Mesh-less laparoscopic treatment of apical prolapse

Александров, А Е; Smith, Alice; Rabischong, B.; Botchorishvili, R.

doi:10.52054/fvvo.13.2.013

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…Трехмерное и четырехмерное ультразвуковые исследования набирают свою популярность в гинекологии, особенно при изучении последствий родовой травмы и диагностики симптомов дисфункции мышц тазового дна [1,4,5,6]. Однако, большинство доступных на сегодняшний день биометрических данных, опубликованных урогинекологическими научными ассоциациями, как правило, касаются родильниц, имеющих ранние симптомы пролапса или других урогинекологических состояний [2,3,7].…”

Section: Introductionunclassified

Ultrasound Morphometry of the Pelvic Floor Muscles in Women of Reproductive Age

En'kova,

Obernikhin,

Belov

et al. 2024

Žurnal anatomii i gistopatologii

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Biometric studies in nulliparous women conducted to date are limited by small sample sizes. The pelvic floor muscles perform an important function throughout a woman’s life. They provide fixation and maintenance of the pelvic organs, stretches during childbirth, ensuring the formation of the birth canal, and are a potential site for the formation of a hernia in the female body. Impaired function of this muscle group can lead to either excessive muscle contraction (chronic pelvic pain syndrome) or excessive stretching (pelvic organ prolapse). The purpose of the study is to assess the morphometric properties of the pelvic floor muscles in nulliparous women using 3D ultrasound scanning (sonography). Material and methods. The observation group consisted of 60 women of middle reproductive age who applied for an appointment with an obstetriciangynecologist with complaints of pain of various types localized in the perineum and pelvis, decreased desire and quality of sexual life, clinically confirmed by a diagnosis of incompetence of the pelvic floor muscles. The control group consisted of 30 women without dysfunction of the pelvic floor muscles according to clinical examination. The main criterion for inclusion of patients in the study was reproductive age - 18–45 years and natural childbirth in obstetric and gynecological history. Results. We found that the absence of visible sonographic markers of changes in the myofascial structures of the pelvis is not a prognostically significant criterion for muscle dysfunction, since predominantly changes in morphometric parameters are a reliable sign of the formation of pelvic floor muscle failure. Conclusion. The ultrasound morphometry method, which allows one to assess dynamic changes in the size of muscle and fascial structures, can be used in the clinical practice of an obstetrician-gynecologist. Early diagnosis of a violation of the structure of pelvis myofascial complex will allow early implementation of measures aimed at prevention and timely treatment.

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Section: Introductionunclassified

Ultrasound Morphometry of the Pelvic Floor Muscles in Women of Reproductive Age

En'kova,

Obernikhin,

Belov

et al. 2024

Žurnal anatomii i gistopatologii

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Literature review, surgical decision making algorithm, and AGREE II‐S comparison of national and international recommendations and guidelines in pelvic organ prolapse surgery

Pecorella,

Morciano,

Sparic

et al. 2024

Intl J Gynecology & Obste

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The average lifespan has increased over time due to improvements in quality of life, leading to an aging population that stays healthy for longer. Pelvic organ prolapse (POP), whether uterine or vaginal, is a problem that severely impairs quality of life and imposes significant restrictions. The present study provides the reader with a summary of the many surgical techniques used in POP surgery, comparing international guidelines, offering an algorithm that is simple to understand, and allows the reader to quickly choose the table that includes the best surgical therapy for each individual. Using relevant keywords, the writers searched the PubMed and Scopus databases for relevant publications from 2000 to April 2023. Studies with cases of oncologic disorders or prior hysterectomy performed for another reason were not included in the analysis. Ten distinct international guidelines are highlighted and examined in the present study. We used the Appraisal of Guidelines for Research and Evaluation II‐S (AGREE II‐S) method to assess their quality, and incorporated the results into the conclusion. Worldwide, anterior colporrhaphy is the preferred method of treating anterior compartment abnormalities, and mesh is virtually always used when recurrence occurs (which happens in about half of the cases). Worldwide, posterior colporrhaphy is commonly used to repair posterior compartment abnormalities. Only a few national guidelines (the Iranian guideline, Acta Obstetricia et Gynecologica Scandinavica [AOGS], and the German‐speaking countries) permit the use of mesh or xenograft in cases of recurrence. There is agreement on the abdominal approach (sacrocolpopexy) with mesh for treating apical deformities. Sacrospinous‐hysteropexy is the standard method used to guide the vaginal approach; mesh is typically used to aid in this process. There are just three recommendations that do not include vaginal operations: HSE, AOGS, and Iran. Of obliteration techniques, colpocleisis is unquestionably the best. In conclusion, our analysis highlights the significance of customized methods in POP surgery, taking into account the requirements and preferences of each patient. To choose the best surgical therapy, criteria and patient features must be carefully considered.

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