Relationship between the Pelvic Organ Prolapse Quantification system (POP-Q), the Pelvic Floor Impact Questionnaire (PFIQ-7), and the Pelvic Floor Distress Inventory (PFDI-20) before and after anterior vaginal wall prolapse surgery

Relevance. According to world data, nowadays prevalence of pelvic floor dysfunction and pelvic organ prolapsed reaches 28%. Most specialists relate pregnancy and delivery to main factors of pelvic prolapse development. Due to lifespan growth frequency of pelvic organ prolapse development increases. According to FDA data annually in the world is made more than 100 000 surgeries with synthetic implants, herewith heavy complications occur in 3.4% and mild complications occur in 14.8% of all cases. About 58% of surgeries are made to women under the age of 60, 13% of patients needs re-intervention during next 5 years. It should be noted that in cases of relapse more than 30% of women need re-intervention. Aim. Evaluate implant-associated complications after mesh-implants setting. Materials and methods. We have made retrospective analysis of mesh-implant use in 458 patients with pelvic organ prolapse in 2018-2018 yy. on the base of Bashkir State Medical University clinic. In order to assess quality of life after mesh-implant setting, we used the following questionnaires: Incontinence Questionnaire Short Form (ICIQ-SF), and also Female Sexual Function Index (FSFI). In order to assess blood microcirculation indices after surgery, we used laser Doppler flowmetry evaluation from anterior vaginal wall. Results. All in all, there were revealed 13 (2.84%) implant-associated complications. In 4 patients ICIQ-SF points were from 3 to 15, which indicates manifestation of urgent urine incontinence signs. According to FSFI questionnaire, sexually active women have 31.5 points. Basic factor, which provokes pelvic floor muscles dysfunction is delivery. Besides, in group of women of reproductive age, pelvic floor muscles dysfunction (PFMD) is associated with the presence of concomitant gynecologic diseases (uterine myoma, endometriosis, ovarian tumors). In the group of women older than 45 years with the presence of somatic pathology - obesity and impaired blood circulation. According to LDF data from anterior vaginal wall women with PFMD have low blood circulation indices, herewith the lowest indices are registered in the group of women older than 45 years.

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Changes of Pelvic Organ Prolapse Symptoms and Quality of Life One Year After Pessary Fitting

ACTA MEDICA IRANICA ◽

10.18502/acta.v59i6.6890 ◽

2021 ◽

Author(s):

Tahereh Eftekhar ◽

Zinat Ghanbari ◽

Leila Pourali ◽

Maryam Deldar Pesikhani ◽

Soodabeh Darvish ◽

...

Keyword(s):

Pelvic Organ Prolapse ◽

Pelvic Floor ◽

Significant Proportion ◽

Pelvic Organ ◽

Vaginal Wall ◽

Sexually Active ◽

Sexual Symptoms ◽

Before And After ◽

Prolapse Symptoms ◽

One Year

Pelvic organ prolapse (POP) is the descend of pelvic organs, including the uterus, bladder, and rectum, to the vaginal wall. Patients with POP may present with symptoms such as vaginal bulging with other symptoms like urinary, defecatory, or sexual dysfunction. This study was conducted to evaluate the changes of POP symptoms one year after pessary fitting. Patients with symptomatic pelvic organ prolapse who presented to the pelvic floor clinic of an academic hospital between August 2016 and April 2019 were considered. Pelvic organ prolapse symptoms, including urinary, defecatory, sexual, and bulging symptoms, were recorded before and one year after pessary fitting. Pelvic floor distress inventory (PFDI)-20 and pelvic floor impact questionnaire-7 (PFIQ-7) were evaluated before and after treatment for all subjects. We analyzed the characteristics of 110 patients who used the pessary for 12 months. At the baseline, the most common prolapse symptoms were vaginal bulging and pelvic pressure. All urinary, defecatory, and sexual symptoms significantly improved one year after regular pessary use (P<0.001). Changes in PFDI-20 and PFIQ-7 before and after pessary use showed a significant improvement in both frequency and satisfaction of sexual function (P<0.001). The study showed significant improvement in bulging, urinary, and defecatory symptoms. Although the majority of patients were not sexually active, a significant proportion of sexually active patients reported an increase in sexual satisfaction.

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Native-Tissue Anterior Colporrhaphy Versus Transvaginal Mesh for Anterior Pelvic Organ Prolapse

50 Studies Every Obstetrician-Gynecologist Should Know ◽

10.1093/med/9780190947088.003.0035 ◽

2021 ◽

pp. 191-196

Author(s):

Nick Rockefeller ◽

Peter Jeppson

Keyword(s):

Pelvic Organ Prolapse ◽

Clinical Case ◽

Pelvic Organ ◽

Vaginal Wall ◽

Anterior Vaginal Wall ◽

Anterior Colporrhaphy ◽

Transvaginal Mesh ◽

Anterior Vaginal Wall Prolapse ◽

Native Tissue ◽

Landmark Study

This article provides a summary of a landmark study in the management of pelvic organ prolapse. This study sought to evaluate if patients with anterior vaginal wall prolapse should be managed with a traditional native tissue colporrhaphy or with transvaginal mesh. This article briefly reviews other relevant studies related to vaginal prolapse and concludes with a relevant clinical case.

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Study of correlation between symptoms and signs in women with anterior vaginal wall prolapse

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172953 ◽

2017 ◽

Vol 6 (7) ◽

pp. 3155

Author(s):

Smita Anand Bijwe ◽

Pooja Rajbhara

Keyword(s):

Pelvic Organ Prolapse ◽

Strong Association ◽

Descriptive Study ◽

Pelvic Organ ◽

Vaginal Wall ◽

Anterior Vaginal Wall ◽

Outpatient Clinics ◽

Urinary Function ◽

Anterior Vaginal Wall Prolapse ◽

Symptoms And Signs

Background: Pelvic organ prolapse is a common, distressing and disabling condition affecting up to 30% of the women, 20- 60 years of age, attending Gynaecology outpatient clinics. Objective of present work was to know the effect of Pelvic Organ Prolapse (POP) on micturition symptoms.Methods: Descriptive study including 64 women presenting with POP symptoms. Subjects were evaluated using POP-Quantification system, Urinary Distress Inventory.Results: Women were asked to rate the extent to which they were bothered by their urinary function on a scale of 1 to 10, with 1 being not at all and 10 being extremely. Ten women (16%) reported 1 to 4, 23 (37%) reported 5 to 7, and 29 (47%) reported and gt;8.Conclusions: Strong association does exist between POP and micturition symptoms which are obstructive in nature and those causing urge incontinence.

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Influence of Toileting Behaviour on Anterior Vaginal Wall Prolapse Natural Course

10.21203/rs.3.rs-752098/v1 ◽

2021 ◽

Author(s):

Osman Kose ◽

Yavuz Tarik Atik ◽

Deniz Gul ◽

Burak Uysal ◽

Haci Ibrahim Cimen ◽

...

Keyword(s):

Symptom Control ◽

Pelvic Organ ◽

Vaginal Wall ◽

Anterior Vaginal Wall ◽

Natural Course ◽

Sitting Position ◽

Anterior Vaginal Wall Prolapse ◽

Initial Symptoms ◽

Group 2 ◽

Group 1

Abstract Background: Many risk factors have been proposed for POP, and the cause seems most plausible to be multifactorial. This study aimed to investigate the effect of toileting behaviors on the anterior vaginal wall prolapse (AVWP) natural course.Methods: The data of 75 women who had been operated for symptomatic AVWP were recorded. The patients with grade ³II AVWP were included in this study, and they were divided into two groups according to voiding and defecation position. The volunteers who were voiding in the sitting position defined as Group 1, and Group 2 included the volunteers who were voiding in squatting position. The Colo-Rectal-Anal Impact Questionnaire (CRAIQ), Pelvic Floor Impact Questionnaire (PFIQ), Pelvic Organ Prolapse Impact Questionnaire (POPIQ), Urinary Impact Questionnaire (UIQ) and visual analog pain scores were used for evaluation of patients’ symptoms. Results: 44 patients enrolled in group 1 (sitting position) and 31 patients enrolled in group 2 (squatting position). BMI, number of parity, menopause duration, topical estrogen using, comorbidities, presence of constipation and urinary incontinence, and ped count for incontinence were similar in both groups. The time from initial symptoms to surgery was demonstrated shorter in group 2, 12 (3-73) and 24 (2-182) months, respectively (p=0.001). The PFIQ and POPIQ scores and the POP-related VAS score were statistically higher in patients who were voiding and defecating in squatting positions. Conclusion: Questioning the toileting position of patients with AVWP may be effective on the treatment option of the patient and may be beneficial on symptom control.

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Changes in muscularis propria of anterior vaginal wall in women with pelvic organ prolapse

European Journal of Histochemistry ◽

10.4081/ejh.2016.2604 ◽

2016 ◽

Vol 60 (1) ◽

Cited By ~ 6

Author(s):

A. Vetuschi ◽

A. D'Alfonso ◽

R. Sferra ◽

D. Zanelli ◽

S. Pompili ◽

...

Keyword(s):

Risk Factors ◽

Smooth Muscle ◽

Pelvic Organ Prolapse ◽

Smooth Muscle Cells ◽

Muscularis Propria ◽

Muscle Cells ◽

Pelvic Organ ◽

Vaginal Wall ◽

Anterior Vaginal Wall ◽

Collagen Iii

The objective of this study was to evaluate the morphological and immunohistochemical alterations of tissue removed from the upper third of anterior vaginal wall in a sample group of the female population presenting homogenous risk factors associated with Pelvic Organ Prolapse (POP). The case study consisted of 14 patients with POP and there were 10 patients in the control group. Patient selection was carried on the basis of specific criteria and all of the patients involved in the study presented one or more of the recognized POP risk factors. Samples were taken from POP patients during vaginal plastic surgery following colpohysterectomy, and from control patients during closure of the posterior fornix following hysterectomy. Samples were processed for histological and immunohistochemical analyses for Collagen I and Collagen III, α-Smooth Muscle Actin (α-SMA), Platelet-Derived-Growth-Factor (PDGF), matrix metalloproteinase 3 (MMP3), Caspase3. Immunofluorescence analyses for Collagen I and III and PDGF were also carried out. In prolapsed specimens our results show a disorganization of smooth muscle cells that appeared to have been displaced by an increased collagen III deposition resulting in rearrangement of the muscularis propria architecture. These findings suggest that the increase in the expression of collagen fibers in muscularis could probably due to a phenotypic switch resulting in the dedifferentiation of smooth muscle cells into myofibroblasts. These alterations could be responsible for the compromising of the dynamic functionality of the pelvic floor.

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