Prevalence Of Pelvic Organ Prolapse Research Articles

Clinically significant changes in anal sphincter hiatal area in patients with gestational diabetes mellitus and pelvic organ prolapse.

The prevalence of pelvic organ prolapse (POP) increases with age and parity. Specifically, the prevalence of POP among women aged 20 to 39 is 9.7%, while it rises to 49% among women over 80 years old. Additionally, as the number of deliveries increases, the prevalence of POP also rises accordingly, with a rate of 12.8% for women with one delivery history, 18.7% for those with two deliveries, and 24.6% for women with three or more deliveries. It causes immense suffering for pregnant women. To evaluate the relationship between the levator ani muscle's hiatus (LH) area and POP in patients with gestational diabetes mellitus (GDM) using perineal ultra-sound. The study cohort comprised 104 patients aged 29.8 ± 3.7 years who sought medical care at our institution between January 2021 and June 2023. All were singleton pregnancies consisting of 75 primiparas and 29 multiparas, with an average parity of 1.7 ± 0.5. According to the POP diagnostic criteria, the 104 subjects were divided into two groups with 52 members each: POP group (patients with GDM combined with POP) and non-POP group (patients with GDM without POP). Perineal ultrasound was used to measure differences in the anteroposterior diameter, transverse diameter, and LH area. Receiver operating characteristic curves were drawn to determine the optimal cutoff values for the LH anteroposterior diameter, transverse diameter, and area for diagnosing POP. Statistically significant increase in the LH area, anteroposterior diameter, and lateral diameter were observed in the POP group compared with the non-POP group (P < 0.05). Both groups exhibited markedly elevated incidence rates of macrosomia and stress urinary incontinence. For the POP group, the area under the curve (AUC) for the LH area was 0.906 with a 95% confidence interval (CI): 0.824-0.988. The optimal cutoff was 13.54cm², demonstrating a sensitivity of 83.2% and a specificity of 64.4%. The AUC for the anteroposterior diameter reached 0.836 with a 95%CI: 0.729-0.943. The optimal cutoff was 5.53 cm with a sensitivity of 64.2% and a specificity of 73.4%. For the lateral diameter, its AUC was 0.568 with a 95%CI: 0.407-0.729. The optimal cutoff was 4.67 cm, displaying a sensitivity of 65.9% and a specificity of 69.3%. Logistic regression analysis unveiled that age, body weight, number of childbirths, total number of pregnancies, and gestational weight gain constituted the independent risk factors for the cooccurrence of GDM and POP. Three-dimensional perineal ultrasonography of LH size and shape changes can effectively diagnose POP. Age, weight, number of births, number of pregnancies, and weight gain during pregnancy are independent risk factors affecting the cooccurrence of GDM and POP. GDM can increase the LH area in patients, and an enlarged LH leads to an increased incidence of POP.

Association Between Striae and Pelvic Organ Prolapse in Women: A Systematic Review and Meta-Analysis.

The high prevalence of pelvic organ prolapse (POP) and related complications shows the necessity of early identification of risk factors. It is considered that striae and POP share a similar physiopathology. However, the link between the two is still inconclusive and requires further investigation. We conducted this study to evaluate the association between striae and POP. Databases such as PubMed, Embase, Cochrane Library, Scopus, Web of Science, and Google Scholar were searched to find relevant literature from inception up to May 2023. Full-text articles published in English or other languages and observational studies were included. The statistical analysis was performed using STATA 14.2. The random effects model was performed and heterogeneity was ≥ 50%. Statistical tools such as the Chi-squared test and the I2 index were used to calculate the level of heterogeneity among studies. Additionally, we utilized Funnel plots and Egger tests to assess the presence of publication bias. Seven studies were selected for meta-analysis, yielding a total of 605 patients and 660 control subjects, to assess the link between striae and POP. The overall pooled odds ratio (OR) was 2.08 (95% confidence interval 1.04-4.19, I2 = 80.40%). Our analysis revealed a strong relationship between POP and striae (p < 0.001). This study recommends that stretch marks may be used as a helpful indicator of the risk for POP. Evaluation of striae as a risk factor and screening tool for detecting women at risk for the development of POP should be addressed in future well-designed studies. However, there is a need for high-quality studies in this field owing to the low quality of evidence.

Worldwide Prevalence of Pelvic Organ Prolapse: A Systematic Review and Meta-Analysis.

The prevalence of pelvic organ prolapse is varied in different countries. For validating the results of numerous studies on the prevalence of Pelvic organ prolapse in the world, a meta-analysis study seems necessary to provide an accurate and valid prevalence for planners and researchers in this field. Therefore, we aimed to investigate the worldwide prevalence of pelvic organ prolapse using the meta-analysis method. By using valid keywords, searching was done in ISI Web of Science, PubMed, Scopus, and Medline databases, and 22 articles were selected based on inclusion criteria between 2009 and 2021. The quality of articles was checked using The Joanna Briggs Institute (JBI) checklist. Meta-analysis was performed on collected data using Comprehensive Meta-Analysis Software (CMA, Version 2). Meta-analysis of data was done with a random-effects model. The heterogeneity of the study was checked using the I2 index. Publication bias was assessed by the Egger test and funnel graph. The overall prevalence of included studies was 30.9% (95% confidence interval: 24.4-38.2%), (P<0.001, heterogeneity I2=99.8%). Meta-analysis of subgroups in studies that used a questionnaire to estimate the prevalence rate showed the prevalence was 25.0% and, in the studies, used the physical examination was 41.8%. Studies carried out in different parts of the world have examined the prevalence of pelvic organ prolapse using different tools. Since some cases are asymptomatic, especially in the low stage of prolapse, physical examination of pelvic organ prolapse should be considered an essential tool in evaluating pelvic organ prolapse.

Prevalence and risk factors of pelvic organ prolapse among women in Sidama region, Ethiopia: A community-based survey.

Pelvic organ prolapse is a descent of the vaginal compartments and the surrounding organ due to loss of support of the vaginal tissue. It has a significant psychological, physical, and social impact that affects women's quality of life. However, its true prevalence is unknown due to the variability in the methods used to diagnose the disorder. This study aimed to determine the prevalence of pelvic organ prolapse and its associated risk factors among women in Sidama region, Ethiopia. A community-based cross-sectional survey was conducted in the Dale-Wonsho Health and Demographic Surveillance Site, Sidama region, from March to October 2023. A multi-stage stratified cluster sampling was used to select a sample of 816 women. Anatomical prolapse was diagnosed based on the standardized pelvic organ prolapse quantification method, and symptomatic prolapse was assessed by patient-reported symptoms. A complex survey-based modified Poisson regression was used to assess the risk factors associated with prolapse. A total of 815 participated in the interview, and 779 (95.6%) underwent pelvic examination to assess for prolapse status. Anatomical prolapse (Stages II-IV) was observed in 241 (30.9%; 95% confidence interval = 24-38.7) of the participants. The prevalence of symptomatic pelvic organ prolapse was 78.5% (95% confidence interval = 69.1-85.7) among women with anatomical prolapse (189/241). This prevalence falls to 24.27% (95% confidence interval = 19.98-29.16) for the total sample population. Higher frequency of childbirth, prolonged heavy lifting activities, and prolonged labor increased the likelihood of developing anatomical prolapse. Childbirth at an early age and prolonged heavy lifting activities were significantly associated with symptomatic prolapse. Anatomical prolapse and symptomatic prolapse are high in the study area. Parity, prolonged heavy lifting, prolonged labor, and early age childbirth were associated with pelvic organ prolapse. Community-based education and interventions that focus on the modification of risk factors are needed.

Finite element analysis of female pelvic organ prolapse mechanism: current landscape and future opportunities.

The prevalence of pelvic organ prolapse (POP) has been steadily increasing over the years, rendering it a pressing global health concern that significantly impacts women's physical and mental wellbeing as well as their overall quality of life. With the advancement of three-dimensional reconstruction and computer simulation techniques for pelvic floor structures, research on POP has progressively shifted toward a biomechanical focus. Finite element (FE) analysis is an established tool to analyze the biomechanics of complex systems. With the advancement of computer technology, an increasing number of researchers are now employing FE analysis to investigate the pathogenesis of POP in women. There is a considerable number of research on the female pelvic FE analysis and to date there has been less review of this technique. In this review article, we summarized the current research status of FE analysis in various types of POP diseases and provided a detailed explanation of the issues and future development in pelvic floor disorders. Currently, the application of FE analysis in POP is still in its exploratory stage and has inherent limitations. Through continuous development and optimization of various technologies, this technique can be employed with greater accuracy to depict the true functional state of the pelvic floor, thereby enhancing the supplementation of the POP mechanism from the perspective of computer biomechanics.

Robotic sacrocolpopexy.

Pelvic organ prolapse (POP) is a common cause of gynecological disease in elderly women. The prevalence of POP has increased with an aging society. Abdominal sacrocolpopexy (ASC) is safer and more effective than the vaginal approach in patients with apical compartment POP because it has a higher anatomical cure rate, a lower recurrence rate, less dyspareunia, and improved sexual function. Laparoscopic sacrocolpopexy (LSC) has replaced ASC. Robotic sacrocolpopexy (RSC) also helps overcome the challenges of LSC by facilitating deep pelvic dissection and multiple intracorporeal suturing. The RSC is technically easy to apply, has a steep learning curve, and offers many advantages over the LSC. However, insufficient data led us to conclude that the LSC is superior overall, especially in terms of costeffectiveness. The present review provides insights into different aspects of RSC, highlighting the most common benefits and concerns of this procedure. We searched for eligible articles discussing this issue from January 2019 to March 2022 to reveal the outcomes of RSC.

Co-Design of a website for women with pelvic organ prolapse: A study protocol

Background Despite high reported prevalence of pelvic organ prolapse (POP), women report difficulties accessing evidence-based and reliable information about the condition. Many rely on social media and other popular and highly visible internet platforms which have been found to contain poor quality information that is difficult for the average patient to understand. The aim of the study is to co-design an information website for premenopausal women with POP. The website design will be based on the Website Developmental Model for the Healthcare Consumer (WDMHC) framework. Methods A four phase process will be utilised as per the WDMHC framework: 1) User, task and environmental analysis; 2) Functional and representational analysis; 3) Cognitive walkthrough, keystroke level model, heuristic testing; 4) Content based testing, expert testing and user-based testing. Ethics approval has been obtained (LS-23-19-Carroll-Ful). Two groups of stakeholders will be recruited (i) patient group (ii) healthcare professional (HCP) group. Patient participants will be recruited from an online pelvic floor dysfunction (PFD) support group (n=950 members). A website designer and HCP stakeholders involved in the multidisciplinary team caring for women with POP will be invited to participate. Both groups will participate in separate co-design online workshops. Focus group workshops will be video-recorded, transcribed and imported into NVivo. Themes and subthemes will be developed. The website will be designed and disseminated to all participants for feedback. Cognitive walkthrough and heuristic testing will be undertaken. Following this, necessary modifications will be made to the website. Participants will then complete a modified System Usability Scale (SUS) and the eHealth Impact Questionnaire, while five HCPs will complete the DISCERN instrument. Conclusion This study will inform the design and testing of an information website for women with POP. The website design and content will be informed by patient and HCP stakeholder voices and the health literacy literature.

Pelvic organ prolapse: a cross-sectional study during mass campaign in two hospitals in the city of Kananga in the Democratic Republic of Congo.

pelvic organ prolapse is a dynamic pathology that can worsen or regress especially postpartum and is the basis of several disorders that bother the patient and alter her quality of life. This study aims to determine the epidemiological, clinical, and therapeutic profile of pelvic organ prolapse in the town of Kananga. this is a cross-sectional study of cases of pelvic organ prolapse recorded during the mass campaign organized in the Bon-Berger Hospital of Tshikaji and Saint Georges Hospital of Katoka in the town of Kananga, from January 1 to July 31, 2023. Non-probability convenience sampling was used to select cases. we recorded 138 cases of prolapse out of 572 patients. The prevalence of pelvic organ prolapse is 24.12% with an average monthly incidence of 19.71 (SD: 4.23) cases per month. The prevalence of recurrence of pelvic organ prolapse is 8.69%. The average age of patients is 54.86 (SD: 11.36) years with an average parity of 7.62 (SD: 1.8) deliveries. Its preoperative symptomatology consists of the intravaginal mass associated with digestive and urinary disorders in 97.00% (n=130), stage III hysterocele predominates in 68.70% (n=92), surgical treatment is the most practiced in 91.79% (n=123) and hysterectomy associated with the treatment of cystocele and rectocele by vaginal surgical access is the most practiced in 80.60% (n=108). pelvic organ prolapse is a real public health problem in the city of Kananga, its symptoms are classic and its treatment is surgical via the vaginal route.

Современный взгляд на проблему генитального пролапса через призму факторов риска.

Introduction. Pelvic organ prolapse (POP) is one of the varieties of pelvic floor hernias and has a significant impact on the quality of life of a modern woman. The prevalence of POP is quite high, and the peak values of its occurrence reach 5% in women aged 60 to 69 years. The current trend in the world towards an increase in the occurrence of POP is associated with an increase in the life expectancy of women, the participation of women in the production process, the presence of concomitant somatic pathology, the identification of risk factors in the detection of a small degree of prolapse allows identifying risk groups for rapid progression of POP and timely implementation of therapeutic measures. Aim. To identify new modern risk factors for POP. Materials and methods. The study is a cohort retrospective non-randomized. The main group consisted of 110 patients with grade II-IV POP according to the POP-Q classification. The control group consisted of 34 women without established gynecological diseases. Results. Women with PОР were significantly more likely to live in rural areas, had a higher average body weight than patients without gynecological pathology, they were in postmenopause for a longer time. Patients with POP were significantly more often observed for diseases of the chronic tonsillitis, the cardiovascular system, as well as for varicose veins of the lower extremities. The patients of the main group had more abdominal operations in the anamnesis and higher parity than in the control group. Conclusion. The risk factors for POP were the duration of postmenopause, high parity (natural childbirth) and overweight. The risk factors for PОР are diseases of the cardiovascular system, varicose veins of the lower extremities, chronic tonsillitis and surgical interventions on the abdominal organs.

Comparison of the use of different accesses for sacrocolpopexy in women with apical prolapse: A literature review

Interest in the issue of genital prolapse is increasing worldwide. The prevalence varies across countries and is higher in resource-limited ones. In countries where systematic statistics are available, the prevalence of pelvic organ prolapse ranges from 3 to 50%. Conservative and surgical methods for correcting this issue are extensively covered in Russian and foreign literature. Sacrocolpopexy is one of these methods, which is commonly used to correct apical prolapse. This review aimed to compare and evaluate the outcomes of abdominal, robotic, and laparoscopic accesses for performing this surgical procedure and assess the advantages and disadvantages of each method. Each surgical approach is analyzed regarding the incidence of postoperative complications, surgical duration, and satisfaction of patients with their quality of life in the postoperative period. Pelvic organ prolapse is an increasingly pressing issue, given the increase in life expectancy and its earlier detection. According to statistical projections, by 2050, 9.2 million women worldwide will have this disease.

Патогенетические особенности формирования несостоятельности тазового дна у женщин репродуктивного возраста

Background. Today, the issue of genital prolapse remains in the spotlight all over the world. This condition accounts for 30–40% of all cases of gynecological diseases. It should be noted that a third of women are women of child-bearing age. The problem of understanding true prevalence of pelvic organ prolapse (РОР) in various age groups is that there are no severe clinical symptoms during early stages of the disease, which ham-pers the diagnosis and, consequently, assessment of the prevalence of genital prolapse. That is why the prevalence of genital prolapse in women of child-bearing age has been little studied in the world literature. The other feature of the РОР diagnosis in young women is that it is difficult to verify pelvic floor dysfunction (PFD) before POP manifestation. Patients often do not seek medical care, since the complaints they present with are not typical for the concept of PFD. The patients’ complaints most often turn out to be related to abnormal vaginal biocenosis or even inflam-matory diseases of the pelvis, sexual dysfunctions. No treatment of such conditions results in abnormal anatomic and topographic interaction be-tween vaginal walls, reduced barrier function of introitus vaginae and altered vaginal microbiota composition, therefore, the woman suffers from recurrent pain that significantly reduces her quality of life. Aim. To study the perineal tissue state during the development of PFD. Methods. The prospective randomized comparative cohort study involved 155 women, who contacted the Department of Gynecology for elective surgical treatment. All patients underwent standard clinical and instrumental assessment for gynecological patients: history taking, physical ex-amination, advanced gynecological assessment, pelvic ultrasound. The assessment program was expanded to complex perineological examination including pelvic floor evaluation according to the method by L.R. Toktar, perineal manometry using the iEase XFT-0010 perineometer (according to the unit user manual), transperineal ultrasound. In addition, evaluation of vaginal biotope and morphological assessment of the levator com-plex were performed. Results. According to the data obtained, abnormal vaginal biotope is the major atypical PFD symptom. This condition is recurrent. The vaginal wall loss of elasticity and abnormal collagenization result in the more profound perineal tissue alterations. Morphological assessment of perineal tissues has revealed levator ani inflammation in 20% of cases and fibrosis in 100% of cases. Conclusions. Recurrent vaginal biocenosis abnormality is a clinical symptom of PFD. Vaginal dysbiosis results in morphological alterations in the vaginal wall structure and probably in the entire levator complex.

Co-Design of a website for women with pelvic organ prolapse: A study protocol.

Despite high reported prevalence of pelvic organ prolapse (POP), women report difficulties accessing evidence-based and reliable information about the condition. Many rely on social media and other popular and highly visible internet platforms which have been found to contain poor quality information that is difficult for the average patient to understand. The aim of the study is to co-design an information website for premenopausal women with POP. The website design will be based on the Website Developmental Model for the Healthcare Consumer (WDMHC) framework. A four phase process will be utilised as per the WDMHC framework: 1) User, task and environmental analysis; 2) Functional and representational analysis; 3) Cognitive walkthrough, keystroke level model, heuristic testing; 4) Content based testing, expert testing and user-based testing.Ethics approval has been obtained (LS-23-19-Carroll-Ful). Two groups of stakeholders will be recruited (i) patient group (ii) healthcare professional (HCP) group. Patient participants will be recruited from an online pelvic floor dysfunction (PFD) support group (n=950 members). A website designer and HCP stakeholders involved in the multidisciplinary team caring for women with POP will be invited to participate.Both groups will participate in separate co-design online workshops. Focus group workshops will be video-recorded, transcribed and imported into NVivo. Themes and subthemes will be developed.The website will be designed and disseminated to all participants for feedback. Cognitive walkthrough and heuristic testing will be undertaken. Following this, necessary modifications will be made to the website. Participants will then complete a modified System Usability Scale (SUS) and the eHealth Impact Questionnaire, while five HCPs will complete the DISCERN instrument. This study will inform the design and testing of an information website for women with POP. The website design and content will be informed by patient and HCP stakeholder voices and the health literacy literature.

Clinical Profile of Patients of Pelvic Organ Prolapse and Its Associated Factors.

Prolapse is among the most common indication for gynaecological surgery. It is difficult to estimate prevalence of pelvic organ prolapse even in developed countries due to lack of epidemiological studies. This study was done to find the prevalence, risk factors and common presenting complaints of women with pelvic organ prolapse. Women with pelvic organ prolapse visiting Paropakar Maternity and Women's Hospital during 4 months duration in 2021 were approached and after obtaining an informed consent, all the patient information on various risk factors and clinical profile(age,parity,body mass index,smoking etc.) for pelvic organ prolpase were collected in a pre-developed proforma. Pelvic Organ Prolapse was classified by Pelvic Organ Prolapse Quantification system. Data analysis was done using statistical package for the social sciences-25. Ethical approval was taken from Institutional Review Committee- National Academy of Medical Sciences. Out of 58 cases enrolled in the study, prevalence of pelvic organ prolapse was found to be 1.28%. Women belonging to age group ≥ 49 years was 91.4%. Bulge symptom was the most common presenting complain among the women, 98.3%. 50% of women (n=29) were grand multipara. 53.4% (n=31) of women had delivered their first baby before 20 years of age. Multiparity,vaginal birth and menopausal age were the common risk factors. Menopausal age, multi-parity, vaginal births, age at first vaginal delivery of less than 20 years were significant risk factors for development of prolapse. Bulge symptom was the most common presenting complaint. However,Smoking habit, overweight were not related to pelvic organ prolapse.

Co-Design of a website for women with pelvic organ prolapse: A study protocol

Background: Despite high reported prevalence of pelvic organ prolapse (POP), women report difficulties accessing evidence-based and reliable information about the condition. Many rely on social media and other popular and highly visible internet platforms which have been found to contain poor quality information that is difficult for the average patient to understand. The aim of the study is to co-design an information website for women with POP. The website design will be based on the Website Developmental Model for the Healthcare Consumer (WDMHC) framework. Methods: A four phase process will be utilised as per the WDMHC framework: 1) User, task and environmental analysis; 2) Functional and representational analysis; 3) Cognitive walkthrough, keystroke level model, heuristic testing; 4) Content based testing, expert testing and user-based testing. Ethics approval has been obtained (LS-23-19-Carroll-Ful). Two groups of stakeholders will be recruited (i) patient group (ii) healthcare professional (HCP) group. Patient participants will be recruited from an online pelvic floor dysfunction (PFD) support group (n=950 members). A website designer and HCP stakeholders involved in the multidisciplinary team caring for women with POP will be invited to participate. Both groups will participate in separate co-design online workshops. Focus group workshops will be video-recorded, transcribed and imported into NVivo. Themes and subthemes will be developed. The website will be designed and disseminated to all participants for feedback. Cognitive walkthrough and heuristic testing will be undertaken. Following this, necessary modifications will be made to the website. Participants will then complete a modified System Usability Scale (SUS) and the eHealth Impact Questionnaire, while five HCPs will complete the DISCERN instrument. Conclusion: This study will inform the design and testing of an information website for women with POP. The website design and content will be informed by patient and HCP stakeholder voices and the health literacy literature.

An evaluation of pelvic organ prolapses in perimenopausal and menopausal Chinese females.

The aim of the study was to evaluate the prevalence of pelvic organ prolapse (POP) and correlate the various factors including, but not limited to, educational status, socio-economic condition, body mass index (BMI), menstrual history, with the status and severity of POP. A retrospective cross-sectional study was conducted between August 2021 and September 2022 and suspected patients of POP were considered from the outpatient Department of Gynecology and Obstetrics. The study has mainly used 3 indicators of socio-economic status, namely, occupation, education, and income. These factors were correlated and statistically analyzed with that of POP. The study findings revealed that there are more symptomatic patients who are illiterate as compared to asymptomatic POP and with increasing education status, there is a decrease in symptomatic POP patients (p<0.05). Also, there is a significant proportion of symptomatic POP patients in the lower class and lower middle class as compared to asymptomatic patients in each class, respectively (p<0.05). It also found that micturition difficulty and vaginal bulging are significantly correlated with the stages of POP (p<0.05). Educational status and socio-economic condition are significant indicators of the presence of symptoms or severity of POP. The study further concluded that menopausal females have more symptomatic POP as compared to pre-menopausal females.

Ovariectomy with simulated vaginal delivery to establish a rat model for pelvic organ prolapse

ABSTRACT The widespread prevalence of Pelvic Organ Prolapse (POP) and the paucity of ongoing treatments prompted us to develop a unique rat model combining ovariectomy and simulated vaginal delivery. We hypothesized that the tissue changes caused by low hormone levels and mechanical stretch could complement each other. Thus, the combined model can potentially mimic the collagen metabolism of vaginal wall tissue as well as mechanical stretch properties to complement disease progression in POP. Ovariectomy with sequential simulated vaginal delivery was performed on rats in the modeling group. Sham surgeries were performed as control. At 2, 4, and 12 weeks after modeling, the vaginal tissues of rats were evaluated by Masson’s trichrome staining, Picro-Sirius red staining, immunohistochemistry, western blotting, and uniaxial tensile tests. Compared to the control group, the vaginal tissues of the model rats showed an atrophic epithelial layer and loose collagen fibers. The smooth muscle fibers were ruptured, smaller in diameter, and disorganized. The ratio of collagen type I/III significantly increased, but the contents of both Collagen I and III decreased. The expression of metalloproteinases 2 and 9 in the tissues increased, and the expression of tissue inhibitors of metalloproteinases 1 and 2 decreased. The tangent modulus of the tissues was significantly increased in the model rats. We verified a novel method to establish a pelvic organ prolapse model in rats. This approach combined the advantages of low hormone levels and mechanical stretch effects.

A serious consequence of pelvic organ prolapse: Hydroureteronephrosis.

We aimed to determine the association between pelvic organ prolapse (POP) and hydroureteronephrosis (HUN), risk factors for developing HUN and resolution of HUN after surgery. A retrospective study was conducted on 528 patients diagnosed with uterine prolapse. All patients with or without HUN were compared in terms of risk factors. The 528 patients were divided into five groups according to the POP-Q classification. A significant relationship was found between POP stage and HUN. The other risk factors for developing HUN were age, rural life, parity, vaginal delivery, smoking, body mass index and increased comorbidity. The prevalence of POP was 12.2% and the prevalence of HUN was 65.3%. All patients with HUN underwent surgery. After surgery, HUN resolved in 292 (84.6%) patients. POP is a multifactorial herniation of pelvic organs out of the urogenital hiatus due to pelvic floor dysfunction. The main etiological factors in POP are older age, grand multiparity, vaginal delivery and obesity. The most important problem in patients with severe POP is HUN due to urethral kinking or urethral obstruction, which is a result of the cystocele squeezing the urethra under the pubic bone. In low-income countries, the main aim is to prevent the development of POP, which is the most common cause of HUN. It is important to increase the level of knowledge about contraception methods and to increase screening and training to reduce other risk factors. Women should be made aware of the importance of gynecological examination in the menopausal period.

Results of surgical correction for cervical elongation with vaginal wall prolapse in patients of reproductive and premenopausal age

BACKGROUND: The problem of cervical elongation is becoming increasingly important due to the rising prevalence of pelvic organ prolapse. In Russia, descent and prolapse of pelvic organs account for 39% of all gynecological pathologies.&#x0D; AIM: This study aimed to compare the immediate and long-term results of surgical treatment for cervical elongation in combination with vaginal wall prolapse in patients of three clinical groups.&#x0D; MATERIALS AND METHODS: A total of 105 patients aged 30 to 55 years with a combination of cervical elongation and vaginal wall prolapse of degrees III were followed up. The patients were divided into three clinical groups based on the implemented surgical techniques, including group 1 (n=36) with Moscow surgery, group 2 (n=35) with modification of the Manchester surgery using synthetic implants, and group 3 (n=34) with Manchester surgery.&#x0D; The patients underwent a comprehensive clinical examination, surgical treatment, and follow-up in the early and long-term postoperative periods (1, 6, 12, 24, and 36 months). The efficacy of surgical treatment was assessed using a questionnaire. During dynamic monitoring, a gynecological examination with a Valsalva maneuver, and transperineal, and transvaginal echography were performed.&#x0D; RESULTS: During the first month after the surgery, patients noted irregular dragging pains in the perineum and/or inguinal region every second. A frequent urge to urinate was reported in 16.7%, 17.1%, and 17.6% of patients in groups 1, 2, and 3, respectively. A further survey revealed that the surgical treatment results were satisfactory, as it had a positive effect on the quality of life and mood and contributed to an increase in social and sexual activity. According to the physical examination, there were no signs of prolapse recurrence and mesh-associated complications. Erosion of the anterior vaginal wall over the polypropylene endoprosthesis was detected 6 months after the surgery in 3 (8.6%) patients of group 2.&#x0D; Genital prolapse recurrence was diagnosed after 1236 months in 7 (20.6%) patients of group 3. After 36 months, degree I prolapse of the posterior (n=1) and anterior (n=1) walls of the vagina was revealed in patients of groups 1 and 2, respectively.

Prevalence of pelvic floor disorders in the Eastern Mediterranean region: A meta-analysis.

High prevalence of risk factors for pelvic floor disorders (PFD) in the Eastern Mediterranean may result in higher rates of prevalence of PFD in comparison to other regions. Despite individual studies, there are no clear statistics on the cumulative prevalence of PFDs in the East Mediterranean region. The aim of this study was to investigate the prevalence of PFDs in the Eastern Mediterranean region. A literature search without language restriction was conducted in PubMed, Cochrane database and Web of Science from 2016 to 01 June 2022. Cross-sectional and cohort studies that reported prevalence of urinary incontinence (UI), constipation, fecal incontinence (FI) and pelvic organ prolapse (POP) among women in the Eastern Mediterranean region were included. Study quality was assessed according to the Joanna Briggs Institute critical appraisal tool. Data were pooled and meta-analysed using a random effects model. CRD42021283127 RESULTS: The search yielded 390 articles, from which 12 studies containing 9905 patients were included. Five studies were high quality and seven were low quality. The prevalence of POP (12 studies, 9905 participants), UI (5 studies, 2340 participants), constipation (4 studies, 2045 participants) and FI (1 study, 166 participants) was 39% (95% CI 21-57; I2 99.8%), 48% (95% CI 16-80; I2 99.7%), 39% (CI 17-60; I2 99.1%) and 14% (95% CI 9-20) respectively. In meta-analysis pooling studies of mixed quality, a high prevalence of PFDs was seen in the Eastern Mediterranean region.PROSPERO No.: CRD42021283127.

Pelvic Organ Prolapse and its Associated Factors Among Women: A Facility Based Cross-sectional Study.

Pelvic organ prolapse is the downward descent of female organs, including the bladder, small bowel, and large bowel, resulting in the protrusion of the vagina, uterus, or both. This disorder, exclusive to women, causes psychological trauma and social withdrawal, leading to an increased rate of gynecologic surgery. To assess the Pelvic Organ Prolapse and its associated factors among Women Visiting public Hospitals in south west Ethiopia. An institution-based cross-sectional study was conducted among gynecologic patients. A total sample size of 408 was allocated to the institutions proportional to their previous month's case load. Data were collected using an interviewer-administered structured questionnaire. The collected data were coded and entered into EpiData version 3.1, then exported to SPSS version 20 for descriptive and inferential analysis. Adjusted odds ratios (AOR) along with a 95% confidence level were estimated, and a P-value < .05 was considered statistically significant. Out of the intended sample size, 393 women participated in the study, resulting in a response rate of 96.3%. The overall magnitude of pelvic organ prolapse among the study participants was 19.8% (95% CI: 16.0, 24.1). Factors significantly associated with pelvic organ prolapse were place of residence (AOR = 2.21, 95% CI: 1.11, 4.40), parity (AOR = 2.82, 95% CI: 1.39, 5.72), age at first pregnancy (AOR = 2.32, 95% CI: 1.27, 4.26), and place of delivery of the first child (AOR = 4.18, 95% CI: 1.97, 8.85). The prevalence of pelvic organ prolapse is high. Place of residence, parity, age at first pregnancy, and place of delivery of the first child were factors significantly associated with pelvic organ prolapse. Therefore, different stakeholders, programmers, and implementers should take aggressive steps to prevent early pregnancy, train health professionals to encourage women to use family planning, and promote institutional delivery.