Pelvic Organ
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2021 ◽  
Author(s):  
Mehmet Ferdi KINCI ◽  
Burak SEZGİN ◽  
Mehmet Onur ARSLANER ◽  
Deniz AKIN GÖKBEL ◽  
İsmail GÖKBEL ◽  
...  

Abstract Background: We aimed to evaluate the short term anatomical and symptomatic results of elderly patients on whom Le Fort colpocleisis operation was performed due to pelvic organ prolapse (POP) in our clinic. Methods: Medical records of fifty-nine sexually inactive and ≥65 aged women with stage 2 or higher vaginal or uterine prolapse who underwent Le Fort colpocleisis operation were prospectively analysed. Pre-operative and 12 months post-operative data were recorded. Turkish validated Global Pelvic Floor Bother Questionnaire (GPFBQ) were also evaluated at pre-operative and 12 months post-operative period in all patients. Anatomical success was determined as no prolapse of any POP-Q point at or below 1 cm above the hymen. Results: A total of 59 patients were conducted in this study. The average age of the patients was 71.67±7.01 (years). The mean BMI was 27.1±9.52 kg/m2. POP-Q point C as well as, Gh and TVL measurements were significantly higher after surgery than those at preoperative period (p<0.01, p<0.01, p<0.01, respectively). There was no recurrence in any case. Evaluation of complications at the pre-operative and post-operative 12th month revealed significant differences for SUI, urinary frequency, nocturia, and pelvic pain symptoms during post-operative period (p:0.007, p<0.001, p:0.01, p<0.001; respectively). Conclusions: Le Fort colpocleisis is a simple and effective procedure that has been found to provide successful anatomical and symptomatic outcomes in sexually inactive and elderly women for POP. However long-term results of this procedure needs further investigation.


2021 ◽  
Vol 8 ◽  
Author(s):  
Xiaoduo Wen ◽  
Haiyan Tian ◽  
Xiaojing Yan ◽  
Quiqing Sun ◽  
Yuanyuan Du ◽  
...  

Objective: To evaluate whether the combined measurement of pelvic organ mobility and levator hiatus area improves the sensitivity of transperineal ultrasound (the index test) for diagnosing pelvic organ prolapse (POP).Methods: We retrospectively recruited women who had been examined in a tertiary gynecological center for symptoms of lower urinary tract incontinence and/or POP between January 2017 and June 2018. We excluded patients who had undergone hysterectomy previously or those who had received corrective surgery. All subjects underwent a standardized interview, POP quantification (POP-Q) examination (a reference standard for patients and controls), and ultrasound measurements of the levator hiatus area at rest (rHA), on contraction (cHA), and on Valsalva (vHA). We also determined the mobility of the bladder neck (BNM), cervix (CM), and rectum ampulla (RAM). Receiver operating characteristic (ROC) curve analyses were performed to determine cut-off values for diagnosis. Diagnostic performance was assessed by sensitivity, specificity, and area under curve (AUC).Results: A total of 343 women were eligible for analysis, including 247 POP patients (stage 2–3 by POP-Q) and 96 controls. Compared with controls, POP cases had significantly higher values for rHA, vHA, cHA, BNM, CM, and RAM. Each parameter was identified as a significant discriminator for POP and controls, as determined by ROC curve analysis, although the cut-off value varied slightly between different parameters. The combination of rHA, vHA, and cHA (with any HA that was ≥ the cut-off) improved the sensitivity from 64–89 to 89–93%. The combination of pelvic organ mobility with rHA, vHA, and cHA, further increased the sensitivity from 89–93 to 95–97%.Conclusion: The combination of levator hiatus area and pelvic organ mobility improved the sensitivity of transperineal ultrasound in the diagnosis of POP, whether used as a frontline test to assist POP-Q grading or to monitor the effect of pelvic floor exercise programs.


Cells ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 2728
Author(s):  
Ihn Han ◽  
Seung Ah Choi ◽  
Seul I Kim ◽  
Eun Ha Choi ◽  
Young Joo Lee ◽  
...  

Pelvic organ prolapse (POP) is a chronic disorder that affects quality of life in women. Several POP treatments may be accompanied by abrasion, constant infection, and severe pain. Therefore, new treatment methods and improvements in current treatments for POP are required. Non-thermal atmospheric-pressure plasma is a rising biomedical therapy that generates a mixed cocktail of reactive species by different mechanisms. In this study, we applied a cylinder-type dielectric barrier discharge plasma device to create a plasma-treated liquid (PTL). The PTL was added to primary cultured human uterosacral ligament fibroblast (hUSLF) cells from POP patients at each stage. Surprisingly, treatment with diluted PTL increased hUSLF cell viability but decreased ovarian cancer cell viability. PTL also decreased cell apoptosis in hUSLF cells but increased it in SKOV3 cells. Our results suggest that PTL protects hUSLF cells from cell apoptosis by controlling the p53 pathway and improves cell viability, implying that PTL is a promising application for POP therapy.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ling-Ying Wu ◽  
Kuan-Hui Huang ◽  
Tsai-Hwa Yang ◽  
Hui-Shan Huang ◽  
Tzu-Shu Wang ◽  
...  

AbstractThis study aimed to explore the effect of pelvic reconstruction surgery on the relation of pelvic organ prolapse (POP) and overactive bladder (OAB) and the impact of preoperative vaginal oestrogen supplement on vaginal tissue. A total of 100 postmenopausal women with symptomatic POP who underwent pelvic reconstruction surgery (laparoscopic sacrocolpopexy or transvaginal mesh) were enrolled in this study. Preoperative vaginal oestrogen was prescribed in 28 cases. The evaluation tools consisted of POP-Q, urodynamic study, Overactive Bladder Symptom Score (OABSS), and urinary NGF. Vaginal maturation index and vaginal specimens for hormone receptors study were investigated during operation to evaluate the effect of topical oestrogen. Follow-up assessments were performed at 1, 3, and 6 months after surgery. Preoperatively, 58 (58%) were POP with OAB. After reconstruction surgery, the OABSS decreased significantly (6.87 ± 0.85 vs 3.77 ± 0.61, p < 0.001) at postoperative 6 months in the group. Remarkable increasing trends of urinary NGF levels are noted till 3 months postoperatively, then decreasing to the baseline level at 6 months postoperative follow-up. Remarkable decrease of mRNA of the androgen receptor and significant higher expression of progesterone receptor (PR) were noted after use of the vaginal oestrogen cream. The severity of OAB in the POP women shows moderate degree according to OABSS. Pelvic reconstruction surgery can significantly improve the OAB symptoms. The surgery induced inflammation effect lasts for about 6 months. Short-term preoperative supplement of topical oestrogen brings alterations of the vaginal epithelium.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaojuan Wang ◽  
Yisong Chen ◽  
Changdong Hu ◽  
Keqin Hua

Abstract Background The objective of this study was to evaluate the overall outcomes and complications of transvaginal mesh (TVM) placement for the management of pelvic organ prolapse (POP) with different meshes with a greater than 10-years of follow-up. Methods We performed a retrospective review of patients with POP who underwent prolapse repair surgery with placement of transvaginal mesh (Prolift kit or self-cut Gynemesh) between January 2005 and December 2010. Baseline of patient characteristics were collected from the patients’ medical records. During follow-up, the anatomical outcomes were evaluated using the POP Quantification system, and the Patient Global Impression of Improvement (PGI-I) was used to assess the response of a condition to therapy. Overall postoperative satisfaction was assessed by the following question: “What is your overall postoperative satisfaction, on a scale from 0 to 10?”. Relapse-free survival was analyzed using Kaplan–Meier curves. Results In total, 134 patients were included. With a median 12-year (range 10–15) follow-up, 52 patients (38.8%) underwent TVM surgery with Prolift, and Gynemesh was used 82 (61.2%). 91% patients felt that POP symptom improved based on the PGI-I scores, and most satisfied after operation. The recurrence rates of anterior, apical and posterior compartment prolapse were 5.2%, 5.2%, and 2.2%, respectively. No significant differences in POP recurrence, mesh-associated complications and urinary incontinence were noted between TVM surgery with Prolift versus Gynemesh. Conclusions Treatment of POP by TVM surgery exhibited long-term effectiveness with acceptable morbidity. The outcomes of the mesh kit were the same as those for self-cutmesh.


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