scholarly journals Responsiveness Of Pelvic Floor Distress Inventory (PFDI) And Pelvic Floor Impact Questionnaire (PFIQ) In Women With Pelvic Organ Prolapse, Undergoing Vaginal Reconstructive Surgery Versus Women With No Surgery

2017 ◽  
Vol 08 (01) ◽  
pp. 11-16
Author(s):  
Naila Mehboob ◽  
Asma Rauf ◽  
Ghana Shahid ◽  
Tehreem Sultana ◽  
Ghazala Mahmud
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Reconstructive Surgery ◽  
Stage Iv ◽  
Pelvic Organ ◽  
Stage Ii ◽  
Cross Sectional ◽  
Vaginal Reconstructive Surgery ◽  
Surgical Group

Objective: To determine the responsiveness of Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) in women with pelvic organ prolapse, undergoing vaginal reconstructive surgery versus women with no surgery. Methodology: This study was a cross sectional comparative study carried out in the department of Obstetrics and Gynecology, Pakistan Air Force Hospital, Mianwali in a period from January 2011 to December 2015. Prolapsed women with stage II or more and with willingness for surgery were included in the surgery group. Those willing for conservative management (pelvic floor exercises) were included in the non-surgical group. All patients in both groups completed the PFDI and PFIQ at baseline and 6 month follow-up. Results: Mean (±SD) age, weight, and parity of the patients were 51.42 (±9.07) years, 58.60 (±6.8) kg and 4.00 (±2.14) respectively. More than half of the patients (61%) belonged to low socio economic status, followed by middle class 34% and upper class 5%. Majority of the patients (61%) were post-menopausal. Most of the patients (72%) had stage II prolapse, followed by stage III (27%) and stage IV (1%). Among the associated symptoms, voiding dysfunction (81%) was most commonly observed symptom. At baseline all the scores were found to be significantly high in surgical group as compared to non-surgical group however at follow-up significantly low scores were observed in surgical group than non-surgical group. Also, significant decrease in mean scores was observed in both the groups from baseline to follow-up. Conclusion: The PFDI and PFIQ both are responsive to change in women undergoing surgical and non-surgical treatment for pelvic organ prolapse. But PFDI and PFIQ are more responsive to change in the surgical group. It was also concluded that PFDI is more responsive than the PFIQ in women with pelvic organ relapse

scholarly journals Prevalence and factors associated with pelvic organ prolapse among women attending the gynecology outpatient clinic at a tertiary hospital in southwestern Uganda

2021 ◽  
Author(s):  
RODGERS TUGUME ◽  
Henry Mark Lugobe ◽  
Paul Kalyebara Kato ◽  
Rogers Kajabwangu ◽  
Hamson Kanyesigye ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Outpatient Clinic ◽  
Clinical Stage ◽  
Multiple Logistic Regression Analysis ◽  
Stage Iv ◽  
Pelvic Organ ◽  
Stage Ii ◽  
Cross Sectional ◽  
Factors Associated ◽  
Perineal Tears

Abstract PurposeTo determine the prevalence, clinical stage at presentation and factors associated with pelvic organ prolapse (POP) among women attending the gynecology outpatient clinic at Mbarara Regional Referral Hospital (MRRH), Uganda. MethodsWe conducted a cross sectional study at the gynecology outpatient clinic of MRRH from September 2019 to January 2020. Multiple logistic regression analysis was done to determine factors associated with pelvic organ prolapse. Results Of 338 participants enrolled, the prevalence of POP was 27.5% (n=93). POP stages were: stage I 11.8% (n=11), stage II 63.4% (n=59), stage III 16.1% (n=15) and stage IV 8.9% (n=8). Grand-multiparity (aOR 17.1, 95% CI: 1.1 – 66.6), birth weight more than 3.5kg (aOR 3.7, 95% CI: 1.1 – 12.6), perineal tears (aOR 6.5, 95% CI: 2.1 – 20.2), peasant farmer (aOR 6.9, 95% CI: 1.6 – 29.9) and duration of labour in the first delivery > 24 hours (aOR 5.7, 95% CI: 1.2 – 29) were significantly associated with POP. ConclusionPOP is common among women attending the gynecology clinic at MRRH with most of them presenting with stage II. There should be routine screening for POP to enable early identification and management especially in those who are grand multiparous, peasant farmers and history of perineal tears.

scholarly journals Current situation of complications related to reconstructive surgery for pelvic organ prolapse: a multicenter study

2021 ◽  
Author(s):  
Zhi-jing Sun ◽  
Tao Guo ◽  
Xiu-qi Wang ◽  
Jing-he Lang ◽  
Tao Xu ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Reconstructive Surgery ◽  
Tissue Repair ◽  
Pelvic Organ ◽  
Native Tissue Repair ◽  
Post Surgery ◽  
Management Of Complications ◽  
Surgery Delay

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.

scholarly journals Neglected Pessary in Patient with Pelvic Organ Prolapse: A Case Report

2019 ◽  
Author(s):  
Zinat Ghanbari ◽  
Maryam Deldar-Pesikhani ◽  
Tahereh Eftekhar ◽  
Leila Pourali ◽  
Atiyeh Vatanchi ◽  
...  
Keyword(s):  
Case Report ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Pelvic Organ ◽  
Purulent Discharge ◽  
Vaginal Mucosa ◽  
Academic Hospital ◽  
Vaginal Pessary ◽  
First Choice

Objective: To report the neglected pessary in a patient with pelvic organ prolapse. Pelvic organ prolapse (POP) is one of the most important medical challenges in women especially elderly. One of the conservative treatments of symptomatic POP is pessary placement. Case report: A 84-year-old woman, para 10 was referred to female pelvic floor clinic of an academic hospital for vaginal bleeding and neglected vaginal pessary. Vaginal examination in the pelvic floor clinic revealed an entrapped ring pessary in severely atrophic vaginal mucosa with purulent discharge. Conclusion: Although pessary is the first choice and one of the best conservative treatment for pelvic organ prolapse, it shouldn’t be used for poor cooperative patient who cannot comply with regular follow-up visits which may cause harmful complications.

Repair of cystocele and apical genital prolapse using 6-strap mesh implant

2019 ◽  
Vol 87 (3) ◽  
pp. 130-136
Author(s):  
Mikhail Elikovich Enikeev ◽  
Dmitry Victorovich Enikeev ◽  
Dmitry Olegovich Korolev ◽  
Olesya Vyacheslavovna Snurnitsyna ◽  
Mikhail Vladimirovich Lobanov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Pelvic Organ ◽  
Stage Ii ◽  
Stage Iii ◽  
Pelvic Organ Prolapse Quantification ◽  
Genitourinary Prolapse ◽  
Mesh Implant

Objective: To assess the outcomes of surgical repair of anterior apical prolapse using the 6-strap mesh implant. Study Design: The prospective study included 100 patients with genitourinary prolapse. We used advanced 6-strap mesh implant. The results were assessed at 1 (n = 100) and 12 (n = 93) months after surgery. Maximum follow-up was over 4 years. The anatomical outcomes according to the Pelvic Organ Prolapse Quantification system and intraoperative and postoperative complications were assessed. Stage II and higher prolapse was considered to be a recurrence. The quality of life and sexual function were assessed using Pelvic Organ Prolapse Distress Inventory 20, Pelvic Floor Impact Questionnaire 7, and Pelvic Organ Prolapse/Incontinence Sexual Questionnaire 12. Results: Median age was 57 years (34–78 years (95% confidence interval)). All patients had stage III cystocele. The anterior vaginal wall descent in all the patients was associated with uterine descent: 37 (37%), stage II; 60 (60%), stage III; in 3 (3%), stage IV. In eight cases, postoperative de novo stress urinary incontinence developed. The quality of life improved in 93 (93%) women as judged by the Pelvic Floor Distress Inventory 20 data and in 87 (87%) women, according to the Pelvic Floor Impact Questionnaire 7 data. The desirable anatomical result (⩽stage I according to the Pelvic Organ Prolapse Quantification system) was achieved in 97 (97%) patients. With the exception of mesh fragment excision due to erosion (grade 3a), all the complications were classified as grade I according to the Clavien–Dindo classification. Conclusion: Genitourinary prolapse repair using 6-strap mesh is efficacious and relatively safe. The method demonstrates good anatomical results in relation to both anterior and apical prolapses with relatively short-term complications.

scholarly journals Factors Associated with Sexual Activity for Women with Pelvic Floor Dysfunction - A Cross-Sectional Study

2020 ◽  
Vol 42 (08) ◽  
pp. 493-500
Author(s):  
Sandra Rebouças Macêdo ◽  
José Ananias Vasconcelos Neto ◽  
José Tadeu Nunes Tamanini ◽  
Leonardo Bezerra ◽  
Rodrigo Aquino Castro
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Pelvic Organ ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

Abstract Objective To examine women with pelvic floor dysfunction (PFDs) and identify factors associated with sexual activity (SA) status that impacts quality of life (QoL). Methods We conducted a cross-sectional study that included women > 18 years old who presented with at least one PFD symptom (urinary incontinence [UI] and/or pelvic organ prolapse [POP]), in outpatient clinics specializing in urogynecology and PFD in Fortaleza, state of Ceará, Brazil, using a service evaluation form and QoL questionnaires. Results The analysis of 659 women with PFD included 286 SA (43.4%) women and 373 non-sexually active (NSA) (56.6%) women, with a mean age of 54.7 (±12) years old. The results revealed that age (odds ratio [OR] = 1.07, 95% confidence interval [CI] 1.03–1.12) and post-menopausal status (OR = 2.28, 95% CI 1.08–4.8) were negatively associated with SA. Being married (OR = 0.43, 95% CI 0.21–0.88) was associated with SA. Pelvic organ prolapse (OR = 1.16, 95% CI 0.81–1.68) and UI (OR = 0.17, 95% CI 0.08–0.36) did not prevent SA. SF-36 Health Survey results indicated that only the domain functional capacity was significantly worse in NSA women (p = 0.012). Two King's Health Questionnaire domains in NSA women, impact of UI (p = 0.005) and personal relationships (p < 0.001), were significantly associated factors. Data from the Prolapse Quality-of-life Questionnaire indicated that NSA women exhibited compromised QoL. Conclusion Postmenopausal status and age negatively affected SA. Being married facilitated SA. Presence of POP and UI did not affect SA. However, NSA women with POP exhibited compromised QoL.

scholarly journals Uterus-preserving Laparoscopic Lateral Suspension with Mesh Operation in Pelvic Organ Prolapse: Initial Experience in a Single Tertiary Center with a Median 24-Month Follow-up

2019 ◽  
Vol 79 (09) ◽  
pp. 983-992 ◽  
Author(s):  
Murat Yassa ◽  
Niyazi Tug
Keyword(s):  
Patient Satisfaction ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Pelvic Organ ◽  
Stage Ii ◽  
Pelvic Floor Ultrasound ◽  
Anterior Compartment ◽  
Tertiary Center ◽  
Laparoscopic Lateral Suspension ◽  
Subjective Cure

Abstract Introduction Laparoscopic lateral suspension with mesh (LLSM) is an effective and less invasive technique for the correction of pelvic organ prolapse. We discuss the primary objectives, subjective success rate and pelvic floor ultrasound outcomes of uterus-preserving LLSM operations. Patients and Methods Seventeen patients who underwent uterus-preserving LLSM (abdominocervicopexy) in a tertiary center were included in this prospective study. Anatomical cure was defined separately for the apical and anterior compartments as a Pelvic Organ Prolapse Quantification (POP-Q) score of less than − 1 cm for each compartment. Subjective cure was defined as the absence of bulge symptoms. Patient satisfaction, sexual function, prolapse-related quality of life, voiding dysfunction, nocturia and constipation were assessed. Transperineal ultrasonography was used to measure anterior compartment mobility and hiatal anteroposterior diameter. Results The anatomical cure rate was 100% for the apical and 88.2% for the anterior compartment, with one symptomatic stage-II cystorectocele and one asymptomatic stage-II cystocele. The subjective cure and patient satisfaction scores were 94.12 and 100%, respectively. Ba and C points were significantly improved, and vaginal lengthening was 10.14 ± 4.19 mm. Bp ascent was 5.72 ± 11.27 mm (p = 0.053). Proximal urethral rotation and retrovesical angles were reduced by 6.24 ± 11.95° and 27 ± 47.2°, respectively (p1 = 0.047; p2 = 0.032). The hiatal anteroposterior diameter was shortened by 4.36% (p = 0.039). A significant improvement was seen with regard to nocturia episodes but not for constipation. No mesh exposure was observed. Conclusions Uterus-preserving LLSM (abdominocervicopexy) was found to be effective for the correction of apical and anterior prolapse with high levels of patient satisfaction. Significant improvements in urge symptoms and frequency of nocturia were observed. Pelvic floor ultrasound outcomes may be useful when comparing this procedure with other surgical techniques.

scholarly journals Prevalence and factors associated with pelvic organ prolapse among women attending the gynecology outpatient clinic at a tertiary hospital in southwestern Uganda

2021 ◽  
Author(s):  
RODGERS TUGUME ◽  
Henry Mark Lugobe ◽  
Paul Kalyebara Kato ◽  
Rogers Kajabwangu ◽  
Hamson Kanyesigye ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Outpatient Clinic ◽  
Clinical Stage ◽  
Multiple Logistic Regression Analysis ◽  
Stage Iv ◽  
Tertiary Hospital ◽  
Pelvic Organ ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

Abstract Purpose To determine the prevalence, clinical stage at presentation and factors associated with pelvic organ prolapse (POP) among women attending the gynecology outpatient clinic at Mbarara Regional Referral Hospital (MRRH), Uganda. Methods We conducted a cross sectional study at the gynecology outpatient clinic of MRRH from September 2019 to January 2020. Multiple logistic regression analysis was done to determine factors associated with pelvic organ prolapse. Results Of 338 participants enrolled, the prevalence of POP was 27.5% (n = 93). POP stages were: stage I 11.8% (n = 11), stage II 63.4% (n = 59), stage III 16.1% (n = 15) and stage IV 8.9% (n = 8). Grand-multiparity (aOR 17.1, 95% CI: 1.1–66.6), birth weight more than 3.5kg (aOR 3.7, 95% CI: 1.1–12.6), perineal tears (aOR 6.5, 95% CI: 2.1–20.2), peasant farmer (aOR 6.9, 95% CI: 1.6–29.9) and duration of labour in the first delivery > 24 hours (aOR 5.7, 95% CI: 1.2–29) were significantly associated with POP.

scholarly journals Patient Satisfaction and Symptoms Improvement in Women Using a Vginal Pessary for The Treatment of Pelvic Organ Prolapse

2019 ◽  
Vol 12 (3) ◽  
pp. 271-275 ◽  
Author(s):  
Nahid Radnia ◽  
◽  
◽  
Maryam Hajhashemi ◽  
Tahereh Eftekhar ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Older Women ◽  
Prospective Observational Study ◽  
Pelvic Organ ◽  
Vaginal Pessary ◽  
Sexual Dissatisfaction ◽  
Appropriate Treatment ◽  
Larger Sample

Pelvic organ prolapse is a common complaint among older women. Vaginal pessary insertion is an appropriate treatment as a non-surgical method with few complications. This paper is a prospective observational study of 68 patients with pelvic organ prolapse that was carried out at the Imam Khomeini Hospital’s Pelvic Floor clinic. The degree of pelvic organ prolapse was graded according to the Pelvic Organ Prolapse Quantification (POP-Q) System. For all patients, the Pelvic Floor Distress Inventory-20 (PFDI-20) questionnaire was completed before vaginal pessary insertion, and after approximately 6 months of treatment. After 6-8 months, we found out that vaginal discharge was significantly increased and the feeling of fullness in the vagina was significantly decreased. However, sexual dissatisfaction, the feeling of incomplete evacuation, fecal and urinary incontinence, frequent urination, and pain or discomfort in the genital region were not significantly different after using a pessary. Approximately half a year later, 96.7% of the women with a successful pessary fitting trial were satisfied and reported a significant improvement in symptoms. Further studies with larger sample size, a different type of pessary, and a longer follow-up duration are recommended to evaluate all the symptoms associated with pelvic organ prolapse and its treatment.

scholarly journals The incidence of mesh extrusion after vaginal incontinence and pelvic floor prolapse surgery

2014 ◽  
Vol 3 (4) ◽  
pp. 76
Author(s):  
Seth Cohen ◽  
Elizabeth Kavaler
Keyword(s):  
Reconstructive Surgery ◽  
Survival Function ◽  
Pelvic Organ ◽  
Synthetic Mesh ◽  
Anterior Repair ◽  
Vaginal Reconstructive Surgery ◽  
Pelvic Floor Prolapse ◽  
One Year

Purpose: The advantages of using synthetic mesh in vaginal reconstructive surgery are significant. However, the concern about extrusion has led many to question its use. We wished to learn the extrusion rates and time to extrusion in patients undergoing vaginal stress incontinence and prolapse surgeries using polypropylene mesh. Materials and methods: Five hundred and seventy six women underwent vaginal reconstructive surgery with synthetic mesh between August 2000 and October 2009 for the treatment of stress urinary incontinence, with or without pelvic organ prolapse repair. 367 patients had at least one year follow-up. Procedures were: pubo-vaginal sling (PVS), PVS and anterior repair, PVS with anterior and/or posterior repairs, and PVS with hysterectomy and anterior and posterior repairs. Time to mesh extrusion was estimated using a survival function curve. Results: Forty-two (11.4%) patients sustained a mesh extrusion. The rate of mesh extrusion was (6.3%) in the PVS group, (14.7%) in the PVS and anterior repair group, (11.1%) in the PVS with anterior and posterior repairs group and (5%) in the PVS with hysterectomy and anterior and posterior repair. Percent extrusion free at one to four years post-op was (91%) and (85%). Conclusion: Our study provides a large series of prolapse cases performed by a single surgeon with follow-up that extends at least one year, with the longest follow-up at eight years. The incidence of long term mesh extrusion needs to be considered with respect to the support advantages of synthetic mesh in planning vaginal reconstructive surgery. 

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