Assessment of Metalloproteinase Matrix 9 (MMP9) Gene Polymorphisms Risk Factors for Pelvic Organ Prolapse in the Brazilian Population

Objective To evaluate the C-1562T matrix metalloproteinase 9 (MMP9) gene polymorphisms as risk factors related to the occurrence of pelvic organ prolapse (POP) and to identify the clinical variables associated with the occurrence of the disease. Epidemiological studies of risk factors for POP do not explain why nulliparous women with no known risk factors also develop POP. Therefore, genetic factors may be involved. Methods Cohort study with 86 women with symptomatic POP (cases), and 158 women without a prior or current diagnosis of this disorder (controls). The groups were analyzed for the presence of MMP9 gene polymorphisms. Genotyping was performed using polymerase chain reaction (PCR) with DNA obtained from a peripheral venous puncture of both groups. Results There were no differences between the cases and controls even when we grouped the mutant homozygous and heterozygous genotypes. The analysis of patients with a complete absence of POP versus patients with total POP also showed no statistically significant differences. Age and home birth were found to be independent risk factors for POP. Conclusions There were no statistically significant differences in the C-1562T MMP9 polymorphisms between the cases and controls in Brazilian women.

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Clinical Risk Factors for Uterine Cervical Elongation among Women with Pelvic Organ Prolapse

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18179255 ◽

2021 ◽

Vol 18 (17) ◽

pp. 9255

Author(s):

Yi-Yin Liu ◽

Chiu-Lin Wang ◽

Zi-Xi Loo ◽

Kun-Ling Lin ◽

Cheng-Yu Long

Keyword(s):

Risk Factors ◽

Pelvic Organ Prolapse ◽

Pelvic Organ ◽

Cervical Length ◽

Uterine Weight ◽

Cervical Elongation ◽

Vaginal Length ◽

Independent Risk Factors ◽

Cervical Amputation ◽

Total Vaginal Length

Background: Cervical elongation is commonly associated with pelvic organ prolapse (POP). It was an identified risk for recurrent prolapse after hysteropexy, requiring additional surgeries. The aim of the study is to investigate the risk factors for uterine cervical elongation among women with POP. Methods: In this single-center retrospective cohort study, women who underwent vaginal total hysterectomy for POP between 2014 and 2016 were collected. The cervical and total uterine lengths were measured by pathologists, while the ratio of cervical length to total uterine length were calculated. The cervical elongation is defined as corpus/cervix ratio ≤ 1.5. Results: A total of 133 patients were enrolled in this study. Among these patients, 43 women had cervical elongation and 90 women had normal length of uterine cervix. We found that age > 65 years old (67.4% vs. 42.2%, p = 0.007), total vaginal length ≥ 9.5 cm (65.1% vs. 45.6%, p = 0.035), uterine weight < 51 gm (72.1% vs. 52.2%, p = 0.03), and Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6) ≥ 12 (30.2% vs. 14.4%, p = 0.032) were associated with the risk of cervical elongation. There were no significant differences on preoperative urodynamic parameters in the two groups. Conclusion: The patient age > 65 years old, the total vaginal length of POP-Q system ≥ 9.5 cm, uterine weight < 51 g, and POPDI-6 ≥ 12 are independent risk factors of cervical elongation in women with POP. For women scheduled for pelvic reconstructive hysteropexy, concomitant cervical amputation should be considered.

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Evaluation of the fibulin 5 gene polymorphism as a factor related to the occurrence of pelvic organ prolapse

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.5.680 ◽

2020 ◽

Vol 66 (5) ◽

pp. 680-686

Author(s):

Marcus Vinicius Barbosa de Paula ◽

Marcos Antônio de Farias Lira Júnior ◽

Vivian Costa e Silva Crocco Monteiro ◽

Ricardo Peres Souto ◽

César Eduardo Fernandes ◽

...

Keyword(s):

Pelvic Organ Prolapse ◽

Fragment Length Polymorphism ◽

Univariate Analysis ◽

Home Birth ◽

Binary Logistic Regression ◽

Pelvic Organ ◽

Control Group ◽

Case Group ◽

Independent Risk Factors

SUMMARY OBJECTIVE Pelvic organ prolapse (POP) is a very frequent situation in our population that may lead to a significant decrease in patients’ quality of life. Currently, we are looking for predictive factors for the development of POPs; thus, this study seeks to evaluate whether the Fibulin 5 polymorphism (FBLN5) is associated with the occurrence of POP. METHODS This is a cohort study with postmenopausal women who were divided into groups by POP stage: POP stages 0 and I (control group) and POP stages III and IV (case group). Subsequently, analyses of genetic polymorphisms of FBLN5 were performed using the Restriction Fragment Length Polymorphism (RFLP) technique. RESULTS A total of 292 women were included in the study. Pregnancy, parity and vaginal delivery in the patients, as well as in data described in the literature, were related to the occurrence of POP in the univariate analysis. However, after binary logistic regression, home birth and age remained independent risk factors for POP. We found no association between the FBLN5 polymorphism and the occurrence of POP (p = 0.371). CONCLUSION There was no association between the FBLN5 polymorphism and the occurrence of POP in Brazilian women.

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44 Risk factors for readmission after minimally invasive pelvic organ prolapse surgery

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2021.04.069 ◽

2021 ◽

Vol 224 (6) ◽

pp. S771-S772

Author(s):

A. Berger ◽

J. Tan-Kim ◽

S. Menefee

Keyword(s):

Risk Factors ◽

Pelvic Organ Prolapse ◽

Minimally Invasive ◽

Pelvic Organ ◽

Prolapse Surgery ◽

Pelvic Organ Prolapse Surgery

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A nationwide population‐based survey on the prevalence and risk factors of symptomatic pelvic organ prolapse in adult women in China – a pelvic organ prolapse quantification system‐based study

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.16675 ◽

2021 ◽

Author(s):

H Pang ◽

L Zhang ◽

S Han ◽

Z Li ◽

J Gong ◽

...

Keyword(s):

Risk Factors ◽

Pelvic Organ Prolapse ◽

Pelvic Organ ◽

Population Based ◽

Adult Women ◽

Pelvic Organ Prolapse Quantification ◽

Population Based Survey

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Incidence and risk factors for reoperation of surgically treated pelvic organ prolapse

International Urogynecology Journal ◽

10.1007/s00192-011-1483-3 ◽

2011 ◽

Vol 23 (1) ◽

pp. 35-41 ◽

Cited By ~ 22

Author(s):

Patrick Dällenbach ◽

Carol Jungo Nancoz ◽

Isabelle Eperon ◽

Jean-Bernard Dubuisson ◽

Michel Boulvain

Keyword(s):

Risk Factors ◽

Pelvic Organ Prolapse ◽

Pelvic Organ

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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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Long-term observation on postoperative recurrence and complications of transvaginal mesh surgery for pelvic organ prolapse

Gynecologic and Obstetric Investigation ◽

10.1159/000520979 ◽

2021 ◽

Author(s):

Junfang Yang ◽

Kun Zhang ◽

Jinsong Han ◽

Yiting Wang ◽

Ying Yao ◽

...

Keyword(s):

Risk Factors ◽

Pelvic Organ Prolapse ◽

Protective Factor ◽

Pelvic Organ ◽

Vaginal Mesh ◽

Transvaginal Mesh ◽

Mesh Exposure ◽

Mesh Surgery ◽

Post Menopause

Objective: This study aims to evaluate the risk factors for subjective recurrence and complications of patients who underwent transvaginal synthetic mesh surgery. Design：This retrospective cohort study included patients who received transvaginal mesh (TVM) surgery between January 2005 and June 2019. Methods: The information of patients was collected, including basic characteristics, subjective recurrence, and mesh-related complications. The clinical characteristics of patients with and without subjective recurrence were compared. The sexual activities of patients before and after the operation were recorded. SPSS 20.0 was used for the statistical analysis. Results: A total of 257 patients were included. Among them, 62 (24.1%) patients were lost to follow-up. The median follow-up time was 80 months (12 months, 170 months). Finally, 195 patients were followed up, 11 (5.6%) patients had a subjective recurrence of pelvic organ prolapse, and 26 (13.3%) patients had mesh-related complications (11 patients with de novo pain and 15 patients with mesh exposure). We found significant differences in age (68.9±5.1 vs. 63.4±5.8 years old), years of post-menopause (17.5±6.3 vs. 13.3±6.9 years), previous hysterectomy (27.3% vs. 6.0%), and concomitant hysterectomy (45.5% vs. 81.0%) between patients with and without subjective recurrence (P<0.05). The mesh exposure proportion of patients with total vaginal mesh (47.6%) was significantly higher than that with anterior vaginal mesh (2.9%) (P<0.05). Furthermore, 6.7% of sexually active patients reported do novo dyspareunia. Limitation: The investigators could only record the subjective recurrence of patients, thus there is a lack of objective recurrence data. Conclusion: Age, years of post-menopause and previous hysterectomy are risk factors for subjective recurrence of transvaginal mesh surgery; however，concomitant hysterectomy is a protective factor. Mesh exposure is the most common complication, especially for total vaginal mesh repair surgery.

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Pelvic Organ Prolapse in Countries of Different Economy: A Systematic Review

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v14i2.28436 ◽

2019 ◽

Vol 14 (2) ◽

pp. 7-21

Author(s):

Shishir Paudel ◽

Anisha Chalise ◽

Ganesh Dangal ◽

Tulsi Ram Bhandari ◽

Gehanath Baral

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Pelvic Organ Prolapse ◽

Uterine Prolapse ◽

National Income ◽

Significant Risk ◽

Pelvic Organ ◽

Reference List ◽

Medical Subject Headings ◽

Pubmed Database

Aims: This review was done to identify the reported prevalence rate of pelvic organ prolapse among the different world populations. Methods: Systematic review of Pelvic Organ Prolapse (POP) using the PRISMA checklist; PubMed database was searched on reportingthe prevalence of POP and its management measures in January 2020. Medical Subject Headings (MeSH) like "Pelvic Organ Prolapse"OR "Uterine Prolapse" OR “Vaginal Wall Prolapse” OR "Cystocele"AND "Prevalence [key word/s]" were used. Additional articles were identified through the reference list of the retrieved articles. Results: Out of 91 screened articles, 46 full articles were eligible and only 15 satisfied by selection criteria for the systematic review.The methodological score rated for the quality of studies is 4.5±1.7 (range=2-7) out of 8 points. The mean prevalence of POP diagnosis was 40%; with 42.44% in low and lower-middle-income countries,and 35.56%in upper-middle and high-income countries. Increasing age and parity, body mass indexand fetal macrosomia were found to be the significant risk factors irrespective of the country’s economy. Conclusions:The low and lower-income countries have almost twice the burden of prolapse than the countries of the higher economy. The major risk factors associated with prolapse remain common in all countries irrespective of national income or development.

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