Efficacy of laparoscopic pectopexy versus laparoscopic sacrocolpopexy and antibacterial performance of nanosilver-coated urethral catheter for postoperative catheterization in patients with pelvic organ prolapse

Abstract

This study aimed to compare the clinical efficacy of laparoscopic sacrocolpopexy (LSC) and laparoscopic pectopexy (LP) for the treatment of pelvic organ prolapse (POP) and to evaluate the antibacterial effect of nanosilver-coated urethral catheters. The clinical data of 112 patients with POP, including 56 patients who underwent LP and 56 patients who underwent LSC, from March 1, 2019 to March 31, 2021 were retrospectively evaluated. All patients underwent routine catheterization with nanosilver-coated urethral catheters after surgery. The baseline data, intraoperative and postoperative efficacy, serum inflammatory indexes and postoperative complications were compared. The surgery was successfully completed in both groups, and a total of 10 patients in both group underwent intraoperative repair of the anterior and posterior vaginal walls. The surgical duration was significantly shorter and the intraoperative blood loss was significantly lower in the LP group than in the LSC group (P <0.05 for both). In both groups, the POP quantification stage, which was ≥I prior to surgery, was ≤I at six months after surgery. The PFIQ-7, PFDI-20 and PISQ-12 scores were significantly improved in both groups (P <0.05 for all), and the improvements were significantly better in the LP group than in the LSC group (P <0.01). During the 6-month follow-up period, no patient developed urinary tract infection. The levels of postoperative serum inflammatory factors WBC, ESR and CRP were increased in the LSC group and higher than those in the LP group, highlighting the significant anti-infection effect of the nanosilver-coated catheter. Mesh exposure occurred in one patient in the LSC group. In the LSC group, postoperative symptoms including abnormal defecation, lower abdominal pain/soreness, new stress urinary incontinence, and dyspareunia. In the LP group, abnormal defecation and lower abdominal pain were present in one patient each. The rate of postoperative complications was higher in the LSC group than in the LP group. While both LSC and LP could restore pelvic floor anatomic structure and organ function in patients with POP, shorter surgical duration, less blood loss, and better therapeutic effect were observed in patients undergoing LP. Nanosilver-coated antibacterial catheters exhibited good antibacterial effect in patients with routine catheterization after surgery. This study provides a new treatment plan for the treatment of pelvic organ prolapse, and also provides a new nursing method for postoperative urinary tract infection.