In 2012, 32-year-old Ms. Wang gave birth to a baby boy during a long period of labor, and she had backache after giving birth, which improved after rest and waist massage.
In 2018, after long-term exercise and constipation, I felt that my abdomen was distended, my mouth was swollen, a lump came out and disappeared when I was lying down, and I didn't pay attention to urine leakage when walking, lifting heavy objects, and coughing.
In 2023, the urine leakage will worsen, and the prolapsed mass will become larger, affecting life, and in December, it was decided to go to the expert group of female urinary incontinence and pelvic floor diseases in the Department of Urology of the First Affiliated Hospital of Xi'an Jiaotong University.
After New Year's Day, Ms. Wang was admitted to the hospital for surgery**, and Professor Li Xudong performed "pelvic floor reconstruction + midurethral tension-free suspension" for her under general anesthesia! After surgery, the normal anatomical position of the posterior urethra of the bladder neck can be restored, the pressure in the posterior urethra can be increased, and the sphincter of the posterior urethra can be improved, so as to achieve the purpose of the highest level; Pelvic visceral bulge caused by pelvic floor injury and functional deterioration can be repaired through pelvic floor reconstruction, structural reconstruction and tissue replacement in women, so as to achieve the purpose of restoring the anatomical position of organs, and solve the symptoms of stress urinary incontinence and pelvic floor organ prolapse at one time through combined surgery.
Stress urinary incontinence (SUI) is present in 60% of patients with pelvic prolapse (POP), and we have found that patients with pelvic prolapse, some of whom have pelvic prolapse, have stress urinary incontinence in 10% to 12% of patients. Therefore, for patients with pelvic prolapse, we should still be active**, if the patient restores the prolapsed organ before surgery, and the patient is found to have stress urinary incontinence after the pressure-induced experiment, what should these patients do**?
For patients with POP-Q score prolapse POP with mild to moderate SUI, conservative should be the preferred recommended approach, and the choice should be based on factors such as patient preference, degree of disease, and benefits and risks of the chosen regimen. **Methods include follow-up observation, lifestyle intervention, pelvic floor muscle training (PFMT), pelvic floor physics**, application of pessary, medication**, traditional Chinese medicine acupuncture, etc.
Surgery with POP with SUI**.
Surgery with pure **POP has limited efficacy for SUI, and we recommend concomitant anti-SUI surgery (level of evidence: C). The main anti-SUI surgical methods are mid-urethral slings (MUS) and burch colposupension (burch).
Professor Li Xudong introduced: If the conservative ** is ineffective and the quality of life is poor, young patients are advised to do the mid-urethral tension-free suspension surgery after the pubic bone, not to do the transobturator, some patients with the obturator will have leg pain, and the sling should be better and use a super soft sling with a large mesh. Bladder prolapse should never be put on a mesh and sutured with slow absorbable threads.