Female Pelvic Floor Dysfunction Continues to Negatively Impact Quality-of-Life during the COVID-19 Lockdown

The COVID-19 pandemic led to dramatical changes in elective medical care. We analysed its impact on patients with female pelvic floor dysfunction during the 6 weeks of lockdown in Austria. A cross-sectional study was conducted: All 99 women who presented at the urogynaecologic outpatient clinic of the Medical University of Vienna with pelvic organ prolapse (POP) or urinary incontinence (UI) from December 2019 up to the lockdown in March 2020 were included and contacted. 97% of these women (96 participants) agreed to participate in the survey conducted to asses pelvic floor related quality of life (QoL) through telephone- interrogation. The mean age was 59 ± 14.8 years, the POP group consisted of 42 women while the UI group included 54 women. Most participants (83% of POP and 81% of UI cases) stated that their female pelvic floor dysfunction had remained equally relevant or had become even more significant during the lockdown. Associated symptoms and psychological strain also maintained their relevance during the lockdown (UI: p = 0.229; POP: p = 0.234). Furthermore, 97% of all interviewed women indicated to be strongly willing to continue their treatment. A generalised linear model regression revealed no clinical or demographic risk factors for psychological strain during the lockdown (p > 0.05). Our results demonstrate that women’s QoL remains significantly impaired by their pelvic-floor disorders even during a worldwide crisis such as COVID-19. Therefore, elective disciplines such as urogynaecology urgently require novel and innovative strategies for continued patient care even in times of a lockdown.

Antibacterial polymer nanofiber-coated and high elastin protein-expressing BMSCs incorporated polypropylene mesh for accelerating healing of female pelvic floor dysfunction

To solve the bio-inertness of widely used polypropylene (PP) mesh for treating pelvic floor dysfunction (PFD), a novel strategy of incorporation with elastin gene-transfected bone marrow stem cells (BMSCs) and antibacteria drug-loaded polylactic acid (PLA) nanofibrous mat covering layer was proposed to overcome the limitation of the pristine PP mesh. Then, a series of physicochemical and in vitro experiments were applied to investigate the improvement of the as-prepared material. The elastin protein expression was proved to be upregulated without obvious cytotoxicity influence after the gene transfection and also improved the cell migration rate. In addition, the antibacteria drug-loaded PLA nanofibrous mat on the PP mesh could efficiently inhibit bacteria and showed no significant impact on cell adhesion and proliferation. Thus, we believe that the incorporation of the elastin gene-transfected BMSCs and nanofiber-coated PP mesh would be a potential candidate in the application of female PFD.