Age and/or postmenopausal status as risk factors for pelvic organ prolapse development: systematic review with meta-analysis

Brito, Luiz Gustavo Oliveira; Pereira, Gláucia Miranda Varella; Moalli, Pamela; Shynlova, Oksana; Manonai, Jittima; Weintraub, Adi Y.; Deprest, Jan; Bortolini, Maria Augusta Tezelli

doi:10.1007/s00192-021-04953-1

Cited by 30 publications

(19 citation statements)

References 116 publications

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“…Garshasbi et al [14] found that the incidence of POP in women increased with age, and age ≥ 50 was a risk factor for POP. Brito et al [15] systematically reviewed the risk factors of prolapse and found that the risk of patients over 35 years old was 2.4 times higher than that of young people. When the age was over 50, the disease risk increased by 86% per 1-year-old.…”

Section: Applied Bionics and Biomechanicsmentioning

confidence: 99%

The Application of a Multidimensional Prediction Model in the Recurrence of Female Pelvic Organ Prolapse after Surgery

Wang¹,

Shao²

2022

Applied Bionics and Biomechanics

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Objective. The relationship between multiple indicators of women and postoperative recurrence of pelvic organ prolapse was analyzed to establish a model for predicting postoperative recurrence of female pelvic organ prolapse. Methods. Three hundred patients with pelvic organ prolapse who underwent pelvic organ prolapse surgery at our hospital were monitored for 1-2 years to determine their prognosis. Whether there was a postoperative recurrence, they were divided into two groups. We collected the relevant data from the two groups of patients before and after surgery. Through single factor and logistic multivariate analysis, we selected the risk factors that may affect the recurrence of patients to construct a prediction model. We verified the identification ability, proofreading ability, and clinical applicability of the model. Results. Eighty-four patients with pelvic organ prolapse who had postoperative recurrence were assigned to the recurrence group, and 216 patients were included in the nonrecurrence group. Based on the logistic multivariate analysis results, we constructed a nomogram model containing 5 dimensions of age, BMI, degree of prolapse, pubic fissure, and serum calcium to predict postoperative recurrence. The tests revealed that the model had an excellent identification ability ( AUC = 0.910 ), and the expected recurrence rate was significantly in agreement with the actual recurrence rate ( U = − 0.007 , Brief = 0.087 ). The Hosmer-Lemeshow goodness-of-fit test demonstrated that the model had good calibration ( c 2 = 29.352 , P = 0.522 ), and the decision curve showed that the threshold probability was in the range of ~12% to 100%, having a high net benefit value. Conclusion. Based on the present study findings, we concluded that the constructed nomogram model has suitable identification, calibration, and clinical applicability.

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Section: Applied Bionics and Biomechanicsmentioning

confidence: 99%

The Application of a Multidimensional Prediction Model in the Recurrence of Female Pelvic Organ Prolapse after Surgery

Wang¹,

Shao²

2022

Applied Bionics and Biomechanics

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“…The incidence of prolapse increases with age, accelerating after the age of 50 years. 12,24 One of many possible reasons is compounded years of mechanical stress on the muscles and connective tissue, but because a certain amount of force may be needed to maintain tissue strength, the threshold where this mechanical stress becomes a negative influence on pelvic organ support is unclear. Another reason is that hypoestrogenism that occurs with menopause.…”

Section: Aging and Menopausementioning

confidence: 99%

“…Estrogen receptors have been found in the vagina, endopelvic fascia, arcus valuate, levator ani, and uterosacral ligaments, and estrogen may have a beneficial effect on these supportive tissues. 24,25 Although there is strong evidence to support hormonal changes as an influencing factor in the development of prolapse, it is challenging to separate the effects of menopause and other aspects of aging.…”

Section: Aging and Menopausementioning

confidence: 99%

Nonoperative Management of Pelvic Organ Prolapse

Sung

Jeppson

Madsen

2023

Obstetrics &Amp; Gynecology

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Pelvic organ prolapse (POP) is defined as the descent of one or more of the anterior, posterior, or apical vagina. It is a common condition, with up to 50% of women having prolapse on examination in their lifetimes. This article provides an overview of the evaluation and discussion of nonoperative management of POP for the obstetrician-gynecologist (ob-gyn), with consideration of recommendations from the American College of Obstetricians and Gynecologists, the American Urogynecologic Society, and the International Urogynecological Association. The initial evaluation of POP requires a history documenting whether the patient is experiencing symptoms and what they are, and discovery of which symptoms they believe are attributable to prolapse. Examination determines the vaginal compartment(s) and to what degree prolapse exists. In general, only patients who have symptomatic prolapse or medical indication should be offered treatment. Although surgical options exist, all patients who are symptomatic and desire treatment should be offered nonsurgical treatment first, including pelvic floor physical therapy or a pessary trial. Appropriateness, expectations, complications, and counseling points are reviewed. Educational opportunities between the patient and the ob-gyn include disentangling common beliefs that the bladder is dropping or that concomitant urinary or bowel symptoms are necessarily caused by prolapse. Improving patient education can lead to a better understanding of their condition and better alignment of treatment goals and expectations.

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“…2 Fecal incontinence (FI), defined as involuntary loss of feces and/or flatus, 3 is more common in the postmenopausal period and older age; however, the evidence is scarce regarding estrogen treatment to reduce FI symptoms. 4 Age is another risk factor 5 for pelvic organ prolapse (POP), defined as the bulging of pelvic organs by the vaginal canal. 6 Hormone therapy (HT) containing estrogen is considered the best and most important treatment for POI-women to reduce the risk of impairment due to hypoestrogenism, with some evidence in repercussions on bone health, cardiovascular system, and general symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…Fecal incontinence (FI), defined as involuntary loss of feces and/or flatus, 3 is more common in the postmenopausal period and older age; however, the evidence is scarce regarding estrogen treatment to reduce FI symptoms. 4 Age is another risk factor 5 for pelvic organ prolapse (POP), defined as the bulging of pelvic organs by the vaginal canal. 6…”

Section: Introductionmentioning

confidence: 99%

Fecal Incontinence or Pelvic Organ Prolapse Among Women with Premature Ovarian Insufficiency

Fante

Juliato

Benetti‐Pinto

et al. 2023

Journal of Coloproctology

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Objectives To assess the status of the pelvic floor muscle (PFM) of premature ovarian insufficiency women (POI women) and the incidence of fecal incontinence (FI) and pelvic organ prolapse (POP). Methods A secondary analysis of a cross-sectional study with 150 women with POI was performed. Pelvic floor muscle assessment was performed with the PERFECT scale. The subscales POPDI-6 and CRADI-8 of the questionnaire Pelvic Floor Distress Inventory-20 (PFDI-20) were used for pelvic floor symptoms focused on FI and POP. Moreover, FI and POP were also assessed as dichotomous variables (yes/no). Results Women with FI and POP did not present differences in the PFM assessment across P (p = 0.61), E (p = 0.78), R (p = 0.22), and F (p = 0.79) variables when compared with women with POI; no differences were also seen between women with and without POP according the pelvic muscles: P (p = 0.91), E (p = 0.99), R (p = 0.62), and F (p = 0.10). Women with FI and POP presented higher scores in all PFDI-20 subscales and total score when compared with the control group (p < 0.05). Conclusions Pelvic floor muscle assessment within POI women with or without FI or POP did not differ. However, PF symptoms are more severe in the FI or POP groups.

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Age and/or postmenopausal status as risk factors for pelvic organ prolapse development: systematic review with meta-analysis

Cited by 30 publications

References 116 publications

The Application of a Multidimensional Prediction Model in the Recurrence of Female Pelvic Organ Prolapse after Surgery

The Application of a Multidimensional Prediction Model in the Recurrence of Female Pelvic Organ Prolapse after Surgery

Nonoperative Management of Pelvic Organ Prolapse

Fecal Incontinence or Pelvic Organ Prolapse Among Women with Premature Ovarian Insufficiency

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