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Background Pelvic organ prolapse (POP) is a prevalent condition caused by weakened pelvic floor support structures. Extracellular matrix alterations, including changes in collagen type I, collagen type III, and matrix metalloproteinase 1 (MMP-1), contribute to the pathogenesis of this condition. Human platelet-rich fibrin lysate (hPRF-L) is a novel regenerative treatment that has shown beneficial results in treating structural weaknesses related to various pelvic floor diseases, including POP. Methods This study protocol aims to investigate the effects of hPRF-L injection on collagen I, III, and MMP-1 in the vaginal mucosa of a rat POP model. POP will be induced in female Sprague-Dawley rats, which will be randomly assigned to control, sham, and hPRF-L treatment groups. The hPRF-L group will receive weekly injections of hPRF-L (25, 50, or 75 μL) into the vaginal mucosa for 4 weeks. Vaginal tissue samples will be collected, and collagen type I, collagen type III, and MMP-1 expression will be evaluated using quantitative reverse transcription polymerase chain reaction and immunohistochemical analyses. Data analysis will be performed with ANOVA and post-hoc tests. Discussion The findings from this study protocol are expected to provide valuable insights into the mechanisms by which hPRF-L impacts the structural integrity of the pelvic floor. By elucidating these mechanisms, this study aims to inform future POP treatment strategies. The anticipated results are an increase in collagen type I and III expression and a reduction in MMP-1 levels in the hPRF-L treatment group compared to the control and sham groups. These outcomes could support the use of hPRF-L as a regenerative therapy for managing POP, offering a potential alternative to more invasive surgical interventions. Conclusion The expected results will contribute to the development of less invasive treatments for POP, improving patient outcomes and quality of life.
Background Pelvic organ prolapse (POP) is a prevalent condition caused by weakened pelvic floor support structures. Extracellular matrix alterations, including changes in collagen type I, collagen type III, and matrix metalloproteinase 1 (MMP-1), contribute to the pathogenesis of this condition. Human platelet-rich fibrin lysate (hPRF-L) is a novel regenerative treatment that has shown beneficial results in treating structural weaknesses related to various pelvic floor diseases, including POP. Methods This study protocol aims to investigate the effects of hPRF-L injection on collagen I, III, and MMP-1 in the vaginal mucosa of a rat POP model. POP will be induced in female Sprague-Dawley rats, which will be randomly assigned to control, sham, and hPRF-L treatment groups. The hPRF-L group will receive weekly injections of hPRF-L (25, 50, or 75 μL) into the vaginal mucosa for 4 weeks. Vaginal tissue samples will be collected, and collagen type I, collagen type III, and MMP-1 expression will be evaluated using quantitative reverse transcription polymerase chain reaction and immunohistochemical analyses. Data analysis will be performed with ANOVA and post-hoc tests. Discussion The findings from this study protocol are expected to provide valuable insights into the mechanisms by which hPRF-L impacts the structural integrity of the pelvic floor. By elucidating these mechanisms, this study aims to inform future POP treatment strategies. The anticipated results are an increase in collagen type I and III expression and a reduction in MMP-1 levels in the hPRF-L treatment group compared to the control and sham groups. These outcomes could support the use of hPRF-L as a regenerative therapy for managing POP, offering a potential alternative to more invasive surgical interventions. Conclusion The expected results will contribute to the development of less invasive treatments for POP, improving patient outcomes and quality of life.
Introduction: Pelvic organ prolapse (POP) is a common condition affecting over half of women above the age of 50. Sacrocolpopexy is a widely recognized surgical approach for apical prolapse, restoring the vaginal axis effectively. Despite its efficacy, complications such as bowel dysfunction and stress urinary incontinence (SUI) are common. Ileopectopexy, a newer technique utilizing the iliopectineal ligament, offers an alternative that may reduce complications while maintaining efficacy. This study compares the outcomes of robotic sacrocolpopexy and ileopectopexy in a tertiary care setting. Materials and methods: This study retrospectively analyzed the collected database of 35 patients who underwent robotic sacrocolpopexy or ileopectopexy between 2021 and 2023. Surgeries were performed using either the Da Vinci or Hugo robotic systems. Parameters studied included console time, blood loss, complications, hospital stay, recurrence rates, and follow-up duration. Data was statistically analyzed using SPSS (IBM Corp., Armonk, NY, v28.0), with a p-value of <0.05 considered significant. Results: Both groups had similar age distributions and presenting symptoms, most commonly complete uterine prolapse. Ileopectopexy had no complications, while sacrocolpopexy saw two vaginal lacerations. Blood loss was minimal across all cases (<100 mL). Post-operative bowel complaints were more frequent in the sacrocolpopexy group (14%), but absent in ileopectopexy. Hospital stay, console time, and additional procedures were comparable. Follow-up was longer for sacrocolpopexy (34.8 vs. 5.3 months). Conclusion: Both robotic sacrocolpopexy and ileopectopexy effectively managed apical prolapse with minimal blood loss and comparable hospital stays. However, ileopectopexy showed fewer bowel complications, making it a promising alternative. More extensive studies with longer follow-ups are needed to validate these findings.
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