scholarly journals Transperineal ultrasound to estimate the appropriate ring pessary size for women with pelvic organ prolapse

2021 ◽  
Author(s):  
Claudia Manzini ◽  
Mariëlla I. J. Withagen ◽  
Frieda van den Noort ◽  
Anique T. M. Grob ◽  
Carl H van der Vaart
Keyword(s):  
Pelvic Organ Prolapse ◽  
Operating Characteristic ◽  
Pelvic Organ ◽  
Transperineal Ultrasound ◽  
Small Ring ◽  
Receiver Operating Characteristic Curves ◽  
Ring Pessary ◽  
Hiatal Area ◽  
Significant Difference ◽  
Control Study

Abstract Introduction and hypothesis The objective was to predict the successful ring pessary size based on the levator hiatal area (HA). Methods This is a prospective case–control study. Women with symptomatic pelvic organ prolapse (POP) choosing pessary treatment were included. All women underwent an interview, clinical examination, and 3D/4D transperineal ultrasound (TPUS). The ring pessary size used in each trial and the reason for unsuccessful trials were recorded. In addition, levator hiatal area divided by ring pessary size (HARP ratio) was measured at rest, maximum contraction, and maximum Valsalva. The HARP ratios of successful and unsuccessful trials were compared, receiver operating characteristic curves in the prediction of successful trials were constructed, and the cut-off optimizing sensitivity and specificity was identified. Results A total of 162 women were assessed and 106 were included with 77 successful trials, 49 unsuccessful trials owing to dislodgment or failure to relieve POP symptoms, and 20 unsuccessful trials owing to pain/discomfort. Rest HARP ratio and Valsalva HARP ratio were significantly smaller in the successful trials versus dislodgment/failure to relieve POP symptoms trials (mean rest HARP ratio [SD]: 2.93 [0.59] vs 3.24 [0.67], p = 0.021; median Valsalva HARP ratio (IQR): 4.65 (1.56) vs 5.32 (2.08), p = 0.004). No significant difference was observed between pain/discomfort trials and successful trials. The best cut-off for the prediction of successful trials was Valsalva HARP ratio ≤ 5.00. Conclusions Unsuccessful fitting trials due to dislodgment/failure to relieve POP symptoms are associated with a small ring pessary with respect to the levator HA. A ring pessary that produces a Valsalva HARP ratio > 5.00 has a higher risk of dislodgment/failure to relieve POP symptoms.

scholarly journals The Degree of Cystocele and Rectocele with Hiatal Area Levator Ani

2017 ◽  
pp. 225
Author(s):  
Fernandi Moegni ◽  
Hari Santoso
Keyword(s):  
Pelvic Organ Prolapse ◽  
Levator Ani ◽  
Pelvic Organ ◽  
Stage I ◽  
Stage Iii ◽  
Cut Point ◽  
Hiatal Area ◽  
4D Ultrasound ◽  
Significant Difference ◽  
Sensitivity Specificity

Objective: To investigate the degree of cystocele and rectocele with a maximum of levator hiatal area (AHL) during Valsava. Methods: Secondary data analysis of 90 patients with uterine prolapse January 2012 to November 2013 in the clinic Uroginekologi RSCM, Jakarta. 3D/4D ultrasound measurement and pelvic organ prolapse system Quantification (POP-Q) stage I-IV cystocele and rectocelestage I-IV. All statistical analyses were analyzed using Stata 20 for Windows. Results: Significant difference cystocele stage I-II (n = 25) with stage III-IV (n = 65), the maximum AHL with a difference of 4.33 cm2 (p = 0.040). In rectocele stage I-II (n = 64) and stage III-IV (n = 26) of 3.85 cm2 (p = 0.130). AUC values for stage I-II and III-IV cystocele was 0.607 (IK95% from 0.467 to 0.738), and the ROC for rectocele was 0.603 (IK95% from 0.472 to 0.734). The ROC optimal cut point for cystocele stage I-II with III-IV with the highestsensitivity and specificity is 29 cm2 (0.523 sensitivity, specificity 0.520), the rectocele is 30 cm2 (0.538 sensitivity, specificity 0.584). Conclusion: There is a significant relationship between the degree of cystocele and area of the levator ani muscles when Valsava, but there is no relationship at rectocele. The value of maximum area under the curve (AUC) hiatal area of the levatorani muscle in distinguishing stage I-II and III-IV cystocele are relatively similar to rectocele stage I-II and III-IV. Optimal cut point hiatal area of the levatorani muscle in distinguishing stage I-II and III-IV cystoceleis 29 cm2, while for rectocele is 30 cm2 with sensitivity and specificity values were quite good. Keywords: cystocele, levatorani hiatal area, pelvic organ prolapse, rectocele

HUBUNGAN ANTARA USIA, PARITAS, PEKERJAAN DAN INDEK MASSA TUBUH DENGAN KEJADIAN PROLAP ORGAN PANGGUL BERDASARKAN SKOR PELVIC ORGAN PROLAPSE QUANTIFICATION

2019 ◽  
Vol 2 (1) ◽  
pp. 39-44
Author(s):  
Ermawati Ermawati ◽  
Hafni Bachtiar
Keyword(s):  
Pelvic Organ Prolapse ◽  
Case Control Study ◽  
Pelvic Organ ◽  
Case Control ◽  
T Test ◽  
Pelvic Organ Prolapse Quantification ◽  
Chi Square ◽  
Chi Square Test ◽  
Control Study

Prolap organ panggul merupakan kondisi yang mempengaruhi kualitas hidup wanita. Prolaps organ panggul ini dapat disebabkan oleh perlukaan sewaktu proses persalinan, proses penuaan, komposisi jaringan pada seorang wanita, batuk- batuk kronis, atau sering melakukan pekerjaan berat. Pengenalan dini prolaps terkait dengan prognosis pemulihan anatomik dan fungsional organ panggul. Hingga kini, penerapannya dalam dunia klinis belum banyak sehingga pelatihan dan pembelajaran lebih lanjut tentang pelvic organ prolapse quantification (POPQ) jelas diperlukan. Penelitian ini dilakukan dengan metode case control study di polikilinik Obgin RSUP. Dr. M. Djamil Padang mulai bulan September 2013 sampai jumlah sampel terpenuhi sebanyak 98 orang. Dengan 49 orang kelompok kontrol dan 49 orang kelompok kasus .Analisis dilakukan untuk menilai hubungan usia, paritas, pekerjaan dan indek massa tubuh dengan kejadian prolap organ panggul berdasarkan skor POPQ. Data disajikan dalam bentuk tabel. Data diuji dengan t test dan chi square test. Jika p<0,05 menunjukan hasil yang bermakna. Terdapat hubungan yang bermakna antara usia dengan kejadian prolap organ panggul dengan (p<0,05) dan OR 27,871.terdapat hubungan yang bermakna antara paritas dengan kejadian prolap organ panggul dengan (p<0,05) dan OR 52,970.Dari analisa statistik pekerjaan tidak bisa di uji secara statistik.indek massa tubuh tidak terdapat hubungan yang bermakna terhadap kejadian prolap organ panggul.(p>0,05)

scholarly journals Differential diagnosis of middle compartment pelvic organ prolapse with transperineal ultrasound

2021 ◽  
Author(s):  
José Antonio García-Mejido ◽  
Zenaida Ramos-Vega ◽  
Alberto Armijo-Sánchez ◽  
Ana Fernández-Palacín ◽  
Rocío García-Jimenez ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Transperineal Ultrasound ◽  
Middle Compartment

scholarly journals OP18.05: Hiatal area and pelvic floor distress inventory scoring in Chinese pelvic organ prolapse women

2013 ◽  
Vol 42 (s1) ◽  
pp. 99-99
Author(s):  
S. S. Chan ◽  
R. Cheung ◽  
A. Yiu ◽  
L. Lee ◽  
Y. Yiu
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Pelvic Organ ◽  
Hiatal Area

scholarly journals Acceptance of ring pessary in pelvic organ prolapse

2019 ◽  
Vol 14 (2) ◽  
pp. 46-48
Author(s):  
Madhu Shrestha
Keyword(s):  
Patient Satisfaction ◽  
Retrospective Study ◽  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Vaginal Ring ◽  
Ring Pessary ◽  
Very High

Aims: To evaluate the use of pessaries for women with Pelvic Organ Prolapse irrespectivve POP-Q stages. Method: This is retrospective study conducted at Paropakar maternity and Women’s hospital from mid April to mid December 2018 on 114 women with pelvic organ prolapse. Result: Total of 114 women with prolapse evaluated. Age of presentation ranged from 36 to 85 years. Twenty cases (17.6%) underwent prolapsed surgery and 71 cases (62.2%) had ring pessary. Conclusion: Overall acceptance of vaginal ring pessary is very high. It can be used in the majority of women with patient satisfaction and without noteworthy complication.

scholarly journals Leptin, resistin and visfatin as useful predictors of gestational diabetes mellitus

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Ahmed Tijani Bawah ◽  
Mohammed Mustapha Seini ◽  
Albert Abaka-Yawason ◽  
Huseini Alidu ◽  
Salifu Nanga
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Operating Characteristic ◽  
Case Control Study ◽  
First Trimester ◽  
Anthropometric Parameters ◽  
Receiver Operating Characteristic Curves ◽  
Control Study

Abstract Background Lipids and adipokines including leptin, resistin and visfatin play various roles in the pathophysiology of Gestational Diabetes Mellitus (GDM). This study was aimed at determining whether serum leptin, resistin and visfatin are significantly altered during the first trimester of pregnancies that subsequently develop GDM and whether such changes are useful in predicting the disease. Methods This was a case-case control study which compared first trimester biochemical and anthropometric parameters in 70 pregnant women who subsequently developed GDM and 70 pregnant women without GDM at the Volta Regional Hospital, Ho, Ghana. Lipid profile and some selected adipokines were analyzed and first trimester body mass index (BMI) was determined. Results There were significant differences (p < 0.05) in leptin, resistin, and visfatin as well as significant dyslipidemia among those with GDM compared to those without GDM. Furthermore, the area under the Receiver Operating Characteristic Curves (AUCs) for leptin, resistin and visfatin were; 0.812, 0.836 and 0.799 respectively. Increased first trimester leptin (OR = 1.166; CI = 1.104–1.233; p < 0.0001), resistin (p < 0.0001) and visfatin (p < 0.0001) were associated with GDM. Conclusion Hyperleptinemia, hyperesistinemia and hypervisfatinemia precede GDM and can serve as good predictive indices for gestational diabetes mellitus.

Successful use of ring pessary with support for advanced pelvic organ prolapse

2015 ◽  
Vol 26 (10) ◽  
pp. 1517-1523 ◽  
Author(s):  
Jing Ding ◽  
Chun Chen ◽  
Xiao-chen Song ◽  
Lei Zhang ◽  
Mou Deng ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Ring Pessary ◽  
Advanced Pelvic Organ Prolapse

scholarly journals Verification of the Chromosome Region 9q21 Association with Pelvic Organ Prolapse Using RegulomeDB Annotations

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Maryam B. Khadzhieva ◽  
Dmitry S. Kolobkov ◽  
Svetlana V. Kamoeva ◽  
Anastasia V. Ivanova ◽  
Serikbay K. Abilev ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Chromosome Region ◽  
Pelvic Organ ◽  
Association Analyses ◽  
Genome Wide ◽  
Individual Snps ◽  
Hereditary Component ◽  
Polymerase Chain ◽  
Pelvic Floor Support ◽  
Control Study

Pelvic organ prolapse (POP) is a common highly disabling disorder with a large hereditary component. It is characterized by a loss of pelvic floor support that leads to the herniation of the uterus in or outside the vagina. Genome-wide linkage studies have shown an evidence of POP association with the region 9q21 and six other loci in European pedigrees. The aim of our study was to test the above associations in a case-control study in Russian population. Twelve SNPs including SNPs cited in the above studies and those selected using the RegulomeDB annotations for the region 9q21 were genotyped in 210 patients with POP (stages III-IV) and 292 controls with no even minimal POP. Genotyping was performed using the polymerase chain reaction with confronting two-pair primers (PCR–CTPP). Association analyses were conducted for individual SNPs, 9q21 haplotypes, and SNP-SNP interactions. SNP rs12237222 with the highest RegulomeDB score 1a appeared to be the key SNP in haplotypes associated with POP. Other RegulomeDB Category 1 SNPs, rs12551710 and rs2236479 (scores 1d and 1f, resp.), exhibited epistatic effects. In this study, we verified the region 9q21 association with POP in Russians, using RegulomeDB annotations.

scholarly journals Evaluation of variation in coagulation among children with Mycoplasma pneumoniae pneumonia: a case–control study

2017 ◽  
Vol 45 (6) ◽  
pp. 2110-2118 ◽  
Author(s):  
Tianhua Li ◽  
Haiying Yu ◽  
Weina Hou ◽  
Zhiyong Li ◽  
Chunfang Han ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Operating Characteristic ◽  
Case Control Study ◽  
Case Control ◽  
Healthy Children ◽  
Thrombin Time ◽  
Receiver Operating Characteristic Curves ◽  
Mycoplasma Pneumoniae Pneumonia ◽  
Control Study ◽  
D Dimer

Objective Acute organ embolism in children with Mycoplasma pneumoniae pneumonia (MPP) has been reported, but changes in coagulation are unclear. This study aimed to investigate changes in coagulation in children with MPP. Methods A total of 185 children with MMP (cases) and 117 healthy children (controls) were recruited. We measured prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and plasma fibrinogen (FIB) and D-dimer levels. Results Plasma FIB (3.39 ± 0.96 g/L vs 2.93 ± 0.6 6g/L, t = 4.50) and D-dimer (326.45 ± 95.62mg/L vs 263.93 ± 103.32mg/L, t=5.36) in MPP children were higher than controls and PT (9.54 ± 4.97S vs 11.48 ± 5.96S, t=3.05) and APTT (31.41 ± 12.01S vs 38.38 ± 11.72S, t=4.95) were shorter than controls. FIB, D-dimer, PT, and APTT were not different between the high IgM-titre and low-titre groups. The areas under the receiver operating characteristic curves in cases and controls for plasma FIB and D-dimer levels were 0.654 (95% confidence interval [CI], 0.593–0.716, P = 0.031) and 0.682 (95% CI, 0.619–0.744, P = 0.032), respectively. Conclusions Children with MPP have a higher risk of blood coagulation and thrombosis. Controlling these problems should be considered as soon as possible.

Sign in / Sign up

Export Citation Format

Share Document