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ABSTRACT: OBJECTIVE: To assess the self-perceived quality of life in women with advanced pelvic organ prolapse before and after mesh surgery. STUDY DESIGN: Women with symptomatic pelvic organ prolapse (stage III-IV according to pelvic organ prolapse quantification (POP-Q)) were invited to participate in the study. All enrolled patients underwent prolapse surgery using the transvaginal mesh technique. Success was defined as ICS POP-Q stage 0 and I. The SF36v2 questionnaire was used as a subjective outcome measure. RESULTS: 113 patients were available for follow-up at 6-8 weeks and 16-18 months. Overall anatomic success rates were 87.6%. Statistically significant improvements in the self-perceived quality-of-life were found in 3 individual domains (general health (GH), vitality (V) and mental health (MH)) and in one summary domain (MCS) at 6-8 weeks post-op. In one individual and one summary domain (role - physical (RP) and physical component summary (PCS)) the scores were significantly lower. At the end of the study statistically significant improvement was observed in four out of eight individual domains (vitality (V), menthal health (MH), physical functioning (PF), social functioning (SF)) as well as in both summary scores (PCS and MCS). CONCLUSIONS: Reconstructive mesh surgery improved significantly various self-perceived quality of life dimensions. Therefore, women should expect significant improvement in their general quality of life after this type of operation. The assessment of urogenital well-being should be a routine attitude when counseling menopausal women.
European journal of obstetrics, gynecology, and reproductive biology 04/2013; · 1.97 Impact Factor
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ABSTRACT: Use of morcellation during laparoscopic hysterectomy may result in seeding of uterine tissue throughout the abdominal cavity and development of 'iatrogenic' leiomyomatosis peritonealis disseminata.
Two years after a supracervical laparoscopic hysterectomy a 42-year-old parous women presented with abdominal pain and bloating. CT scans and subsequent surgical exploration reveled multiple solid tumors containing cysts filled with altered blood. Histologically the tumors had characteristic features of a benign leiomyoma with smooth muscle cells infiltrated by endometrial glands.
Pieces of smooth muscle cell and endometrial uterine tissue lost in the abdominal cavity during morcellation may progress to leiomyomatosis peritonealis disseminata with unusual appearance.
Ginekologia polska 01/2013; 84(1):68-71. · 0.41 Impact Factor
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ABSTRACT: In the last few years cytokines have been shown to be the most important local cell signaling molecules, strongly involved in the pathogenesis of the overactive bladder symptoms. Proper bladder function is dependent on gap junction activity The main gap junction proteins which can be found in bladder smooth muscle are Connexin 43 (Cx43) and Connexin 45 (Cx45). Experimental studies focused on the influence of Basic Fibroblast Growth Factor on Connexin expression in bladder smooth muscle cells have shown an increased expression of Cx43, contrary to Cx45. Elevated level of Connexin 43 leads to overactivity of muscle fibers. It was also proved that expression of these proteins in tissues is modulated by cytokines. Regulation of the Cx43 promoter depends on an activating factor 1 (AP-1), cyclic monophosphate (cAMP) and retinoid concentration as well. AP-1 is induced by extracellular-signal-regulated kinases (ERK 1/2) through the activation of basic fibroblast growth factor (bFGF). Recent studies revealed that cytokine-induced modulation of gap junction plays an important role in the pathogenesis of OAB, whereas activation of sympathetic fibers via beta adrenoreceptors (beta-AR) causes relaxation of the bladder The beta-3 adrenoreceptors are divided into beta-1, beta-2, beta-3 subtypes. beta-3 adrenoreceptors have been found in fat and smooth muscle tissue. Density of beta-3 AR is very high in urinary bladder detrusor Activation of beta-3 AR leads to the relaxation of smooth muscle fibers during the filling phase and is cAMP-dependent. Missense mutation of this receptor subtype in the human bladder leading to the substitution of Tryptophan (Trp) by Arginine (Arg), occurs in about one-third of the world's population. Studies have shown that about 50% of women with Trp 64 Arg polymorphism have OAB symptoms. Higher concentration of beta3-AR with Trp 64 Arg polymorphism in bladders of women with diagnosed OAB is probably associated with a lower level of cAMP and weaker relaxation of the bladder smooth muscle. The role of the muscarinic receptors (M1-M5) in the pathogenesis of OAB has been widely described. Unfortunately due to lack of selective muscarinic ligands, the function of each subtype of the receptor has not been fully elucidated yet. A mouse model lacking one or more muscarinic receptors types has been constructed recently Animals were used to assess the real influence of various muscarinic receptors on bladder function. Studies have confirmed the importance of these receptors in the function of the urinary tract, offering a new insight in their mutual interactions and pathogenesis of OAB. Better understanding of these and new mechanisms may improve the process of diagnosis and treatment of the disease in the near future.
Ginekologia polska 11/2012; 83(11):844-8. · 0.41 Impact Factor
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ABSTRACT: INTRODUCTION AND HYPOTHESIS: To investigate the associations between single nucleotide polymorphism (SNP) type 1G/2G at position -1607/-1608 of the matrix metalloproteinase (MMP)-1 gene and SNP type 5A/6A at position -1612/-1617 of the MMP-3 gene and the development of pelvic organ prolapse (POP) in women. METHODS: 133 patients with symptomatic POP were included in the study group. The control group consisted of 132 women with a normal pelvic floor. 1G/2G MMP-1 and 5A/6A MMP-3 SNPs were determined by polymerase chain reaction (PCR) and restriction fragments length polymorphism analysis. RESULTS: When estimated individually none of the investigated SNPs were associated with POP. The combined MMP-1/MMP-3 SNP analysis showed that the following polymorphic pairs were overrepresented in women with POP: 1G/2G -5A/6A, 2G/2G -5A/6A, 2G/2G -5A/5A, 1G/1G -6A/6A, p = 0.005. CONCLUSIONS: The combined effect of -1607/-1608 MMP-1 and -1612/-1617 MMP-3 SNPs may contribute to the development of POP in some women.
International Urogynecology Journal 10/2012; · 1.83 Impact Factor
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ABSTRACT: With increasing longevity in Poland, women can now expect to live around 40% of their lives after menopause, and there is a growing desire for older women to preserve their vitality sexual function and quality of life. The most common urogenital symptoms associated with menopause are dryness, followed by irritation or itching, and discharge, with a substantial number of post-menopausal women also being affected by dysuria. These symptoms are the result of vaginal atrophy which is in turn caused by reduced transudation through the vaginal epithelium and reduced cervical gland secretions resulting from post-menopausal estrogen depletion. Vaginal atrophy generally occurs 4-5 years after the last menstrual period and progressively increases in prevalence in the subsequent years. Importantly vaginal atrophy is strongly associated with sexual dysfunction, and lower urinary tract symptoms, such as frequency urgency nocturia and dysuria, as well as incontinence and recurrent infection are reported more frequently in the presence of vaginal atrophy Those symptoms, apart from being bothersome for the patients also negatively impact their quality of life. Consequently before irreversible changes occur, early detection and treatment of vaginal atrophy should be implemented. Estrogen therapy is the most commonly prescribed treatment. Estrogens restore the cytology pH and vascularity of the vagina, resulting in symptom resolution for the majority of treated women. Because vaginal atrophy symptoms tend to occur later than vasomotor symptoms, many women do not necessarily require or wish to take systemic estrogen treatment if their symptoms are restricted to the urogenital tract. Vaginal estrogen products deliver estrogen locally to vaginal tissues with little or no systemic absorption and provide an effective alternative to systemic estrogen therapy for these women. Various vaginal estrogen preparations such as conjugated equine estrogens, estradiol and estriol vaginal creams, a sustained-release intra-vaginal estradiol ring and a low-dose estradiol and estriol tablets are useful therapeutic options in the treatment of this condition. Moreover; a low dose treatment with a minimised systemic absorption rate may be considered in women with a history of breast cancer and associated severe vulvovaginal atrophy. It should be mentioned that vaginal lubricants once applied on a regular basis may also be effective in alleviating the symptoms of vaginal atrophy and should be offered to women wishing to avoid the use of local vaginal estrogen preparations and in cases where local estrogen therapy is contraindicated. Vaginal dehydroepiandrosterone (DHEA), vaginal testosterone, and tissue selective estrogen complexes are new, emerging therapies; however more clinical studies are necessary to confirm their efficacy and safety in the treatment of postmenopausal vulvovaginal atrophy.
Ginekologia polska 10/2012; 83(10):772-7. · 0.41 Impact Factor
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ABSTRACT: Sling operations have been performed for over 15 years. In recent years these operations have become the gold standard in the treatment of stress urinary incontinence (SUI) due to their efficacy safety and low invasiveness. Approximately 4% of women will undergo a surgery for SUI in the course of their life. As with any surgical intervention, there may be some technical problems, as well as intra- and postoperative complications, the most common of which is bladder injury Other complications encountered during mid-urethral slings procedures include bleeding (retropubic or vaginal hematomas), urethral perforation, urinary tract infections, postoperative vaginal or urethral erosions, bowel perforation, chronic pelvic pain, wound infection, nerve injury transient and persistent voiding dysfunction such as de novo urgency incomplete bladder emptying or urinary retention. Below we present a case of a patient with diagnosed vesicovaginal fistula after sling operation (TVT-tension-free vaginal tape). Upon admission the patient reported dysuria, persistent urinary leakage and abnormal, abundant vaginal discharge.
Case report and review of literature concerning surgical treatment of stress urinary incontinence and its complications.
Analysis of medical documentation of the patient treated at the Second Department of Gynecology Medical University of Lublin. Review of abstracts or papers in the Medline database related to surgical treatment of urinary incontinence and its complications.
Bladder perforation is one of the most common complications of the retropubic approach for MUS placement. The presence of mesh within the bladder may arise from direct bladder perforation or from subsequent erosion of the sling. Such lesions do not cause any serious health consequences for patients on condition they are detected intraoperatively and appropriately repaired, but when unrecognized, they results in the development of considerable symptoms and negatively influence the quality of patient life. Improperly treated, it can lead to development of an abnormal communication between the urinary bladder and the anterior wall of the vagina -vesicovaginal fistula. We should suspect unrecognized bladder injury in case of patients with any persistent voiding symptoms after a sling procedure such as long lasting dysuria, persistent urinary leakage, hematuria, recurrent infections, chronic pain and voiding difficulties. Diagnosis and treatment of vesicovaginal fistula is long lasting and difficult for the patient and the surgeon. Füth-Mayo operation is an effective treatment method for the majority of vesicovaginal fistulas. During this operation we suture all layers of fistula separately (bladder perivesical fascia and vaginal wall). Although with this operation we solve one problem, the patient still might suffer from recurrent SUI. Alternative methods of treatment which can be offered to patients after unsuccessful SUI operation are periurethral injections with bulking agents or electrical stimulation of the pelvic floor muscles. Both methods are effective in the therapy of recurrent SUI. In our case periurtehral injection of Bulkamid did not provide a total cure. Therefore, we completed the treatment with electrical stimulation of the pelvic floor muscles using patient-controlled electrodes placed in the vagina to stimulate muscles with current frequency of 50 Hz, amperage between 0-60 mA and duration of 250 micros. This procedure produced a series of changes in the stimulated area and enabled to cure the incontinence.
Ginekologia polska 10/2012; 83(10):784-8. · 0.41 Impact Factor
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ABSTRACT: OBJECTIVES: To evaluate sexual function among women with advanced pelvic organ prolapse (POP) before and after Prolift(®) vaginal reconstructive mesh surgery. STUDY DESIGN: Assessments were performed preoperatively and 12-18months after the surgery, including physical examination using the Pelvic Organ Prolapse Quantification (POP-Q) scale as well as the Female Sexual Function Index (FSFI) questionnaire. RESULTS: Fifty-nine sexually active patients who underwent vaginal reconstructive surgery due to advanced POP between June 2008 and January 2010 were included in the study. Analysis of the FSFI questionnaire showed no statistically significant differences after surgery, despite proper anatomical results. When comparing the group of women who underwent additional surgical restoration of the perineal body with patients without this procedure we also did not observe any differences in FSFI scores. CONCLUSIONS: Surgical treatment of advanced POP with the Prolift(®) system does not negatively influence sexual function, but patients should not expect a significant improvement after this type of operation. Additionally performed surgical restoration of perineal body does not reduce sexual function, either.
European journal of obstetrics, gynecology, and reproductive biology 08/2012; · 1.97 Impact Factor
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ABSTRACT: Nerve growth factor is a complex regulator of neural plasticity along the micturition pathways. The aim of this review is to summarize the current evidence for a role of NGF in urinary bladder function both in experimental and clinical settings. There is bulk of strong evidence that experimental administration of NGF elicits the symptoms of increased sensation, urgency and bladder hyperreflexia which strongly resemble overactive bladder syndrome (OAB) and interstitial cystitis/painful bladder syndrome (IC/PBS). Therefore in human studies there are attempts to employ urinary NGF levels as a diagnostic marker in various forms of OAB and IC/PBS. It has been shown that urinary NGF levels are correlated with severity of OAB symptoms and in patients successfully treated with antimuscarinics agents or detrusor botulinum toxin injection, urinary NGF levels decrease significantly in association with reduction of urgency severity
Ginekologia polska 07/2012; 83(7):532-6. · 0.41 Impact Factor
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ABSTRACT: Ovarian cancer is the sixth most common cancer in women worldwide and remains the leading cause of death due to gynecologic tumors. Bad prognosis is caused by advanced-stage high-grade disease. To reduce mortality and improve outcomes in this type of cancer researchers attempt to introduce new therapies based on genetic engineering or immunotherapy Th17 lymphocytes belong to the helper T cell population. These cells arise from immature CD4 + lymphocytes in the presence of IL-6 and TGF-beta. Produce IL-17A, IL-17F, IL-21, IL-22, IL-26, IL-6, TNF-alpha. Interleukin-17 and Th17 cells play an active role in inflammation and autoimmune diseases. The existence of these cells was confirmed in different types of cancer. However the exact role of IL-17 in tumor immunopathogenesis remains undefined. It has been reported that expression of interleukin-17 in tumor cells suppresses tumor progression through enhanced antitumor immunity or promotes tumor progression through an increase in inflammatory angiogenesis.
Ginekologia polska 04/2012; 83(4):295-300. · 0.41 Impact Factor
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ABSTRACT: In the current mini-review, we present a short overview of genetic as well as immunohistochemical p14(ARF) alterations either in primary human endometrial carcinomas (ECs) or in metastatic lesions originated from malignant endometrium. The prognostic utility of p14(ARF) in uterine malignancies has also been briefly discussed.
Frontiers in bioscience (Elite edition) 01/2012; 4:2457-63.
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ABSTRACT: Alterations in the transforming growth factor-β (TGF-β) signaling cascade are engaged in the development of human neoplasms through the deregulation of proliferation, differentiation and migration. However, in endometrial cancer, the role of endoglin, which acts as an accessory receptor in the TGF-β pathway, is still unknown. The aim of our study was the evaluation of endoglin mRNA and protein expression levels in endometrial cancer as compared to normal endometrium. TGF-β(1) and TGF-β type II receptor were involved in the investigation since they directly cooperate with endoglin during signal propagation. Obtained results were correlated with clinicopathological parameters of studied material to determine endoglin contribution to tumor development and progression.
mRNA level assessment was performed using real-time technique, whereas protein expression was determined by ELISA assay.
The endoglin mRNA level was not significantly altered in cancerous samples as compared to normal tissue, whereas its protein level demonstrated significant upregulation (p < 0.001) associated with increased tumor malignancy, assessed by histological grade and myometrium infiltration.
An increase in endoglin protein expression level may interfere with the oncogenic potential of TGF-β(1) and TGF-β type II receptor in endometrial cancer. Correlation of the endoglin level with pronounced cancer malignancy suggests that it may be regarded as a potential prognostic marker of primary endometrial cancer.
Oncology 11/2011; 81(3-4):243-50. · 2.27 Impact Factor
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ABSTRACT: Functional disorders of the female lower urinary tract like urge incontinence, idiopathic urinary retention and symptoms of urgency-frequency occasionally do not respond properly to classical behavioral and pharmacological therapy Therefore, additional alternative therapies are needed to alleviate these bothersome symptoms. Sacral neuromodulation (SNS) utilize mild electrical pulses which activate or suppress neural reflexes responsible for voiding by stimulating the sacral nerves that innervate the bladder, external urethral sphincter and pelvic floor muscles. The exact mechanism of SNS action is not yet fully understood but it is assumed that it influences the neuroaxis at different levels of the central nervous system and restores the balance between inhibitory and activatory control over the voiding reflex. There is numerous evidence on the success of SNS not only in the treatment of refractory urge incontinence in adult and children but also in idiopathic urinary retention and symptoms of urgency-frequency
Ginekologia polska 11/2011; 82(11):851-6. · 0.41 Impact Factor
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ABSTRACT: During menopausal transition not only ovarian production of estrogens but also marked decrease of adrenal androgen production are observed Decreased secretion of adrenal DHEA and DHEA-S result in reduction of peripheral conversion of these steroids into active estrogens and androgens. Intracrinology describes the biosynthesis of active steroids in peripheral target tissues in which the action of theses steroids takes place, without release into the extracellular space or general circulation. DHEA administration to postmenopausal women significantly increases bone mineral density decreases insulin resistance and amount of fat tissue and exerts an estrogenic effect on vaginal cytology in the absence of endometrial stimulation. Moreover animal experiments proved that DHEA suppresses the growth of breast cancer which is yet another reason to consider this steroid as a part of hormone replacement therapy in women.
Ginekologia polska 09/2011; 82(9):690-5. · 0.41 Impact Factor
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ABSTRACT: To assess the vascular parameters in the urethra of nulliparous females and to compare the vascularity among various parts of the urethra, using high-frequency endovaginal ultrasonography (EVUS).
Twenty-two nulliparous women, mean age 27 years, underwent EVUS using a biplane transducer at 12 MHz frequency. Color Doppler examinations of the urethra were recorded and further evaluated off-line using special software (Pixel Flux) for quantitative assessment of the vascularity. The urethra was divided into four regions of interest (ROIs) in the midsagittal plane and three ROIs in the axial plane. The following parameters were measured: velocity (V), perfused area (A), perfusion intensity (I), pulsatility index (PI), and resistance index (RI). Interobserver and intraobserver reproducibility analysis was also performed.
In midsagittal plane, the midurethra presented the highest value of V and lowest value of A. The intramural part showed the lowest value of I and the highest values of RI and PI. In the distal urethra, the highest value of I and the lowest value of RI was seen. In the axial plane, the values of V, A, and I were statistically significantly higher in the external part of the midurethra compared with the internal part. Excellent interobserver and intraobserver reproducibility was shown in the majority of parameters for the entire urethra.
Vascularity differs in different parts of the urethra. Pixel Flux is a valuable tool for providing reproducible quantitative analysis of vascular parameters for the entire urethra.
World Journal of Urology 07/2011; 29(5):625-32. · 2.41 Impact Factor
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ABSTRACT: Mid urethral slings are effective surgical treatment for stress urinary incontinence. However, 5% to 20% of patients still experience surgical failure with clinically significant recurrent or persistent stress urinary incontinence. Since a subset of these failures may be caused by improper tape position, we elucidated whether additional paraurethral fixation of a tape to prevent displacement during tensioning could improve the transobturator sling outcome.
The study was done in 463 patients with stress urinary incontinence who were randomly allocated to treatment with a standard transobturator intravaginal monofilament sling procedure (232) or to an intravaginal transobturator monofilament sling with additional 2-point tape fixation (231). Another 2 absorbable sutures parallel to the urethra were added to fix the tape and prevent displacement during tape tensioning. Outcome was assessed by a cough test and a 1-hour pad test at 12 months.
Clinical efficacy of the procedure with fixation was significantly higher with 195 women (95.12%) cured or improved compared to the 199 (88.73%) cured or improved with the standard sling (chi-square 5.71, p = 0.0169). There was no increase in intraoperative or postoperative complications. Also, among patients with intrinsic sphincter deficiency we noted a significantly better outcome in the fixation group than in the control group, that is 39 of 41 patients (95.1%) cured or improved vs 31 of 42 (73.8%) (chi-square 10.65, p = 0.0011).
Tape fixation significantly increases the clinical efficacy of the transobturator sling, especially in patients with intrinsic sphincter deficiency.
The Journal of urology 07/2011; 186(1):180-4. · 4.02 Impact Factor
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ABSTRACT: The aim of the study was to investigate the variability of bony pelvis architecture from the viewpoint of transobturator sling placement.
The pelvimetry was performed on 122 women who underwent pelvic computed tomography. Measurements included: the distance between the interobturator foramina line and inferior pubic symphysis (IF-PS distance) as well as pubic arch angle, pubic ramus width, and pubic symphysis length.
The length of the IF-PS distance varied between 7.4 and 26.9 mm (mean 15.2 ± 4.3 mm, median 14.2 mm). The distribution of measurements was asymmetrical with a tilt of the values towards shorter distances. In 11.5% of women, the IF-PS distance was longer than 20 mm. The IF-PS distance correlated with the pubic ramus width (r = 0.37, p < 0.0001) and pubic arch angle (r = -0.22, p = 0.017).
The IF-PS distance varies considerably in the general population of women.
International Urogynecology Journal 04/2011; 22(8):1005-9. · 1.83 Impact Factor
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ABSTRACT: The aim of this review was to discuss the putative etiology of Müllerian duct anomalies and to present the current diagnostic strategy and therapy Congenital defects of the female reproductive tract result from failure in the proper embryological development and fusion of the Müllerian ducts. Their causative factors are not fully understood yet. Clinical symptoms, if any appear usually during adolescence or early adulthood, and in some cases might affect the reproductive outcome. Imaging techniques such as hysterosalpingography ultrasonography and magnetic resonance are mainstay for the diagnosis. The classification system of these anomalies facilitates the decision about therapy and prognosis, however individual approach in every case is strongly recommended.
Ginekologia polska 02/2011; 82(2):137-45. · 0.41 Impact Factor
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ABSTRACT: TGFβ signaling cascade plays a vital role in neoplastic transformation, but the function of betaglycan, which is a TGFβ accessory receptor, is still unknown in particular cancer. Evaluation of betaglycan expression both at mRNA (real-time PCR) and protein (ELISA) level in the context of TGFβ canonical signaling components, i.e., TGFβ1, TGFβ2, and TGFβRII, in endometrial carcinomas was performed. Betaglycan mRNA expression level was significantly (p < .001) downregulated with simultaneous betaglycan protein level upregulation in cancer samples. Obtained results suggest that endometrial cancer is associated with disruption of accessory receptor betaglycan expression, what may alter TGFβ2-induced signaling.
Cancer Investigation 02/2011; 29(2):137-44. · 1.85 Impact Factor
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Ginekologia polska 12/2010; 81(12):947-9. · 0.41 Impact Factor
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Tomasz Rechberger,
Paweł Miotła,
Konrad Futyma,
Aleksandra Bartuzi,
Antoni Basta,
Marcin Opławski,
Klaudia Stangel-Wójcikiewicz,
Włodzimierz Baranowski,
Jacek Doniec,
Artur Rogowski, [......],
Igor Bakon,
Jacek Magnucki,
Andrzej Witek,
Agnieszka Drosdol,
Agnieszka Solecka,
Andrzej Malinowski,
Wojciech Ordon,
Artur Jakimiuk,
Wojciech Borucki,
Radosław Rodzoch
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ABSTRACT: To evaluate the prevalence rate of various pelvic floor disorders among patients treated in 8 academic centers in Poland due to pelvic organ prolapse (POP).
The study group consisted of 717 women scheduled for reconstructive surgery due to POP. Risk factors, functional abnormalities along with symptoms affecting quality of life, were assessed by means of disease specific questionnaire. The stage of the disease was assessed after gynecological examination using POP-Q score.
The mean age of affected women with POP was 61,25 years (median 61), and mean BMI--27.62 (median--27.29). 80% of women were menopausal. Mean time of symptoms related to disease was 65,6 months; whereas the time relapsed from first doctor diagnosis of POP to hospital admission was 50.6 months. 97.4% affected women were multiparous. Only 1.21% women with POP were nulliparous. Family history of prolapse was found in 13.4% of patients, whereas familial positive history of urinary incontinence was 10%. Lower urinary tract symptoms (LUTS) among the analyzed group were as follows: frequency--almost 50%, urgency 32.2%, feeling of improper voiding -29,6% and voiding difficulty -17.7%. Functional disorders of lower bowel were found in 43% of patients and the most prevalent symptom was constipation (31%), followed by empting difficulty (12%), dyschesia (9%), and urge stool empting (7.7%). Cardiovascular diseases were found among 43% of respondents, whereas pulmonary diseases with chronic coughing were present in 20% of the analyzed population. Subjective POP symptoms reported by women were as follows: feeling of heaviness in lower abdomen--378%, perineal pain--27.8%, lumbosacral pain-34.2%, and abdominal pain--28.4%. Female sexual disorders were reported by 9,8% women and dyspareunia was found in 7.6% of responders. POP was the main reason for sexual abstinence only in 1 out of 10 patients. More than 30% of patients from the study group underwent previously pelvic surgery due to various reasons. POP related quality of life measured by VAS (Visual Analogue Scale) was 61.4 points (median--60). The most common finding during gynecological examination was cystocele--96.5%, followed by rectoenterocele--92.7%, and central defect--79%. Mean POP quantification was stage III in POP-Q scale. LUTS symptoms (urinary incontinence, urgency and voiding difficulties) were present among 81% of patients whereas lower gastrointestinal disorders (constipation, fecal incontinence, dyschesia) were found in 43% of women affected by POP.
Mean delay time from objective POP diagnosis until decision concerning surgical treatment was more than 5 years. The most common risk factors associated with POP were: multiparity with vaginal deliveries, obesity and aging. The most common defect found among patients with POP was cystocele, followed by rectoenterocele and central defect however most patients presented with advanced combined defects.
Ginekologia polska 11/2010; 81(11):821-7. · 0.41 Impact Factor
