assessed by the Pelvic Organ Prolapse Quantification (POP-Q) system and the patients who had symptomatic apical prolapse POP-Q ≥ II were included in the study. Patients were evaluated preoperatively and postoperatively at the 3rd, 6th and 12th month, with respect to anatomical changes as well as sexual function.
RESULTS: A statistically significant difference was found when the preoperative C points was compared with the C points postoperatively, at 3rd, 6th and 12th months in both the LP and LPUSL groups (p < 0.001). Additionally, there were statistically significant difference between the LP and LPUSL groups in terms of C and Aa points at the 6th and 12th postoperative months in favour of the LPUSL group (p = 0.007, p = 0.005 respectively). There was also a statistically significant difference when Ba points were compared between the two groups at the 12th postoperative month, in favour of the LPUSL group (p = 0.002). There were no statistically significant differences between the groups with respect to the variables of the Female Sexual Function Index. Additionally, all parameters were significantly better in both groups at the 3rd and 12th months than the preoperative values in post hoc analysis; only desire also had a significant improvement between the 3rd and 12th months in the LPUSL group in post hoc analysis.
CONCLUSIONS: Pectopexy operation seems to be a successful surgical approach as an alternative to sacrocolpopexy. The addition of uterosacral ligament plication to pectopexy operation improves the anatomical restoration more drastically than with LP on its own. Moreover, either LP or LPUSL has improved the majority of sexual function indices.
METHODS: This is a prospective randomised study. Forty patients who underwent laparoscopic pectopexy (LP) and laparoscopic pectopexy with uterosacral ligament plication (LPUSL) were included in the study. A total of 38 patients were evaluated in the study. Patients were assessed by the Pelvic Organ Prolapse Quantification (POP-Q) system and the patients who had symptomatic apical prolapse POP-Q ≥ II were included in the study. Patients were evaluated preoperatively and postoperatively at the 3rd, 6th and 12th month, with respect to anatomical changes as well as sexual function.
RESULTS: A statistically significant difference was found when the preoperative C points was compared with the C points postoperatively, at 3rd, 6th and 12th months in both the LP and LPUSL groups (p < 0.001). Additionally, there were statistically significant difference between the LP and LPUSL groups in terms of C and Aa points at the 6th and 12th postoperative months in favour of the LPUSL group (p = 0.007, p = 0.005 respectively). There was also a statistically significant difference when Ba points were compared between the two groups at the 12th postoperative month, in favour of the LPUSL group (p = 0.002). There were no statistically significant differences between the groups with respect to the variables of the Female Sexual Function Index. Additionally, all parameters were significantly better in both groups at the 3rd and 12th months than the preoperative values in post hoc analysis; only desire also had a significant improvement between the 3rd and 12th months in the LPUSL group in post hoc analysis.
CONCLUSIONS: Pectopexy operation seems to be a successful surgical approach as an alternative to sacrocolpopexy. The addition of uterosacral ligament plication to pectopexy operation improves the anatomical restoration more drastically than with LP on its own. Moreover, either LP or LPUSL has improved the majority of sexual function indices.
摘要：
目的：目的是确定在骨盆器官脱垂的胸膜固定术中增加子宫骶韧带折叠术是否能增加解剖学改善和女性性功能。
方法：这是一项前瞻性随机研究。本研究包括40例接受腹腔镜胸膜固定术（LP）和腹腔镜胸膜固定术合并子宫骶韧带折叠术（LPUSL）的患者。在研究中评估了总共38名患者。通过盆腔器官脱垂定量（POP-Q）系统评估患者，并将有症状的根尖脱垂POP-Q≥II的患者纳入研究。患者在术前和术后3日进行评估，第6个月和第12个月,关于解剖学变化以及性功能。
结果：术前C点与术后C点比较，差异有统计学意义，在第三,LP和LPUSL组的第6个月和第12个月(p<0.001)。此外,在术后第6个月和第12个月，LP和LPUSL组之间的C和Aa点在统计学上有显着差异，有利于LPUSL组（分别为p=0.007，p=0.005）。术后第12个月两组间Ba点比较也有统计学差异,有利于LPUSL组（p=0.002）。在女性性功能指数的变量方面，两组之间没有统计学上的显着差异。此外,在术后分析中,两组的所有参数在第3个月和第12个月均显著优于术前值;在术后分析中,LPUSL组的仅愿望在第3个月和第12个月之间也有显著改善.
结论：Pectopexy手术似乎是一种成功的手术方法，可以替代骶结肠切除术。与使用LP本身相比，在胸膜固定术中增加子宫骶韧带折叠可以更大地改善解剖恢复。此外，LP或LPUSL改善了大多数性功能指标。
方法：这是一项前瞻性随机研究。本研究包括40例接受腹腔镜胸膜固定术（LP）和腹腔镜胸膜固定术合并子宫骶韧带折叠术（LPUSL）的患者。在研究中评估了总共38名患者。通过盆腔器官脱垂定量（POP-Q）系统评估患者，并将有症状的根尖脱垂POP-Q≥II的患者纳入研究。患者在术前和术后3日进行评估，第6个月和第12个月,关于解剖学变化以及性功能。
结果：术前C点与术后C点比较，差异有统计学意义，在第三,LP和LPUSL组的第6个月和第12个月(p<0.001)。此外,在术后第6个月和第12个月，LP和LPUSL组之间的C和Aa点在统计学上有显着差异，有利于LPUSL组（分别为p=0.007，p=0.005）。术后第12个月两组间Ba点比较也有统计学差异,有利于LPUSL组（p=0.002）。在女性性功能指数的变量方面，两组之间没有统计学上的显着差异。此外,在术后分析中,两组的所有参数在第3个月和第12个月均显著优于术前值;在术后分析中,LPUSL组的仅愿望在第3个月和第12个月之间也有显著改善.
结论：Pectopexy手术似乎是一种成功的手术方法，可以替代骶结肠切除术。与使用LP本身相比，在胸膜固定术中增加子宫骶韧带折叠可以更大地改善解剖恢复。此外，LP或LPUSL改善了大多数性功能指标。
