Quality of life after surgery for genital prolapse in elderly women: obliterative and reconstructive surgery
Quality of life after surgery for genital prolapse in elderly women: obliterative and reconstructive surgery
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DOI：
10.1007/s00192-006-0240-5
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发表时间：
2007-07-01
影响因子：
1.8
通讯作者：
Walters, Mark D.
中科院分区：
文献类型：
--
作者：
Barber, Matthew D.;Amundsen, Cindy L.;Walters, Mark D.
本研究的目的是确定晚期盆腔器官脱垂的闭塞性和重建性阴道手术是否能改善老年妇女的生活质量。前瞻性招募年龄≥ 65岁、患有3期或4期盆腔器官脱垂、需要手术矫正的女性患者。受试者根据个人偏好和性期望接受闭塞或重建阴道手术。受试者在术前、术后6个月和12个月接受盆腔器官脱垂定量检查，并完成盆底窘迫量表（PFDI）、盆底影响问卷（PFIQ）、SF-36和Beck抑郁量表。入组79例受试者，其中70例完成随访：闭塞组30例，重建组40例。术后6个月和12个月，两组的PFDI和PFIQ的盆腔器官脱垂、泌尿和结直肠评分均有显著改善，两个治疗组之间无差异。此外，术后两组的SF-36的身体疼痛、活力、社会功能、角色情感和心理健康汇总量表均出现了具有临床意义的显著改善，组间无显著差异。在适当选择的老年妇女中，晚期盆腔器官脱垂的阴道闭合和重建手术均显著改善了健康相关的生活质量。
The objective of this study was to determine if obliterative and reconstructive vaginal surgery for advanced pelvic organ prolapse improve quality of life in elderly women. Women age 65 years or older with stage 3 or 4 pelvic organ prolapse who desired surgical correction were prospectively enrolled. The subjects underwent either obliterative or reconstructive vaginal surgery based on their personal preference and sexual expectations. The subjects received a pelvic organ prolapse quantitation examination and completed the pelvic floor distress inventory (PFDI), the pelvic floor impact questionnaire (PFIQ), the SF-36, and the Beck depression inventory preoperatively, 6 and 12 months after surgery. Seventy-nine subjects were enrolled, 70 of whom completed follow-up: 30 in the obliterative group and 40 in the reconstructive group. Both groups demonstrated significant improvements in the pelvic organ prolapse, urinary, and colorectal scales of the PFDI and PFIQ 6 and 12 months after surgery with no differences between the two treatment groups. In addition, there were significant and clinically important improvements noted in the bodily pain, vitality, social functioning, role-emotional, and mental health summary scales of the SF-36 in both groups after surgery, with no significant difference between groups. In appropriately selected elderly women, both obliterative and reconstructive vaginal surgery for advanced pelvic organ prolapse significantly improved health-related quality of life.