scholarly journals MP28-09 A NOVEL MODEL OF PELVIC ORGAN ISCHEMIA: PELVIC FLOOR CONTRACTILE FUNCTION IS MORE RESISTANT TO ISCHEMIA AND POST-ISCHEMIA REPERFUSION THAN BLADDER DETRUSOR MUSCLE

2016 ◽  
Vol 195 (4S) ◽  
Author(s):  
Amy D. Dobberfuhl ◽  
Catherine Schuler ◽  
Robert E. Leggett ◽  
Elise J.B. De ◽  
Robert M. Levin
2021 ◽  
Author(s):  
Adharika Agrawal ◽  
Moeez Ashfaque ◽  
Ankit Kumar Malik ◽  
Mohammad Junaid ◽  
Mayank Sinha ◽  
...  

Abstract Levator ani is a healthy and fatigue resistant striated muscle. It is stung like a sway around the midline pelvic effluents like the uterus, bladder, and bowel. The pubococcygeus muscle has four fibers; Posterior fibers, Puborectalis, Puboanalis, Pubovaginalis. Here, the Pubovaginalis forms a U-shaped sling, supporting the Pelvic organ-like bladder, uterus. Therefore, during Parturition, weakness or tear of the sling occurs, responsible for the pelvic organ prolapse. Pelvic organ prolapse includes the drop of the vaginal wall or the uterus. The weakness of the pelvic floor also causes urinary incontinence, defined as the involuntary loss of urine when the intravesical pressure exceeds the urethral pressure in the absence of detrusor muscle. So, it is very important to be aware of the pelvic floor exercises, which help in strengthening the pelvic floor and prevent complications. Some women may think the leakage of urine and organ prolapse as a regular phenomenon that may contribute to incontinence and prolapse, study objective was to see the awareness in the women about the complications. This survey highlights the need for awareness. It promotes early education among females about pelvic floor structure, exercise, the importance of early diagnosis, and the correct treatment to avoid complications. Author contribution: Authors have analyzed the data and wrote the paper. The author contributed to manuscript revisions and approved the final version of the manuscript and agreed to the responsibility for the content. Methods. This survey has developed on the basis of analysis of women suffering from urinary leakage and prolapse issues. The date in which the responses have been collected are 2-11-2020 to 3-03-2021.This study comprises a cross-sectional survey, a 3-part questionnaire to 246 females who know the English language, which has three sections where section one, prolapse and incontinence knowledge questionnaire which is made up of 13 questions, to evaluate knowledge of females about urinary incontinence. Section two has 14 questions that contain information about the treatment of the problem and prognosis and the remaining 12 questions in section three including demographic information. It has been distributed among 700 women on which 246 filled this form and answered all the questions which were asked in the questionnaire . Inclusion and exclusion criteria: The following inclusion criteria: age - born between 2003 − 1960, understanding of basic english language it is because this is the common language which is understood by the whole community. As there is no specification in terms of region or nation. The English language is commonly understood by most people. should have a smartphone or computer, should have access to the internet and awareness of the google form. Exclusion criteria are as follows: Women who have gone under surgical intervention, who do not know the english language, who cannot see. Data collection procedure: The conduction of this research involves the questionnaire used by researchers; the difference is of inclusion criteria among females. This form has reliability and validity as per prior check by an expert. The technique to distribute the questionnaire is snowball sampling. Results: The overall awareness level for the sub sample population was calculated to be at 42.67%. Awareness for urinary leakage was 45.12% and pelvic organ prolapse 40.25% Conclusions: More than half of the population is estimated to be unaware of basic knowledge of the subject


1998 ◽  
Vol 274 (3) ◽  
pp. R822-R829 ◽  
Author(s):  
Long-En Chen ◽  
Anthony V. Seaber ◽  
Rima M. Nasser ◽  
Jonathan S. Stamler ◽  
James R. Urbaniak

The ultimate goal of replantation and microsurgical reconstructive operations is to regain or improve impaired function of the tissue. However, the data related to the influence of NO on tissue function are limited. This study evaluated the effects of the NO donor S-nitroso- N-acetylcysteine (SNAC) on contractile function of skeletal muscle during reperfusion. Forty-nine rats were divided into six groups. The extensor digitorum longus (EDL) muscles in groups I and II were not subjected to ischemia-reperfusion but were treated with a low (100 nmol/min) or high (1 μmol/min) dose of SNAC. In groups III- V, the EDL underwent 3 h of ischemia and 3 h of reperfusion and was also treated with low (100 nmol/min) or high doses (1 or 5 μmol/min) of SNAC. Group VI was a phosphate-buffered saline (PBS)-treated control group. Twenty additional animals were used to document systemic effects of SNAC and PBS only. SNAC or PBS was infused for 6.5 h, beginning 30 min before ischemia and continuing throughout the duration of reperfusion. Contractile testing compared the maximal twitch force, isometric tetanic contractile forces, fatigue, and fatigue half time of the experimental EDL and the contralateral nontreated EDL. The findings indicate that 1) SNAC does not influence contractile function of EDL muscle not subjected to ischemia-reperfusion, 2) SNAC significantly protects the contractile function of ischemic skeletal muscle against reperfusion injury in the early reperfusion period, and 3) the protective role of SNAC is critically dosage dependent; protection is lost at higher doses. The conclusion from this study is that supplementation with exogenous NO exerts a protective effect on the tissue against reperfusion injury.


Author(s):  
Zhi-jing Sun ◽  
Tao Guo ◽  
Xiu-qi Wang ◽  
Jing-he Lang ◽  
Tao Xu ◽  
...  

Abstract Introduction and hypothesis This study aimed to investigate the evaluation and management of complications after pelvic floor reconstructive surgery for pelvic organ prolapse in China. Methods Complications of pelvic floor reconstructive surgery for pelvic organ prolapses from 27 institutions were reported from November 2017 to October 2019. All complications were coded according to the category-time-site system proposed by the International Urogynecological Association (IUGA) and the International Continence Society (ICS). The severity of the complications was graded by the Clavien-Dindo grading system. Four scales were used to evaluate patient satisfaction and quality of life after management of the complications: the Patient Global Impression of Improvement (PGI-I), the Pelvic Floor Impact Questionnaire Short Form (PFIQ-7), the Pelvic Organ Prolapse Symptom Score (POP-SS), and a 5-point Likert-type scale that evaluated the patient’s choice of surgery. Results Totally, 256 cases were reported. The occurrence of complications related to transvaginal mesh (TVM) and laparoscopic sacrocolpopexy (LSC) had a significantly longer post-surgery delay than those of native tissue repair surgery (p < 0.001 and p = 0.010, respectively). Both PFIQ-7 and POP-SS score were lower after management of complications (p < 0.001). Most respondents (81.67%) selected very much better, much better, or a little better on the PGI-I scale. Only 13.3% respondents selected unlikely or highly unlikely on the 5-point Likert-type scale. Conclusions The occurrence of complications related to TVM surgery and LSC had a longer post-surgery delay than native tissue repair surgery. Long-term regular follow-up was vital in complication management. Patient satisfaction with the management of TVM complications was acceptable.


2021 ◽  
Vol 81 (02) ◽  
pp. 183-190
Author(s):  
Gert Naumann

AbstractThe current treatment for urinary incontinence and pelvic organ prolapse includes a wide range of innovative options for conservative and surgical therapies. Initial treatment for pelvic floor dysfunction consists of individualized topical estrogen therapy and professional training in passive and active pelvic floor exercises with biofeedback, vibration plates, and a number of vaginal devices. The method of choice for the surgical repair of stress urinary incontinence consists of placement of a suburethral sling. A number of different methods are available for the surgical treatment of pelvic organ prolapse using either a vaginal or an abdominal/endoscopic approach and autologous tissue or alloplastic materials for reconstruction. This makes it possible to achieve optimal reconstruction both in younger women, many of them affected by postpartum trauma, and in older women later in their lives. Treatment includes assessing the patientʼs state of health and anesthetic risk profile. It is important to determine a realistically achievable patient preference after explaining the individualized concept and presenting the alternative surgical options.


Author(s):  
Beatriz Sánchez-Sánchez ◽  
Beatriz Arranz-Martín ◽  
Beatriz Navarro-Brazález ◽  
Fernando Vergara-Pérez ◽  
Javier Bailón-Cerezo ◽  
...  

Therapeutic patient education programs must assess the competences that patients achieve. Evaluation in the pedagogical domain ensures that learning has taken place among patients. The Prolapse and Incontinence Knowledge Questionnaire (PIKQ) is a tool for assessing patient knowledge about urinary (UI) and pelvic organ prolapse (POP) conditions. The aim of this study was to translate the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) into Spanish and test its measurement properties, as well as propose real practical cases as a competence assessment tool. The cross-cultural adaptation was conducted by a standardized translation/back-translation method. Measurement properties analysis was performed by assessing the validity, reliability, responsiveness, and interpretability. A total of 275 women were recruited. The discriminant validity showed statistically significant differences in the PIKQ scores between patients and expert groups. Cronbach’s alpha revealed good internal consistency. The test–retest reliability showed excellent correlation with UI and POP scales. Regarding responsiveness, the effect size, and standardized response mean demonstrated excellent values. No floor or ceiling effects were shown. In addition, three “real practical cases” evaluating skills in identifying and analyzing, decision making, and problem-solving were developed and tested. The Spanish PIKQ is a comprehensible, valid, reliable, and responsive tool for the Spanish population. Real practical cases are useful competence assessment tools that are well accepted by women with pelvic floor disorders (PFD), improving their understanding and their decision-making regarding PFD.


Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 387
Author(s):  
Karolina Eva Romeikienė ◽  
Daiva Bartkevičienė

Every woman needs to know about the importance of the function of pelvic-floor muscles and pelvic organ prolapse prevention, especially pregnant women because parity and labor are the factors which have the biggest influence on having pelvic organ prolapse in the future. In this article, we searched for methods of training and rehabilitation in prepartum and postpartum periods and their effectiveness. The search for publications in English was made in two databases during the period from August 2020 to October 2020 in Cochrane Library and PubMed. 77 articles were left in total after selection—9 systematic reviews and 68 clinical trials. Existing full-text papers were reviewed after this selection. Unfinished randomized clinical trials, those which were designed as strategies for national health systems, and those which were not pelvic-floor muscle-training-specified were excluded after this step. Most trials were high to moderate overall risk of bias. Many of reviews had low quality of evidence. Despite clinical heterogeneity among the clinical trials, pelvic-floor muscle training shows promising results. Most of the studies demonstrate the positive effect of pelvic-floor muscle training in prepartum and postpartum periods on pelvic-floor dysfunction prevention, in particular in urinary incontinence symptoms. However more high-quality, standardized, long-follow-up-period studies are needed.


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