Objective To explore the axial changes of vagina before, 1 year and 5 years after radical hysterectomy (RH) by MRI visualization. Methods A total of 30 cervical cancer patients who received RH in Nanfang Hospital of Southern Medical University from October 2015 to October 2016 underwent pelvic MRI examination 1 year and 5 years after operation respectively were included. Mimics 23.0 software was used to reconstruct the pelvis and vagina, the preoperative and posterior pelvis and vagina were matched and corrected by pelvic tilt correction system and placed in the same space. The axial stress points of vagina were named P1~P3 before surgery, 1 year and 5 years after surgery, respectively. The length of vagina, the angle and coordinates of upper and lower sections of P1~P3 were measured, and the differences of axial changes of vagina after operation were compared. Results The angle of P2 was (19.99±4.26) °higher than that of P1 and the vagina shortened by (5.55±0.6) cm one year after operation, The angle of P3 was (24.50±4.33)° higher than that of P1 and the vagina shortened by (5.95±1.13) cm five years after operation. The angle of P3 was (4.51±0.33) ° higher than that of P2, and the vagina was shortened (0.42±0.53) cm 5 years after surgery compared with 1 year after surgery (P<0.05). Stress point coordinates of P1 (3.19±0.69, 1.59±0.52), P2 (2.52±0.38, 0.94±0.87), P3 (2.39±0.46, 0.69±0.59). Conclusions After RH, the angle between the upper and lower segments of the vagina is gradually blunt and forward, and the force point is closer to the pubic symphysis in the forward direction and to the vaginal opening in the downward direction, which may be one of the reasons for the long-term rare occurrence of pelvic organ prolapse.
Key words
Radical hysterectomy; /
MRI; /
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Vaginal axial direction; /
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3D visualization research; /
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Pelvic tilt correction
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