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Pelvic Prolapse

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.

Complications associated with the use of mesh to treat female urinary incontinence and pelvic organ prolapse

Complications can result from the use of mesh to treat female stress urinary incontinence or pelvic organ prolapse. While some of these complications are also common to non-mesh-based procedures, the risk of vaginal exposure of mesh, or mesh extrusion into other pelvic organs are unique complications that must be considered when using mesh. Chronic pain after mesh-based procedures can be a difficult complication to manage and may occur. Patients with stress incontinence or prolapse that are considering surgical treatment should be counseled on the potential complications and the likelihood of them occurring. Although there has been focus on the development, introduction and regulation of mesh, the diagnostic clinical decision-making process has not been put under scrutiny, and likely significantly impacts patient outcomes. There is a need to develop patient reported outcome measures for mesh procedures, and further work is needed to create a standardized way to measure and communicate different types of mesh-related complications. Future research to focus on the diagnostic clinical decision making process is recommended, including education on the ‘whole journey’ of the patient during the perioperative pathway.

Blayne Welk,a Roger Dmochowski,b Kathryn McCarthy,c James Keck,d Sherif Mourad,e Hashim Hashim,f

  1. Department of Surgery, Epidemiology & Biostatistics, Western University, London, Canada
  2. Department of Urology, Surgery, and Obstetrics and Gynecology, Vanderbilt Medical Center, Nashville, TN, USA
  3. Department of Colorectal surgery, North Bristol NHS Trust, Bristol, UK
  4. Department of Colorectal Surgery St. Vincent’s Health Melbourne, Australia
  5. Ain Shams University, Cairo, Egypt
  6. Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
Source: Blayne Welk, Roger Dmochowski, Kathryn McCarthy, James Keck, Sherif Mourad, Hashim Hashim. Complications associated with the use of mesh to treat female urinary incontinence and pelvic organ prolapse. Continence. Volume 12, 2024, 101713, ISSN 2772-9737, https://doi.org/10.1016/j.cont.2024.101713.

Robotic Surgery in Pelvic Organ Prolapse: A Retrospective Comparison of Ileopectopexy and Sacrocolpopexy.

Pelvic organ prolapse (POP) is a common condition affecting over half of women above the age of 50. Sacrocolpopexy is a widely recognized surgical approach for apical prolapse, restoring the vaginal axis effectively.

Application of transperineal pelvic floor ultrasound in postpartum pelvic organ injury and prolapse in women.

To investigate SUI (stress urinary incontinence) and POP (pelvic organ prolapse) in women after childbirth by transperineal ultrasonography.

In this retrospective study, 107 six-week postpartum primiparous mothers and 42 healthy nulliparous women were selected during the period from January 2021 to March 2023, in Pudong New Area People's Hospital.

Sacrospinous Hysteropexy-Video Tutorial of Construction and Application of a Feasible and Inexpensive Teaching Model for Simulation.

Sacrospinous hysteropexy is one of the preeminent uterus-preserving surgical techniques for treating pelvic organ prolapse supported by level one evidence. As training on models greatly improves surgical skills and outcomes, we developed a simple and inexpensive model to simulate sacrospinous hysteropexy.

Long-term follow-up after laparoscopic reparation of pelvic organ prolapses in a large teaching gynecological center.

To provide a description of laparoscopic approach to correct pelvic organ prolapses and evaluate the risk factors associated with the prolapse recurrence.

We retrospectively analyzed 418 patients with symptomatic pelvic organ prolapse who underwent a laparoscopic reparation at our university center from 2010 to 2020.

UroARC: A novel surgical risk calculator for older adults undergoing pelvic organ prolapse and stress urinary incontinence surgery.

Surgeries for pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are commonly performed in older adults, many of whom are also frail. A surgical risk calculator for older adults undergoing POP/SUI surgeries that incorporates frailty, a factor known to increase the risk of surgical complications, would be helpful for preoperative counseling but currently does not exist.

Comparison Between Anterior-Apical Mesh (Surelift) and Anterior Mesh (Surelift-A) in Transvaginal Pelvic Organ Prolapse Surgery: Surgical and Functional Outcomes at 1-Year Follow-Up.

Surelift is a transvaginal synthetic mesh (TVM) kit that is intended to treat anterior and apical pelvic organ prolapse (POP). The kit can be configured to use an anterior-apical (Surelift) or anterior (Surelift A) approach.

Self-management of vaginal pessaries for prolapse: the TOPSY trial key findings

Women with symptomatic pelvic organ prolapse are offered a choice of conservative and surgical treatment options. Two thirds of women choose a vaginal pessary, a support device inserted in the vagina. This article reports the finding of a randomized controlled trial published in 2023 evaluating the cost-effectiveness of self-management of pessary compared to clinic-based care. Women were recruited in 21 centres across the UK and 340 women were randomized to pessary self-management or clinic-based care. The primary outcome measure was prolapse-specific quality of life and secondary outcomes were generic quality of life, pelvic floor symptoms, sexual function, self-efficacy, pessary complications, pessary use and pessary confidence. Participants’ health care resource use was measured. The trial showed that at 18 month follow-up self-management was not associated with better or worse quality of life than clinic-based care. Women in the self-management group reported fewer pessary complications and lower healthcare resource use.

Rohna Kearney MD FRCOG Consultant Urogynaecologist, The Warrell Unit, Saint Mary's Hospital, Manchester, Division of Developmental Biology and Medicine, School of Medical Sciences, University of Manchester and Manchester Academic Health Science Centre, Manchester, UK. Conflicts of interest: Rohna Kearney declares payment as an expert scientific advisor from the British Standards Institute, the author declare a grant from National Institute for Health and Care Research (NIHR) Health Technology Assessment (HTA) programme related to the research described in this article

Suzanne Hagen CStat PhD Professor of Health Services Research in the School of Health and Life Sciences, Nursing, Midwifery & Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK. Conflicts of interest: the author declare a grant from National Institute for Health and Care Research (NIHR) Health Technology Assessment (HTA) programme related to the research described in this article

Carol Bugge RN PhD Professor of Nursing, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK. Conflicts of interest: the author declare a grant from National Institute for Health and Care Research (NIHR) Health Technology Assessment (HTA) programme related to the research described in this article

Source: Rohna Kearney, Suzanne Hagen, Carol Bugge. Self-management of vaginal pessaries for prolapse: the TOPSY trial key findings. Obstetrics, Gynaecology & Reproductive Medicine. Volume 34, Issue 8, 2024. Pages 229-231, ISSN 1751-7214, https://doi.org/10.1016/j.ogrm.2024.05.004.

The International Consultation on Incontinence Questionnaire Short Form as a Substitute for 1-Hour Pad Weight Testing in the Evaluation of Urinary Incontinence in Patients With Pelvic Organ Prolapse Undergoing Surgery.

Stress urinary incontinence is a postoperative complication occurring in patients with pelvic organ prolapse (POP). Although the 1-hour pad test measures the degree of urinary incontinence qualitatively and quantitatively, some elderly women undergoing POP surgery do not have the daily activities of living to perform the pad test.

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