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

Author(s):  
Nick Rockefeller ◽  
Peter Jeppson

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.

Author(s):  
Smita Anand Bijwe ◽  
Pooja Rajbhara

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.


2021 ◽  
Author(s):  
Osman Kose ◽  
Yavuz Tarik Atik ◽  
Deniz Gul ◽  
Burak Uysal ◽  
Haci Ibrahim Cimen ◽  
...  

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.


2016 ◽  
Vol 60 (1) ◽  
Author(s):  
A. Vetuschi ◽  
A. D'Alfonso ◽  
R. Sferra ◽  
D. Zanelli ◽  
S. Pompili ◽  
...  

<p>The objective<strong> </strong>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.</p><p><strong> </strong></p>


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