Objective To investigate the effectiveness of laparoscopic Y-shaped polypropylene mesh in the treatment of uterine and vaginal vault prolapse. Methods Between June 2010 and December 2012, 24 patients with uterine and vaginal vault prolapse were treated by laparoscopic pelvic reconstruction (vagina and uterus-sacral fixation) with Y-shaped polypropylene mesh. The age of patients was 35-60 years (mean, 48.6 years). The disease duration was 2-8 years (mean, 5 years). According to the pelvic organ prolapse quatitative (POP-Q) classification by International Continence Society (ICS), 16 cases were classified as uterine prolapsed degree II and 8 cases as degree III; 15 cases were classified as vaginal prolapse degree I, 7 cases as degree II, and 2 cases as degree III. All patients received postoperative follow-up regularly. Subjective evaluation was done based on prolapse quality of life questionnaire (P-QOL), and objective evaluation based on POP-Q classification. Results All the patients were operated successfully. The operation time was 22-68 minutes (mean, 33 minutes); the blood loss was 30-80 mL (mean, 51 mL); the indwelling urethral catheter remain was 3-7 days (mean, 4 days); and the hospitalization days were 4-9 days (mean, 6.8 days). Twenty-four patients were followed up 3-12 months (mean, 9 months), of whom, 2 were followed up less than 6 months. All patients had normal urination after withdrawal of urethral catheter, and the residual urine volume was in normal range. No patients had mesh erosion and discomfort during sex, vaginal and anal bearing down. The P-QOL scores at 3, 6, and 12 months after operation were significantly improved when compared with the preoperative value (P lt; 0.05); but there was no significant difference among 3, 6, and 12 months after operation (P gt; 0.05). The postoperative POP-Q classification was degree 0 in 19 cases and degree I in 3 cases, and the objective cure rate was 91.7%. No recurrence was found during follow-up. Conclusion Laparoscopic Y-shaped polypropylene mesh for treatment of uterine and vaginal vault prolapse is a safe and effective method, especially applicable to preserve the uterus, and higher requirements of sexual life of patients.
In order to standardize and improve the level of TCM diagnosis and treatment of uterine prolapse, the Gynecology Branch of China Association of Traditional Chinese Medicine and the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine took the lead in initiating the revision of the "Guidelines for the TCM diagnosis and treatment of uterine prolapse". Based on the existing relevant literature, the guideline revision working group strictly abides by the principles and steps of evidence-based guideline revision, and establishes a multi-disciplinary and multi-field expert team to standardize the guideline revision work. This plan focuses on the necessity of guideline revision, the establishment and division of labor of the guideline project team, the determination of clinical problems, the screening and evaluation of evidence, and the formation of recommendations.