Analysis of differences in Pelvic Organ Prolapse Quantification scores at different anatomical sites before and after anesthesia for guiding surgical planning in female patients with pelvic organ prolapse

分析麻醉前后不同解剖部位盆腔器官脱垂定量评分的差异,以指导盆腔器官脱垂女性患者的手术方案制定。

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Abstract

OBJECTIVE: This study aimed to analyze the differences in Pelvic Organ Prolapse Quantitation (POP-Q) scores before and after anesthesia in patients with pelvic organ prolapse at different sites and explore the influence of POP-Q scores on surgical decision making. METHODS: A prospective observational study was conducted involving 60 female patients with pelvic organ prolapse who underwent surgical treatment at the Chongqing Health Center for Women and Children between January 2023 and June 2023. The cohort included 26 patients with uterine prolapse and 34 patients with cystocele. POP-Q scores and other relevant data were compared under two conditions: before anesthesia (with Valsalva maneuver) and after anesthesia (with cervical traction). RESULTS: There were no statistical differences in the mean age, menopausal status, mean body mass index, mean number of pregnancies, or related primary diseases between the two groups (p>0.05). The minimum tractive force required for cervical traction after anesthesia was 4.81 N. In both groups, the POP-Q scores for points C, D, and Bp were significantly higher after anesthesia than before anesthesia (p<0.05). In the uterine prolapse group, there were no significant changes in the scores for points Aa, Ba, and Ap before and after anesthesia (p>0.05). However, in the cystocele group, the score for point Aa decreased significantly after anesthesia compared to before anesthesia (p=0.016). CONCLUSION: The increased scores of points C, D, and Bp after anesthesia suggest that the evaluations of uterine prolapse should be based on post-anesthesia measurements. Conversely, evaluations of cystocele should rely on pre-anesthesia measurements due to the decrease in point Aa scores observed after anesthesia.

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