scholarly journals Evaluation of Pelvic Floor Dysfunction for Patient with History of Total Vaginal Hysterectomy at Dr Sardjito General Hospital Yogyakarta

Author(s):  
Mochammad Andi Gunawan ◽  

Introduction: Uterine prolapse is the herniation of the uterus into or beyond the vagina as a result of failure of the ligamentous and fascial supports. It often coexist with prolapse of the vaginal walls, involving the bladder or rectum. A surgical treatment for uterine prolapse is hysterectomy. Changes in pelvic anatomic structure due to hysterectomy can result in impaired pelvic function because of nerve or pelvic muscle structure damage during surgery. Objective: This study aims to evaluate the presence of pelvic floor dysfunction in uterine prolapse patients who have undergone Total Vaginal Hysterectomy (TVH) surgery at Dr Sardjito General Hospital, from November 2018 to September 2019. Evaluations were carried out using Pelvic Floor Distress Inventory (PFDI) questionnaire. Methods: This study is an analytical descriptive research, using secondary data taken from patient’s medical records at Dr. Sardjito General Hospital Yogyakarta. It uses The Pelvic Floor Distress Inventory (PFDI) questionnaire, which consisted of 3 assessment groups, those are Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6), Colorectal-Anal Distress Inventory 8m(CRADI 8), and Urinary Distress Inventory 6 (UDI- 6). The inclusion criteria of this study were patients with diagnoses of uterine prolapse, cystocele and rectocele, who could be contacted and gave consent to conduct telephone interview. Results: There were 14 patients that met the inclusion criteria, they are uterine prolapse, cystocele and rectocele patients with a history of TVH procedure, were assessed using PFDI questionnaire. All patients did not have any pelvic floor dysfunction either from the POPDI-6, CRADI-8 or UDI-6 assessment groups. The weakness of this evaluation is that the PFDI postoperative value cannot be compared with before surgery, so it cannot be proven that the absence of pelvic floor dysfunction in the patient concerned is a positive result of the surgery performed, or not give significant changes. Conclusion: There is no pelvic floor dysfunction in patients with a history of TVH procedure on the indication of uterine prolapse, which was performed at Dr Sardjito General Hospital Yogyakarta.

2014 ◽  
Vol 69 (2) ◽  
pp. e71-e77 ◽  
Author(s):  
A.B. Rosenkrantz ◽  
M.T. Lewis ◽  
S. Yalamanchili ◽  
R.P. Lim ◽  
S. Wong ◽  
...  

Author(s):  
Mumtaz Adiba Bt Juanda ◽  
Suzanna Daud

Pelvic floor disorders, which includes pelvic organ prolapse (POP), have shown an increasing prevalence among women worldwide. (Wu 2014) It is perceived as embarrassment and affect the women’s quality of life. A 68-year-old housewife, Para 3, complained of a 50-cent coin size lump coming down from her vagina since 2019, which could be reduced back manually inside the vagina. The symptom exacerbated by straining and carrying heavy objects. Ignoring the symptom, causing the lump to increase in size and protruded out from her vagina for the past 2 months. She had 3 SVD with maximum birth weight of 3.75kg and a prolonged second stage of labour in her second pregnancy. She was not aware and never practiced pelvic floor exercise nor taken any HRT. There were no urinary symptoms nor constipation. Her BMI is 25.2kg/m2. Abdominal examination was unremarkable. On speculum examination, vagina was atrophic and third degree uterine prolapse was evident. She was arranged to have Vaginal hysterectomy, anterior colporrhaphy and sacrospinous fixation done. The positive risk factors in this case are multiparity, menopausal status, a history of prolonged labor and frequent heavy lifting. The delay in presentation is due to lack of awareness. It was also found in a study that feeling of embarrassment and social stigma could be the reason. (Abhyankar 2019) Pelvic Floor exercise and avoidance of heavy lifting may be beneficial at onset of symptom. For conclusion, POP awareness is crucial to empower women to prevent POP and seek treatment as soon as they are symptomatic.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S24


Author(s):  
Anupama Dave ◽  
Ruchi Joshi ◽  
Vibhu Goel ◽  
Atisha Dave

Background: MRI is the newest technique used to evaluate patients with pelvic floor disorders. It allows relatively non-invasive, dynamic evaluation of all pelvic organs in multiple planes and can directly visualize the muscular and ligamentous pelvic floor support structures. Using MRI to evaluate pelvic floor disorders may be most helpful in patients with multicompartment findings or symptoms, posterior compartment abnormalities, severe prolapse, or recurrent pelvic floor symptoms after prior surgical repair. MRI is often able to reveal more extensive organ prolapse than physical examination alone.Methods: The present study was carried out in the Department of Radiodiagnosis and Obstetrics and Gynecology of Mahatma Gandhi Memorial Medical College and M.Y. Hospital, Indore, Madhya Pradesh from November 2014 to October 2015. A total of 43 patients who had symptoms of pelvic floor dysfunction like uterine prolapse, urinary or rectal dysfunction were evaluated by high resolution USG. Patients with low lying uterus on USG were subjected to MRI. Before MRI, these patients were assessed by a Gynecologist, and a clinical diagnosis in form of the organ/organs prolapsed and the grade of individual prolapse was assigned and tabled in the prefixed format.Results: Prolapse is more common in patients with greater than 50 years age (63% patients). MRI picked up more lesions compared to clinical examination, 90% as compared to 82.5% on clinical examination. MRI has good correlation with surgery in diagnosing prolapse. Concomitant prolapse of the Anterior and Middle compartment is the most common clinical entity diagnosed on 52.5% patients in our set up. MRI has poor sensitivity in identifying posterior compartment prolapse. There is good agreement between the clinical grading and MRI grading (81.8% correlation).Conclusions: T MRI offers a novel approach of simultaneous imaging of all compartments of the female pelvis at a single setting. With lesser intraobserver variation and better visualization of the pelvic anatomy MRI would help in accurate staging and hence better outcomes in patients in terms of symptom relief.


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.


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.


2013 ◽  
Vol 7 (9-10) ◽  
pp. 199 ◽  
Author(s):  
Rebecca G. Rogers

Pelvic floor disorders (PFDs) can impact sexual function. This summary provides an overview of the impact of stress urinary incontinence and pelvic organ prolapse and their treatments on sexual function. In general, interventions that successfully address PFDs will generally improve sexual function as well. However, there are patients whose sexual function will remain unchanged despite treatment, and a small but significant minority who will report worsened sexual function following treatment for their pelvic floor dysfunction.


2021 ◽  
Vol 14 (5) ◽  
pp. e238669
Author(s):  
Liam Joseph Beamer ◽  
Sarah Neary ◽  
Thomas McCormack ◽  
David Ankers

We describe the first reported case of transient distal ureteric obstruction attributed to post-surgical oedema in a patient with a solitary kidney. This occurred following combined pelvic floor repair and sacrospinous fixation for recurrent pelvic organ prolapse and manifested clinically as anuria, radiological hydroureter and acute kidney injury in the postoperative period. The transient nature of this obstruction, which was managed by a temporary percutaneous nephrostomy, indicates that it was caused by ureteric compression secondary to soft tissue oedema following surgery. We highlight the importance of this potential complication in females with a history of nephrectomy, unilateral renal tract anomalies or severely diminished renal reserve.


2021 ◽  
Author(s):  
Lian Yang ◽  
Shasha Hong ◽  
Yang Li ◽  
Tingting Wang ◽  
Li Hong

Abstract The substantial loss of collagen in the supporting tissues of the pelvic floor is characteristic of pelvic organ prolapse (POP). A bFGF-induced collagen increase has been widely recognized by scholars, but the role of bFGF in pelvic floor dysfunction and the mechanism by which bFGF promotes collagen have not been reported. Here, we elucidated this mechanism. After bFGF stimulation, L929 cells showed significantly increased expression of collagen, integrin β1, and MEK1/2 signaling proteins. Our previous studies showed that integrin β1 plays an important role in electric stimulation-induced collagen expression, which suggests an underlying mechanism. By overexpressing and silencing integrin β1, we proved that integrin β1 is also an important signal transduction protein of bFGF that promotes collagen through the MEK1/2 pathway, which is a classic collagen-promoting pathway. In summary, these findings suggest that bFGF can stimulate the expression of collagen through the integrin β1/p-MEK1/2/p-ERK/1/2 signaling pathway in L929 cells. Keyword Pelvic organ prolapse; bFGF; integrinβ1; ERK1/2; Collagen Special project for Chinese women's pelvic floor dysfunction prevention and treatment (no. 201817092) and the Natural Science Foundation of Hubei Province(no.2019CFB149).


2021 ◽  
Vol 1 (12) ◽  
pp. 946-956
Author(s):  
Rani Salsabilla ◽  
Marie Yuni Andari ◽  
Monalisa Nasrul

Congenital cataracts are the leading cause of blindness in children. Lens opacity in early life has the potential to cause permanent visual impairment if not treated promptly. Cataract surgery performed at the right time can prevent children from amblyopia (lazy eye). This study aims to determine the characteristics of congenital cataracts at the West Nusa Tenggara Provincial General Hospital in the 2018-2019 period. This research uses descriptive method. The data used is secondary data from medical records of congenital cataract patients at the West Nusa Tenggara Provincial General Hospital in the 2018-2019 period. In the 2018-2019 period, 40 children had congenital cataracts. Most of the cataract sufferers were women (52.5%); living outside the city of Mataram (92.5%) with an age distribution of under 12 months (95%) and the rest over 12 months. For infants under 12 months, 53 percent have been diagnosing at the age of 1-2 months. The characteristics of congenital cataracts found were generally bilateral (52.5%), had standard birth weight (52.5%), history of natural birth delivery (67.5%), and had other extraocular congenital abnormalities (72.5%). Most patients with congenital cataracts in the West Nusa Tenggara Provincial General Hospital have been diagnosing at a (pretty/moderately) early age of 1-2 months at the beginning of their lives. So, with appropriate and prompt therapy, hoping that it can reduce the risk of amblyopia.


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