Incidence of and mortality from cervical cancer in northwest Russia is considerably higher than in developed countries. Increased incidence in recent years may be attributed to increased screening.
<b>Introduction:</b> Prolapse can be fixed using a variety of surgical procedures. The goal of the present study was to examine the current literature on various surgical techniques for treating female genital organ prolapse.<br /> <b>Methods:</b> The PubMed and Medline databases were explored for pertinent literature up through August 2022 for this meta-analysis. The terms [surgery] AND [management] AND [genital prolapse OR gynaecological diseases] AND [randomised control studies OR randomised control trials] were used as search criteria. The studies that met the inclusion criteria were considered qualified using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Cochrane handbook of “Systematic reviews of interventions” was used for risk of bias assessment.<br /> <b>Results:</b> The investigations found significant difference in the heterogeneity between the groups with a 76% I<sup>2</sup> value (p<0.00001). There was little variability among the six trials that examined robotic and laparoscopic therapy of prolapse (I<sup>2</sup>=0%, p=0.94). In six investigations, the odd ratio revealed no statistically significant difference between groups (1.05; 95% CI, 0.52, 2.12). However, generally there were no appreciable differences between robotic and laparoscopic treatment of female prolapse. There was a low-risk bias among the selected studies.<br /> <b>Conclusion:</b> According to this meta-analysis study, laparoscopic surgery performed better job of managing prolapse than abdominal surgery.
В статье представлены частота, актуальность и факторы риска, клиника, диагностика генитального пролапса (ГП), стрессовой инконтиненции у женщин в пери- и постменопаузе, а также методы хирургического лечения. Генитальный пролапс является актуальной медико-социальной проблемой, обусловлен демографическими изменениями в современных условиях: увеличением продолжительности жизни женщин, значительной распространенностью ГП, сочетанием с новообразованиями органов малого таза. Частое сочетание у женщин в пери- и постменопаузе ГП с гинекологическими заболеваниями (новообразования матки и ее придатков, эндометриоз) повышает актуальность проблемы, диктует необходимость проведения одномоментного оперативного лечения. Выбор хирургического лечения ГП базируется на возрасте пациентки, текущем качестве жизни, хирургическом анамнезе, желании сохранения коитальной функции и предпочтениях реконструктивной хирургии. Сочетание новообразований яичников или матки, эндометриоза с ГП может быть показанием к проведению ЛАВГ (лапароскопически ассистированной вагинальной гистерэктомии). Целью планирования хирургического лечения ГП и сочетанной гинекологической патологии является максимизация ожидаемого будущего качества жизни пациента и профилактика рецидивов, что диктует необходимость персонализированного подхода к каждой пациентке [1]. Мақалада пери- және постменопауза кезінде кездесетін генитальды пролапс (ГП) пен стресстік инконтиненцияның кездесу жиілігі, өзектілігі, қауіп факторлары, клиникасы, диагностикасы және хирургиялық емдеу әдістері көрсетілген. Генитальды пролапс заманауи жағдайдағы демографиялық өзгерістерге байланысты өзекті медициналық-әлеуметтік мәселе болып табылады: әйелдердің өмір сүруінің ұзаруы, ГП айтарлықтай таралуы, кіші жамбас ағзаларында жаңа түзілістердің қосылуы. Пери- және постменопауза кезінде ГП пен гинекологиялық аурулардың (жатыр мен оның қосалқыларында жаңа түзілістер, эндометриоз) жиі қосарлануы мәселенің өзектілігін жоғарылатып, оперативті емнің бір уақытта жасалуын талап етеді. ГП хирургиялық емі пациенттің жасына, оның өмір сүру сапасына, хирургиялық анамнезіне, коитальды қызметін сақтап қалуға және де реконструктивті хирургияны қалауына негізделеді. Жатырда немесе аналық бездерінде кездесетін жаңа түзілістердің, эндометриоздың ГП пен бірге қосарлануы лапароскопиялық ассистирленген қынаптық гистерэктомияға көрсеткіш болып табылады. ГП пен қосарланған гинекологиялық патологияның хирургиялық емін жоспарлаудың мақсаты, пациенттің болашақта күтілетін өмір сапасын барынша арттыру мен рецидивтердің алдын-алу болып табылады, бұл әрбір науқасқа жеке қарауды талап етеді [1]. The article presents the incidence, relevance and risk factors, clinic and diagnosis of genital prolapse (GP), stress incontinence in peri- and postmenopausal women as well as methods of their surgical treatment. Genital prolapse is an urgent medical and social problem caused by demographic changes in modern conditions: increase in life expectancy of women, significant prevalence of GP, combination with pelvic neoplasms. The frequent combination of peri- and postmenopausal women with gynecological diseases (neoplasms of the uterus and its appendages, endometriosis) increases the urgency of the problem and the need for one-stage surgical treatment. The choice of surgical treatment for GP is based on the patient's age, current quality of life, surgical history, desire to preserve coital function, and preference for reconstructive surgery. The combination of ovarian or uterine neoplasms or endometriosis with GP may be an indication for LAVG (laparoscopically assisted vaginal hysterectomy). The goal of planning surgical treatment of GP and concomitant gynecological pathology is to maximize the expected future quality of life of the patient and to prevent recurrences, which is the need for a personalized approach to each patient[1].
<b>Background:</b> Stress urinary incontinence (SUI) is a widespread illness that mostly affects women, particularly those who have recently given birth or gone through menopause. The purpose of this meta-analysis is to compare the effectiveness of pelvic floor muscle exercises (PFME) plus biofeedback to PFME alone in treating SUI in female patients.<br /> <b>Methods:</b> We systemically searched six electronic databases (PubMed, Scopus, and Web of Science) from inception until February 7, 2022. We included randomized controlled trials (RTCs) comparing patients who had undergone PFME plus biofeedback to PFME alone. For risk of bias-2 (RoB2) assessment, we used cochrane risk of bias assessment tool. Continuous data were pooled as standardized mean difference (SMD), and dichotomous data were pooled as odds ratio with the corresponding 95% confidence intervals (CI).<br /> <b>Results:</b> 15 RCTs were included, with a total of 788 patients with SUI. The overall effect estimate between PFME+BF and PFME alone groups favored the PFME+BF group in improving PFME strength (SMD=0.33, 95% CI [0.14 to 0.52], p=.0009) and did not favor either of the two groups for quality of life (SMD=-0.22, 95% CI [-0.44 to 0.00], p=0.05), leakage (SMD=-0.10, 95% CI [-0.37 to 0.17], p=0.47), pad weight test (SMD=-0.22, 95% CI [-0.44 to 0.00], p=0.05), cure rate (odd ratio [OR]=2.44, 95% CI [0.52 to 11.42, p=0.26), and social activity (SMD=0.66, 95% CI [-0.04 to 1.36], p=0.07).<br /> <b>Conclusion: </b>BF addition to PRME improves cure rate and PFME strength without affecting leakage or quality of life. Healthcare providers must consider patient safety and comfort while choosing BF devices with PFME. SUI management strategies should include BF to improve results.
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