The Novel and Minimally Invasive Treatment Modalities for Female Pelvic Floor Muscle Dysfunction; Beyond the Traditional

Abstract

Pelvic floor dysfunction is a clinical entity that is prevalent among female patients. Determining the exact underlying cause of pelvic floor dysfunction is difficult, and surgical intervention for this clinical entity may be challenging. Pelvic floor dysfunction can affect the quality of life of the patient by causing stress urinary incontinence, pelvic organ prolapse, or both. Well-defined surgical treatment options, minimally invasive approaches, and novel techniques for the treatment of pelvic floor dysfunction have been recently introduced. Here, we evaluated the management options available for patients with stress urinary incontinence and pelvic organ prolapse. We searched Medline and EMBASE databases for relevant articles by using the keywords “pelvic floor dysfunction,” “minimally invasive procedures,” “stress urinary incontinence,” “pelvic organ prolapse,” and “novel techniques”. Traditional treatment options for stress urinary incontinence and pelvic organ prolapse are beyond the scope of our review. Laparoscopic and robotic surgical treatments for pelvic floor dysfunction continue to evolve and develop. These minimally invasive techniques will soon replace open procedures. Alternative novel treatment modalities have also been developed from novel human-compatible materials and are emerging as successful treatments for stress urinary incontinence. The development of these various treatment options has implications for future surgical practice in the field of uro-gynecology.

Prevalence and factors of urinary incontinence among postpartum: systematic review and meta-analysis

“…Conjoined with the unproblematic and orderly cicatrization of the lateral incision, it is conjectured that the lateral episiotomy exerts a specific prophylactic influence on pelvic floor musculature. However, contemporary international scholarship [ 58 ] indicates that lateral episiotomy lacks prophylactic efficacy for the pelvic floor musculature and may precipitate pelvic floor disorders such as stress urinary incontinence. Lateral episiotomy and perineal lacerations can compromise perineal nerves and musculature, undermining the structural integrity of pelvic floor nerves and muscles, which subsequently impinges upon the contractile functionality of the pelvic floor muscle groups and the mechanisms regulating urinary continence [ 59 ].…”

Pelvic floor dysfunction and electrophysiology in postpartum women at 6–8 weeks

“… 5. POP ( Haylen et al, 2016 ; Akın et al, 2018 ): Downward displacements of one or more areas, such as the anterior vaginal wall, posterior vaginal wall, and uterus (cervix) or vaginal apex, were defined anatomically as anterior POP, posterior POP, and apical POP, respectively. The degree of prolapse was quantified and classified into five stages according to POP-Q ( Persu et al, 2011 ) ( Table 1 ).…”

Postmenopausal women in gynecological care

“…Surgical intervention remains the definitive treatment option for patients with symptomatic POP or stress urinary incontinence (SUI). In a large population-based study in the United States, the lifetime risk of any primary surgery for SUI or POP reaches 20% in women aged 80 years [ 90 , 91 ].…”