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Must be based on the incidence of uterine prolapse and anatomic changes in the mechanism, the choice of surgical procedures should consider the following:
(A) the location and degree of prolapse.
(B) the location and size of the uterus, cervix or extended and whether the degree of hypertrophy.
(C) the width of the levator ani muscle and elastic fracture.
(D) the patient's age and general health. Frail elderly undergo complicated surgery is difficult.
(E) the need to retain reproductive function. If a child has been in the birth of the age, should consider sterilization.
(F) the need to retain sexual function.
(G) and complications of tension.
Although many surgical methods can mainly be classified into the following categories:
(A) the main ligaments shorten the relaxation to improve the support strength of the uterus.
(B) to correct abnormal uterine morphology. If the cervix has been extended hypertrophy, part of the cervix must be removed to restore normal cervical length.
(C) shortening the pubic bladder cervical fascia, strengthening the anterior vaginal wall supportive.
(D) suture pubococcygeus fracture, perineal re-establish well-functioning body.
Used for the surgical repair of vaginal anterior and posterior wall, perineal repair and partial resection of the cervix, the operation is relatively simple, better for the majority of uterine prolapse. Followed by vaginal hysterectomy, vaginal repair of anterior and posterior wall re


pair and perineum.

Key words urinary incontinence Tension
55 years old 173 patients (93.01%), fetal birth more than 3 125 cases (67.20%), textile workers and teachers in 114 cases (61.29%), chronic cough or constipation in 44 cases (23.66%). degree prolapse, the average age and duration were significantly greater than the prolapse (P55 years old, prolific, standing workers, chronic cough or constipation prone to uterine prolapse; the degree of uterine prolapse with age and disease progression; uterine prolapse tension higher incidence of urinary incontinence, vaginal hysterectomy with higher rates and higher recurrence rate. Therefore, or more are advised early surgery of uterine prolapse after surgery recurrence re-operation the effect is still good.Li Aitian, Wang Ping, Liu Jianhua

Changle Sanitary School of Shandong Province, Shandong26240
Abstract Objective To study causes of uterine prolapse; the relationship between prolapse degree and ages, and prolapse degree and operative ways, and surgical effects.Methods 186cases with uterine prolapse were retrospec tively studied.The delivery history, working conditions, relationship between disease course and prolapse degree, operative ways, and surgical effects were investigated.Results All186cases had vaginal deliveries, with173cases aged over55years (93.01%), with125cases more than3deliveries (67.20%), with114cases textile workers and teachers (61.29%), with44cased with chronic cough or constipation (23.66%). The average age and disease course in cases of Grade were significantly higher and longer than that in cases of Grade (P
Uterine prolapse is the relaxation of pelvic support tissue disease due to organ prolapse, vaginal delivery after more common in older women, especially postmenopausal women, a higher prevalence. or more often with anterior vaginal prolapse and / or bulging of the posterior wall of the vagina, the anterior vaginal wall prolapse were part of the women also often accompanied by tension incontinence [1]. The several conditions are required surgical treatment, the choice of surgical approach should be based on the patient's age, the degree of uterine prolapse and clinical symptoms may be [2]; Either there is recurrence after surgical procedure were possible. I now work in clinical or more of women in the treatment of uterine prolapse and follow-up report below.1.1 General Information retrospective analysis of Shanghai Second Medical University Ninth People's Hospital and the Kunshan City First People's Hospital in January 1991 ~ December 2000 of 186 hospitalized cases of uterine prolapse surgery, surgery patients were followed up for 3 to 9 years. Sub-degree uterine prolapse see reference [3].

1.2 Methods of delivery in patients with frequency and mode of delivery, the nature of work, surgery, surgical results and postoperative recurrence in some patients for analysis. 3 years of post-menopausal women who planned hysterectomy operation before the given day of Premarin (0.625mg) or Connaught Kun Fu (1mg) oral, and even served 2 weeks; not hysterectomy by the application of Premarin Vaginal or Premarin cream for 2 weeks.

1.3 2 test using statistical method and the t test, significant criteria to take P = 0.055, 173 (93.01%). Are vaginal delivery, delivery 1 child in 9 cases (4.84%), 2 child labor in 52 cases (27.96%), fetal birth more than 3 125 cases (67.20%); farmers in 49 cases (26.34%), textile workers 63 cases (33.87%), teachers in 51 cases (27.42%), other 23 cases (12.37%); 23 patients with chronic cough (12.37%), constipation in 21 cases (11.29%). prolapse 131 cases (70.43%), prolapse in 55 cases (29.57%), all patients with varying degrees of anterior vaginal wall and / or posterior wall prolapse. and the average age and duration of prolapse in Table Statistical analysis showed that the composition of the two groups than differences in surgical procedure there was significant (PUterine prolapse associated with anterior vaginal wall and / or bulging of the posterior wall of the causes of vaginal clear, except for a few pelvic floor tissue dysplasia, the overwhelming majority and productive, vaginal delivery, standing work and chronic cough and habit constipation. Child labor in this information more than 3 125 cases (67.20%), textile workers and teachers, 114 cases (61.29%), chronic cough or constipation in 44 cases (23.66%), also showed that the anterior wall of the uterus with vaginal prolapse and / or bulging of the posterior wall of the vagina with the above-mentioned causes. So pay attention to post-natal rest, strengthen labor protection, control of chronic long-term increase in intra-abdominal pressure can reduce the occurrence of the disease.

Early treatment can reduce the recurrence of uterine prolapse associated with anterior vaginal wall and / or bulging of the posterior wall of the vagina are developed from mild to severe, the data in uterine prolapse patients were older, more course elderly. Early treatment can avoid the more complicated vaginal hysterectomy, the data uterine prolapse vaginal hysterectomy plus vaginal anterior and posterior wall repair only 50.38%, Manchester and simple surgical repair of vaginal wall 46.56% . And uterine prolapse vaginal hysterectomy plus vaginal anterior and posterior wall repair accounted for 89.09%. During surgery, menopause, I found more difficult the longer the surgery, even if the local plus oral estrogen treatment for 2 weeks after the pelvic floor tissue elasticity is still poor, surgery organizations also prone to tear, causing difficulties in operation, and uterus prolapse recurrence rate after surgery. recurrence of uterine prolapse if symptoms are mild. Anterior vaginal prolapse associated with uterine prolapse and urinary incontinence who have tension, better treatment by operation, all the tension the situation under control urinary incontinence. Fewer recurrences in this information, only 10 cases, but again results of operations are good, uterine prolapse recurrence after surgery has also been re-tension control urinary incontinence.

Therefore, uterine prolapse associated with anterior vaginal wall and / or vaginal wall prolapse or more by early surgical treatment is appropriate; recurrence after surgery is still a better surgical treatment again.1 FENG Ji. Obstetrics and Gynecology. Beijing: People's Medical Publishing House, 2002,37
2 Olsen Al.Suith VJ, Bergstorm JO, et al.Epidemiology of surgically man aged pelvic organ prolapse.Obstet Gynicol
3 Nichols DH.Gynecologic and obstetric surgery.St Louis: Mosby-year book, 1993,334(Edit if month)
400 Changle County, Shandong Province Health School

215300 Kunshan City, Jiangsu Province, the First People's Hospital


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