Pelvic organ prolapse management

Abstract

<jats:p> Pelvic organ prolapse describes the loss of support and subsequent descent of pelvic organs into the vagina. It is common, affecting up to 50% of parous women, and can be accompanied by a number of burdening symptoms. Prolapse has been thrown into the spotlight secondary to mesh-related complications. There are a number of effective treatment options to consider when managing pelvic organ prolapse and most do not require mesh. Patients’ choice, comorbidities and likelihood of treatment success should be considered when making decisions about their care. Vaginal mesh surgery is currently on hold in the UK and even prior to this there has been a reduction both in the number of all prolapse surgeries and the number of women seeking surgery to manage their symptoms. This article reviews the current evidence for the management of pelvic organ prolapse, providing an update on the current state of mesh in prolapse surgery and summarises the key evidence points derived from the literature. </jats:p>

Effects of Pelvic-Floor Muscle Training in Patients with Pelvic Organ Prolapse Approached with Surgery vs. Conservative Treatment: A Systematic Review

“…There are different POPs according to the vaginal compartment in which the descent occurs: prolapse of the anterior vaginal wall (cystocele, urethrocele), prolapse of the posterior vaginal wall (enterocele, rectocele), and apical prolapse (uterine prolapse or prolapse of the vaginal vault after a total hysterectomy) [ 1 , 2 , 3 , 4 ]. To determine the severity of POP and its evolution, it is recommended to use the Pelvic Organ Prolapse Quantification (POP-Q) system, which is based on the measurement of the distances between six points located in the vagina and the hymen and which classifies the POP in five stages [ 3 , 5 , 6 ].…”

“…The cause of POP is multifactorial, with pregnancy and childbirth being the most frequently associated risk factors [ 1 , 3 , 7 ]. POP is a common condition, the prevalence of which increases with age, with an estimated 50% of women suffering from POP [ 1 , 3 , 6 , 8 , 9 , 10 ], although only between 3 and 12% of women report symptoms [ 2 , 3 , 7 , 8 ]. Symptoms include a feeling of vaginal heaviness, a sensation of a lump descending into the vagina, a feeling of pelvic discomfort/pressure, and back pain.…”

“…Conservative treatment includes pelvic-floor muscle training (PFMT), lifestyle changes, pessaries, and estrogen treatment, all aimed at preventing the symptoms for and worsening of POP. Obliterative or reconstructive techniques can be used in surgical treatment, but since treatment does not always involve definitive surgery and symptoms can re-develop [ 3 , 6 , 8 , 9 , 10 , 11 ], complementary approaches must be considered. Conservative treatment has the advantage of causing fewer adverse effects and complications [ 12 ].…”

Effect of new-style anterior and posterior vaginal wall repair combined with modified ischial spine fascia fixation on patients with pelvic organ prolapse and their postoperative quality of life

“…Vaginal delivery, prolific birth, vaginal genital area atrophy, pelvic connective tissue disorder, heavy physical labor, neuropathy, and so on are the risk factors for this disease ( 15 ). At present, it is generally believed that the pathogenesis of the disease is the “Hammock Hypothesis,” “Three Levels” theory, “Three Chamber System,” and “Integral Theory” ( 16 ). The pelvic floor tissue is artificially divided into three different levels, or the pelvic cavity is divided into three areas.…”

Вплив Цукрового Діабету На Результативність Хірургічного Лікування Генітального Пролапсу

“…Діагностовано зниження вдвічі кортизолу до 196,7 ± 13,5 нмоль/л у порівнянні з контролем -432,9 ± 26,3 нмоль/л. [6,8,9].…”