title: Total pelvic floor reconstruction surgery for repair of severe pelvic organ prolapse.
abstract: OBJECTIVE
  To evaluate clinical effectiveness of total pelvic floor reconstruction surgery for repair of severe pelvic organ prolapse.
  
  
  METHODS
  We retrospectively analyzed the clinical data of 21 patients with severe pelvic organ prolapse. The anatomical outcomes were evaluated by Pelvic Organ Prolapse Quantitation, functional effectiveness by Prolapse Quality of Life method, and sexual function and operation-related complications were also analyzed.
  
  
  RESULTS
  All surgical operations were accomplished successfully by the same surgeon. No impairment of bladder, urethra, rectum, or great vessels was noted, and no patient required blood transfusion. The mean operation duration was (63±19) minutes, and the mean intra-operative blood loss was (143±72) ml. One patients experienced post-operative urinary retention for 7 days, and the remaining 20 patients were able to micturate spontaneously 1-2 day after surgery. The post-operative morbidity rate was 14.3%. Three patients (14.3%) experienced mesh erosion. Of 12 patients who were sexually active, two patients suffered from algopareunia from dyspareunia, one from de novo overactive bladder, and one from stress urinary incontinence Questionnaire scores showed that the overall post operative quality of life was improved significantly (P=0.000), while quality of sexual life significantly degraded (P=0.044) The anatomic cure rate was 95.2% (20/21), and the patient subjective satisfaction rate was 85.7% (18/21)
  
  
  CONCLUSIONS
  The total pelvic floor reconstruction is a safe and effective approach for the repair of severe pelvic organ prolapse, although its functional effectiveness is not as notable as anatomical outcomes However, the complications such as mesh erosion, low urinary tract symptoms, algopareunia, and dyspareunia should be carefully managed.
authors.affiliation: Department of Gynaecology and Obstetrics, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Xiao-chun
authors.forename: Zhu
authors.initials: Z
authors.lastname: Lan
authors.forename: Lang
authors.initials: L
authors.lastname: Jing-he
authors.forename: Shi
authors.initials: S
authors.lastname: Hong-hui
authors.forename: Gong
authors.initials: G
authors.lastname: Xiao-ming
authors.forename: Li
authors.initials: L
authors.lastname: Lin
authors.forename: Fan
authors.initials: F
authors.lastname: Rong
mesh_terms: D000368:Aged; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery*; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome