Transvaginal management of severe pelvic organ prolapse in nulliparous women

Lo, Tsia‐Shu; Jaili, Sukanda Bin; Uy-Patrimonio, Ma. Clarissa; Karim, Nazura bt; Ibrahim, R. A.

doi:10.1111/jog.13234

Cited by 8 publications

(8 citation statements)

References 32 publications

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“…The study of Lo et al reported on 1,275 surgically managed women with a prolapse of POPQ stage ≥3. In this large sample from one Taiwanese center, collected between 2005 and 2015, 8 women were nulliparous (0.55%) [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, rare cases of POP, linked to other factors, have been reported in nulliparous women [ 4 – 7 ]. The overall rarity of POP in nullipara is confirmed by the low proportion of POP surgery in this group (0.55–1.5%) [ 5 , 8 ], which may be explained by its absence or the presence of low pelvic organ prolapse quantification (POPQ) stages (0, 1, and 2) on clinical examination up to 60 years of age [ 9 ]. A number of earlier studies have shown that clinical POP with symptoms in nulliparous women <60 years occurs in less than 2–3% [ 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

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The symptom of vaginal bulging in nulliparous women aged 25–64 years: a national cohort study

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The symptom of vaginal bulging in nulliparous women aged 25–64 years: a national cohort study

et al. 2018

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“…The first one determines the impact of dysfunction in an individual and the second one quantifies the degree of PoP [21,27]. These two instruments can also be found in numerous studies [23,26,[28][29][30][31][32].…”

Section: Discussionmentioning

confidence: 99%

Use of pessary in the treatment of pelvic floor dysfunctions: a systematic review

Scarabelot¹,

Pereira²,

Ghizzo³

et al. 2018

Physiother Quart.

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Introduction. To describe and evaluate the scientific evidence on the use of pessary in the treatment of pelvic floor dysfunctions.Methods. This systematic review was performed in accordance with the Preferred Reporting items for Systematic Reviews and Meta-Analyses (PRiSMA) guidelines. The databases searched were Sciencedirect, PubMed, PEdro, and BVS. The following descriptors were used: 'clinical trial,' 'pessary,' 'pelvic floor,' and the Boolean operator 'and.' The search was conducted between November 2016 and February 2017. The methodological quality of the selected articles was analysed with the Physiotherapy Evidence database (PEdro) scale.Results. After the insertion of the filters in the databases, 379 titles were selected, of which 5 articles were picked out in pairs for analysis as a whole. The 3 studies investigating the use of pessary in the treatment of pelvic organ prolapse included women with prolapse stages ii-iii. The rings or Gellhorn pessaries were the most frequently used, and all showed benefits in decreasing urinary symptoms and improvement of prolapse.Conclusions. The pessary is beneficial for the treatment of urinary incontinence and pelvic organ prolapse. Good methodological quality was also identified in most studies included.

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“…Complications of vaginal pessaries include persistent expulsion, bleeding, ulcers, vaginal discharge, and fistulas and between 16-45% of women are unable to sustain long-term use (Liu & Lee 2017;Robert et al 2017;Yimphong et al 2017). Surgical interventions are prescribed for around one in ten women with POP but success rates following surgery are variable, dependent on the location and degree of prolapse and the nature of the surgical intervention (Kurkijarvi et al 2017;Lo et al 2017;Lowenstein et al 2017;Schiavi et al 2017). Satisfaction post-surgery is reported to decrease over time, with reduced quality of life and poorer sexual function being commonly reported 12 months post-surgery (Rahkola-Soisalo et al 2017;Tyagi et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Development of a biotensegrity focused therapy for the treatment of pelvic organ prolapse: A retrospective case series

Crowle

Harley

2020

Journal of Bodywork and Movement Therapies

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Introduction: Pelvic organ prolapse (POP), the bulging of pelvic organs into the vagina, is a common condition thought to be caused by weak pelvic tissue. There is a paucity of evidence supporting current treatment approaches. This case series proposes a new biotensegrity-focused hypothesis that POP is caused by taut pelvic tissue and that releasing pelvic tension will improve POP. Methods: Three retrospective patient cohorts are presented illustrating the development of the new biotensegrity-focused therapy (BFT) approach. All women received: postural assessment; pelvic tissue examination; and myofascial release of taut pelvic tissue, trigger points, and scar tissue. A standard assessment SOTAP Subjective experience, the Objective assessment, the Treatment plan, Assessment of treatment outcomes, and subsequent treatment and self-care Plans. Cohort three additionally self-reported symptoms using the short-form PDFI-20 questionnaire at baseline and after final treatment. Results: Twenty-three women participated (Cohort 1 n=7; Cohort 2 n=7; Cohort 3 n=9). Fourteen (61%) presented with cystocele, 10 (44%) urethracele, 7 (30%), cervical descent, and 17 (74%) rectocele. Seven (30%) presented with single prolapse, 8 (35%) double, 6 (26%) triple, and 2 (9%) quadruple. Median treatments received was 5 (range 3-8). All women reported improved prolapse symptoms. Cohort 3 (n=9) reported clinically meaningful reductions (mean 56%) in PFDI-20 total after final treatment. Conclusions: This case series offers preliminary evidence for the association between POP and pelvic tissue tension. Further research is needed to explore these findings and to determine the efficacy of BFT for treating POP in a wider sample.

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Transvaginal management of severe pelvic organ prolapse in nulliparous women

Cited by 8 publications

References 32 publications

The symptom of vaginal bulging in nulliparous women aged 25–64 years: a national cohort study

The symptom of vaginal bulging in nulliparous women aged 25–64 years: a national cohort study

Use of pessary in the treatment of pelvic floor dysfunctions: a systematic review

Development of a biotensegrity focused therapy for the treatment of pelvic organ prolapse: A retrospective case series

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