Support role undifferentiated connective tissue dysplasia in genital organ rolapse evolution

2021 ◽  
Author(s):  
М.С. Селихова ◽  
В.В. Скворцов ◽  
Г.В. Ершов ◽  
А.Г. Ершов ◽  
Г.И. Малякин
Keyword(s):  
Risk Factors ◽  
Pelvic Organ Prolapse ◽  
Connective Tissue ◽  
Pelvic Floor ◽  
Connective Tissue Diseases ◽  
Significant Risk ◽  
Genital Prolapse ◽  
Pelvic Organ ◽  
Genital Organ ◽  
Connective Tissue Dysplasia

Одним из наиболее значимых факторов риска формирования опущений и выпадений внутренних половых органов являются заболевания соединительной ткани. Неуклонный рост числа женщин, страдающих пролапсом органов малого таза, привел к тому, что данная патология стала как медицинской, так и социально-экономической проблемой во многих странах. В то же время данные о роли недифференцированных дисплазий соединительной ткани в развитии пролапса органов малого таза и в формировании недостаточности тазового дна и возможности использования ее с целью прогнозирования данной патологии разноречивы. С целью определения взаимосвязи проявления недифференцированных дисплазий соединительной ткани с развитием пролапса органов малого таза был проведен ретроспективный анализ 157 историй болезни пациенток с пролапсом гениталий. У 27,39% пациенток были отмечены проявления дисплазий соединительной ткани. В 39,53% случаев было выявлено сочетание проявления недифференцированных дисплазий соединительной ткани с родовым травматизмом. У 16,28% от количества случаев с родовым травматизмом и пролапсом органов малого таза выявлены выраженные формы дисплазии соединительной ткани (варикозное расширение вен нижних конечностей, полипоз кишечника, пролапс митрального клапана), потребовавшие хирургической коррекция до беременности или после родов. Выявленная у каждой третьей пациентки, оперированной по поводу несостоятельности тазового дна, недифференцированная дисплазия соединительной ткани позволяет рассматривать ее как фактор риска развития пролапса органов малого таза, особенно в сочетании с травматизацией промежности в родах. Однако для оценки роли и значимости патологии соединительной ткани в прогнозировании формирования опущения и выпадения внутренних половых органов малого таза у женщин необходимы проспективные рандомизированные исследования. One of the most significant risk factors for the formation of internal genital organs is connective tissue diseases. The steady increase in the number of women suffering from pelvic organ prolapse has led to the fact that this pathology has become both a medical and socio-economic problem in many countries. At the same time, the data on the role of undifferentiated connective tissue dysplasias in the development of pelvic organ prolapse and in the formation of pelvic floor insufficiency and the possibility of using it to predict this pathology are contradictory. To determine the relationship between the manifestation of undifferentiated connective tissue dysplasia and the development of pelvic organ prolapse, a retrospective analysis of 157 case histories of patients with genital prolapse was carried out. In 27,39% of patients, manifestations of connective tissue dysplasia were noted. In 39,53% of cases, a combination of the manifestation of undifferentiated connective tissue dysplasias with birth traumatism was revealed. Severe forms of connective tissue dysplasia (varicose veins of the lower extremities, intestinal polyposis, mitral valve prolapse) were found in 16,28% of the number of cases with birth traumatism and pelvic organ prolapse, which required surgical correction before pregnancy or after childbirth. Revealed in every third patient operated on for pelvic floor incompetence, undifferentiated connective tissue dysplasias allows us to consider it as a risk factor for pelvic organ prolapse, especially in combination with perineal trauma during childbirth. However, to assess the role and significance of connective tissue pathology in predicting the formation of prolapse and prolapse of the internal genital organs of the small pelvis in a woman, prospective randomized studies are needed. Keywords: genital prolapse, connective tissue dysplasia, risk factors, social-active age, surgical treatment.

scholarly journals Signs of connective tissue dysplasia in women with genital prolapse

2021 ◽  
Vol 15 (1) ◽  
pp. 32-40
Author(s):  
A. S. Ustyuzhina ◽  
M. A. Solodilova ◽  
A. V. Polonikov ◽  
S. P. Pakhomov ◽  
U. G. Shokirova
Keyword(s):  
Pelvic Organ Prolapse ◽  
Connective Tissue ◽  
Varicose Veins ◽  
Genital Prolapse ◽  
Pelvic Organ ◽  
Main Group ◽  
Control Group ◽  
Systematic Analysis ◽  
Healthy Women ◽  
Connective Tissue Dysplasia

Introduction. Despite a long history of the disease, genital prolapse still have not been definitively solved. A relevance of pelvic organ prolapse in women has been increasing in recent years largely due to a change in the quality of life and desire to sustain their youth. The number of studies pinpointing the cause of the disease in connective tissue dysplasia (CTD) has been increasing annually.Aim: to conduct a systematic analysis and determine most common signs of CTD in women with genital prolapse.Materials and methods. CTD criteria and the relationship with genital prolapse were analyzed. The study was conducted using questionnaires and including clinical studies examining residents of the Belgorod region (135 women). The main group included 91 patients who had signs of pelvic organ prolapse, and control group consisted of 44 healthy women. CTD intensity score proposed by T.Yu. Smolnova et al. (2003) was used to assess signs of dysplasia in women examined allowing to build up three groups in which each symptom was evaluated as severity score.Results. Asthenic constitution was noted in high percentage of women suffering from genital prolapse (16.70 ± 0.38 %) compared with healthy women (2.30 ± 0.15 %; p = 0.016). Mild bruising, increased tissue bleeding tended to rise in main vs. control group (16.50 ± 0.37 % in main group and 0.0 in control group; p = 0.016). Signs of varicose veins and hemorrhoids requiring no surgical treatment were found in 33.00 ± 0.47 % and 4.50 ± 0.21 % in main vs. control group (p = 0.0002), respectively. Genital prolapse and hernia in first-line relatives were recorded in 9.90 ± 0.30 % in main group (p = 0.031), women without signs of prolapse did not indicate prolapse in close relatives.Conclusion. Asthenic constitution, hernias, varicose veins and hemorrhoids, female pelvic and hernial prolapse in close female relatives, a tendency to mild bruising, skeletal anomalies, elastosis skin were among common CTD signs in women with genital prolapse.

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

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.  

scholarly journals “Locus minoris resistentiae” and connective tissue weakness in older women: a case report and literature review on pelvic organ prolapse with inguinal bladder hernia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
A. Esber ◽  
A. Kopera ◽  
M. P. Radosa ◽  
I. B. Runnebaum ◽  
H. K. Mothes ◽  
...  
Keyword(s):  
Case Report ◽  
Inguinal Hernia ◽  
Pelvic Organ Prolapse ◽  
Connective Tissue ◽  
Genital Prolapse ◽  
Pelvic Organ ◽  
Simultaneous Occurrence ◽  
Patient Counselling ◽  
Hernia Sac ◽  
Bladder Hernia

Abstract Background Conditions such as genital prolapse and hernia are known to be related to connective tissue dysfunction. In this report on cases of the rare simultaneous finding of large genital prolapse and post-prolapse repair female inguinal bladder hernia, we aim to contribute to the discussion of a possible clinical definition of connective tissue weakness, for its clinical assessment and preoperative patient counselling. Case presentation Three cases of medial third-grade (MIII, Aachen classification) inguinal bladder hernia developing or enlarging after successful stage-IV pelvic organ prolapse (POP) repair at a university pelvic floor centre are presented. All patients were aged ≥ 80 years with long-standing postmenopausal status. One patient was followed for 5 years and two patients were followed for 6 months. In all patients, ultrasound revealed that the hernia sac contained the urinary bladder, which had herniated through the inguinal hernia orifice. A literature search revealed only one case report of direct female inguinal bladder hernia and few investigations of the simultaneous occurrence of POP and hernia in general. Conclusion The simultaneous occurrence of inguinal hernia and female POP can lead to bladder herniation following prolapse surgery in the sense of a “locus minoris resistentiae”. Clinical examination for simultaneous signs of connective tissue weakness and counselling prior to pelvic reconstructive surgery could help to increase patients’ compliance with further surgical treatment for hernia.

scholarly journals Risk Profile of Uterovaginal Prolapse

2018 ◽  
Vol 1 (2) ◽  
pp. 42-46
Author(s):  
Una Pant ◽  
R. Pradhan ◽  
B. Aryal
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Pelvic Organ Prolapse ◽  
Low Socioeconomic Status ◽  
Genital Prolapse ◽  
Pelvic Organ ◽  
Home Delivery ◽  
Uterovaginal Prolapse ◽  
The Mean ◽  
Post Menopausal

Introduction: Pelvic Organ Prolapse is a common problem in Nepal. The aim of this study was to assess the magnitude of pelvic organ prolapse and risk factors associated with it. Methods: This hospital based retrospective descriptive study was conducted in gynecological Out Patient Department of College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan from October 2011 and September 2013.The data were retrieved from the records and analyzed. Women who were earlier subjected for surgical correction of prolapses Cases with pregnancy were excluded from study. Results: There were total 375 cases of genital prolapse out of total 2075 cases of total gynecological admission i.e. 18% incidence. The mean age of patients was 56.79 years with the mean parity of 5.67. 72% cases developed prolapse during their post-menopausal years. Majority of them (84%) lived in hilly area and (57.3%) cases were involved with heavy occupational activities. 50.7% of genital prolapse were from the lower socioeconomic status. Proplase was seen with patients with higher BMI (26-30). Risk factors identified were unsupervised home delivery, rapid succession of pregnancies, and no rest after delivery. Most common clinical presentation of Pelvis Organ Prolapse was mass per vagina (60%). Conclusions: Prolapse is common among rural, farmers, multiparous and post-menopausal women where most of them delivered at home with prolonged labor. Age, low socioeconomic status and heavy manual activities were associated with the prolapse.

Clinical and anamnestic and biological candidates for participation in the mechanisms of genital prolapse formation in women

2021 ◽  
Vol 20 (1) ◽  
pp. 82-88
Author(s):  
N. M. Milyaeva ◽  
V. V. Kovalev ◽  
E. A. Bortnik ◽  
E. V. Sivov ◽  
E. V. Kudryavtseva ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Scientific Research ◽  
Genital Prolapse ◽  
Pelvic Organ ◽  
Prediction And Prevention ◽  
Pubmed Database ◽  
Mechanisms Of Formation

Introduction. The article presents an overview of the results of modern evidence-based scientific research on the mechanisms of formation of genital prolapse as one of the fundamental causes of pelvic floor muscle insufficiency in women. A systematic analysis of the current literature data on the involvement of clinical, anamnestic and pathogenetic motives in the development of pelvic organ prolapse in women was carried out.Objective: to expand the understanding of the role of anamnestic and biological factors in the pathogenesis of genital prolapse in women.Material and method. The review includes the scale of publications of domestic and foreign authors included in the PubMed database on this topic with a search depth of 20 years. The criteria for inclusion of articles for the system analysis were articles corresponding to the topic chosen for the study of the problem of gynecology, namely, the pathogenesis of genital prolapse in women with a search depth of twenty years. The criteria for exclusion from the study are the age of published scientific works, exceeding a twenty-year period, and inconsistency with the chosen top.Results. The conducted analysis demonstrates the fundamental role of epigenetic factors and molecular genetic predisposition in patients in the progression of genital prolapse which makes it possible to develop personalized prediction and prevention of pelvic floor dysfunction in women, prevention of social burnout.Conclusion. Further study of the mechanisms of formation, determination of the most significant molecular and genetic polymorphisms that increase the risk of pelvic organ prolapse in women, is a promising vector of scientific research. These studies will help to form a pathophysiological basis that allow for a thorough examination to identify a predisposition to the development of a severe disease long before its occurrence.

Biomechanics of the Rat Vagina During Pregnancy and After Vaginal Delivery: A 3-Dimensional Ultrasound Approach

2013 ◽  
Author(s):  
Andrew Feola ◽  
Masayuki Endo ◽  
Jan Deprest
Keyword(s):  
Pelvic Organ Prolapse ◽  
Sexual Dysfunction ◽  
Fecal Incontinence ◽  
Connective Tissue ◽  
Pelvic Floor ◽  
Support System ◽  
Pelvic Floor Disorders ◽  
Focal Point ◽  
Pelvic Organ ◽  
3 Dimensional

The vagina plays a focal point in support by directly supporting the bladder, urethra, uterus, and rectum. The vagina also is a central location for connective tissue and muscle attachments. Failure in any component of this intricate support system can lead to the development of pelvic floor disorders, such as pelvic organ prolapse (POP), urinary and fecal incontinence and sexual dysfunction.

scholarly journals The distribution of pelvic organ support defects in women undergoing pelvic organ prolapse surgery and compartment specific risk factors

2021 ◽  
Author(s):  
Emmanuel Payebto Zoua ◽  
Michel Boulvain ◽  
Patrick Dällenbach
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Pelvic Organ Prolapse ◽  
Reconstructive Surgery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Pelvic Organ ◽  
Posterior Compartment ◽  
Anterior Compartment ◽  
Specific Risk

Abstract Introduction and hypothesis The objective of our study was to describe the distribution of pelvic organ prolapse (POP) in a population of women undergoing POP reconstructive surgery and to identify compartment-specific risk factors. Methods We conducted a retrospective observational study in a cohort of 326 women who underwent POP repair and had a standardized preoperative POP assessment using the Baden-Walker classification. The distribution of POP grade was described for each vaginal compartment. The association between the involvement of each specific compartment and predictors was evaluated with a logistic regression model. Results The frequency of significant POP (grade ≥ 2) was 79% in the anterior compartment, 49% in the middle/apical compartment and 31% in the posterior compartment. Combined significant anterior and apical defects were present in 25% of women. Increasing age was a significant risk factor for apical defect (between 60 and 70 years OR = 2.4, 95% CI 1.2–4.6; > 70 years OR = 3.4, 95% CI 1.7–6.6). Previous hysterectomy (OR = 2.2, 95% CI 1.0–4.6) was a significant risk factor for posterior defect. Conclusions In a population undergoing POP surgery, anterior compartment involvement is the most common and serious defect and can often be associated with an apical defect, especially in older women. In case of previous hysterectomy, the posterior compartment may be weakened. These findings may help surgeons to select the appropriate POP reconstructive surgery, which often should address both anterior and apical defects.

Markers of connective tissue dysfunction in terms of surgical treatment for pelvic organ prolapse

2020 ◽  
Vol 19 (6) ◽  
pp. 90-95
Author(s):  
V.F. Bezhenar ◽  
◽  
E.K. Deriy ◽  
O.A. Ivanov ◽  
Sh.M. Azhimova ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Surgical Technique ◽  
Connective Tissue ◽  
Pelvic Floor ◽  
Individual Case ◽  
Pelvic Organ ◽  
Uterosacral Ligaments ◽  
Working Age ◽  
Patient’S History

Pelvic organ prolapse (POP) is a serious problem in urology and gynecology. Approximately 47% of women of working age suffer from POP. Due to the lack of uniform criteria for choosing an optimal surgical technique, POP relapses and stress urinary incontinence after pelvic floor surgeries are very common. The choice of surgical technique should be based on patient’s history as well as the results of instrumental, genetic, biochemical, morphological, and immunohistochemical examinations. This article covers the role of biochemical markers of POP analyzed in different tissues, such as blood, urine, cells of the vagina and uterosacral ligaments. It was found that different methods of POP markers identification can be used in each individual case. The decision on the tactics of surgical management of POP should be made after receiving the results of morphofunctional examination of the pelvic floor. Key words: connective tissue dysfunction, predictors, pelvic organ prolapse, gene expression

scholarly journals Features of the health status of women with genital prolapse

2021 ◽  
pp. 210-217
Author(s):  
G. I. Teleeva ◽  
L. S. Tselkovich ◽  
R. B. Balter ◽  
T. V. Ivanova ◽  
A. R. Ibragimova ◽  
...  
Keyword(s):  
Health Status ◽  
Reproductive Health ◽  
Connective Tissue ◽  
Genital Prolapse ◽  
Pelvic Organ ◽  
Subsequent Treatment ◽  
High Prevalence ◽  
Connective Tissue Dysplasia ◽  
Health Disorders ◽  
Reproductive Pathology

Introduction. In recent years, more and more attention has been paid to the issues of genital prolapse. This is largely due to the increase in women life expectancy and the need to provide them with a decent quality of life, as prolapse is quite often accompanied by dysfunction of the pelvic organs. In recent years, there has been an increasing amount of literature on undifferentiated connective tissue dysplasia (UCTD). However, most of these studies consider therapeutic or vertebro-neurological problems, while the high prevalence rates of this pathology call for additional research on the pathogenetic mechanisms of the effect of UCTD on pelvic organ prolapse, which will allow us to decide on the choice of subsequent treatment.The purpose and objectives. Asess the effect of undifferentiated connective tissue dysplasia (UCTD) on the formation of disorders of the somatic, gynecological and reproductive health status in women with genital prolapse.Materials and methods. To achieve this goal, we examined 204 women with genital prolapse in the POP-Q classification of stage 2–3, of which 97 were diagnosed with UCTD (the main group), and the remaining 107 patients made up the comparison group.Results. To evaluate the influence of UCTD on the formation of somatic, gynecological and reproductive health disorders in women with genital prolapse. We analyzed anamnestic indications for somatic, gynecological and reproductive pathology of women, as well as assessed the current state of health of patients with genital prolapse. It was found that it is UCTD that determines the development of a particular form of gynecological pathology and affects the formation of genital prolapse.Conclusion. UCTD manifests as various forms of somatic and gynecological health disorders throughout the life of women with genital prolapse. 

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