Pelvic Organ Prolapse – General Overview and Latest Therapy Possibilities
DOI:
https://doi.org/10.12775/QS.2024.25.56803Keywords
pelvic organ prolapse, surgery, pessaries, sacrocolpopexyAbstract
Pelvic organ prolapse (POP) is a very common health problem, which affects increasing number of women. The etiology involves multiple factors, especially ageing or increased abdominal pressure. It refers to the downward displacement of the pelvic organs and its protrusion. This condition can significantly affect the quality of life, causing urinary and fecal incontinence, sexual dysfunctions and self-consciousness. The examination includes both physical and imaging studies. Patients can be offered an observations, pessaries and surgeries, such as obliterative and reconstructive surgeries. A literature for this review was gathered on PubMed and Google Scholar, using keyword “pelvic organ prolapse”, combined with “epidemiology”, “pathophysiology”, “risk factors”, “symptoms”, “complications”, “treatment”, “surgery” and “pessaries”.
References
Jelovsek JE, Maher C, Barber MD. Pelvic organ prolapse. Lancet. 2007 Mar 24;369(9566):1027-38. doi: 10.1016/S0140-6736(07)60462-0. PMID: 17382829.
Aboseif C, Liu P. Pelvic Organ Prolapse. 2022 Oct 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 33085376.
Iglesia CB, Smithling KR. Pelvic Organ Prolapse. Am Fam Physician. 2017 Aug 1;96(3):179-185. PMID: 28762694.
Weintraub AY, Glinter H, Marcus-Braun N. Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse. Int Braz J Urol. 2020 Jan-Feb;46(1):5-14. doi: 10.1590/S1677-5538.IBJU.2018.0581. PMID: 31851453; PMCID: PMC6968909.
Tegerstedt G, Maehle-Schmidt M, Nyrén O, Hammarström M. Prevalence of symptomatic pelvic organ prolapse in a Swedish population. Int Urogynecol J Pelvic Floor Dysfunct. 2005 Nov-Dec;16(6):497-503. doi: 10.1007/s00192-005-1326-1. Epub 2005 Jun 29. PMID: 15986100.
Gabra MG, Tessier KM, Fok CS, Nakib N, Oestreich MC, Fischer J. Pelvic organ prolapse and anal incontinence in women: screening with a validated epidemiology survey. Arch Gynecol Obstet. 2022 Sep;306(3):779-784. doi: 10.1007/s00404-022-06510-7. Epub 2022 Mar 19. PMID: 35305141; PMCID: PMC10069445.
Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, Spino C, Whitehead WE, Wu J, Brody DJ; Pelvic Floor Disorders Network. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008 Sep 17;300(11):1311-6. doi: 10.1001/jama.300.11.1311. PMID: 18799443; PMCID: PMC2918416.
Smith FJ, Holman CD, Moorin RE, Tsokos N. Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol. 2010 Nov;116(5):1096-100. doi: 10.1097/AOG.0b013e3181f73729. PMID: 20966694.
American College of Obstetricians and Gynecologists and the American Urogynecologic Society; INTERIM UPDATE: This Practice Bulletin is updated as highlighted to reflect the US Food and Drug Administration order to stop the sale of transvaginal synthetic mesh products for the repair of pelvic organ prolapse.. Pelvic Organ Prolapse. Female Pelvic Med Reconstr Surg. 2019 Nov/Dec;25(6):397-408. doi: 10.1097/SPV.0000000000000794. PMID: 31663890.
Schulten SFM, Claas-Quax MJ, Weemhoff M, van Eijndhoven HW, van Leijsen SA, Vergeldt TF, IntHout J, Kluivers KB. Risk factors for primary pelvic organ prolapse and prolapse recurrence: an updated systematic review and meta-analysis. Am J Obstet Gynecol. 2022 Aug;227(2):192-208. doi: 10.1016/j.ajog.2022.04.046. Epub 2022 Apr 30. PMID: 35500611.
Jones KA, Moalli PA. Pathophysiology of pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2010 Mar;16(2):79-89. doi: 10.1097/SPV.0b013e3181d6ff65. PMID: 22453155.
Yousefi F, Abbaspoor Z, Siahkal SF, Mohaghegh Z, Ghanbari S, Zahedian M. Association Between Striae and Pelvic Organ Prolapse in Women: A Systematic Review and Meta-Analysis. Int Urogynecol J. 2024 Aug;35(8):1561-1570. doi: 10.1007/s00192-024-05832-1. Epub 2024 Jun 12. PMID: 38864859.
Jelovsek JE, Barber MD. Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. Am J Obstet Gynecol. 2006 May;194(5):1455-61. doi: 10.1016/j.ajog.2006.01.060. PMID: 16647928.
Rogers GR, Villarreal A, Kammerer-Doak D, Qualls C. Sexual function in women with and without urinary incontinence and/or pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(6):361-5. doi: 10.1007/s001920170012. PMID: 11795636.
Lince SL, van Kempen LC, Vierhout ME, Kluivers KB. A systematic review of clinical studies on hereditary factors in pelvic organ prolapse. Int Urogynecol J. 2012 Oct;23(10):1327-36. doi: 10.1007/s00192-012-1704-4. Epub 2012 Mar 16. PMID: 22422218; PMCID: PMC3448053.
Veit-Rubin N, Cartwright R, Singh AU, Digesu GA, Fernando R, Khullar V. Association between joint hypermobility and pelvic organ prolapse in women: a systematic review and meta-analysis. Int Urogynecol J. 2016 Oct;27(10):1469-78. doi: 10.1007/s00192-015-2896-1. Epub 2015 Dec 10. PMID: 26658756.
Ward RM, Velez Edwards DR, Edwards T, Giri A, Jerome RN, Wu JM. Genetic epidemiology of pelvic organ prolapse: a systematic review. Am J Obstet Gynecol. 2014 Oct;211(4):326-35. doi: 10.1016/j.ajog.2014.04.006. Epub 2014 Apr 12. PMID: 24721264; PMCID: PMC4213176.
Altman D, Falconer C, Cnattingius S, Granath F. Pelvic organ prolapse surgery following hysterectomy on benign indications. Am J Obstet Gynecol. 2008 May;198(5):572.e1-6. doi: 10.1016/j.ajog.2008.01.012. Epub 2008 Mar 20. PMID: 18355787.
Handa VL, Blomquist JL, McDermott KC, Friedman S, Muñoz A. Pelvic floor disorders after vaginal birth: effect of episiotomy, perineal laceration, and operative birth. Obstet Gynecol. 2012 Feb;119(2 Pt 1):233-9. doi: 10.1097/AOG.0b013e318240df4f. PMID: 22227639; PMCID: PMC3266992.
Jackson SR, Avery NC, Tarlton JF, Eckford SD, Abrams P, Bailey AJ. Changes in metabolism of collagen in genitourinary prolapse. Lancet. 1996 Jun 15;347(9016):1658-61. doi: 10.1016/s0140-6736(96)91489-0. PMID: 8642960.
Sze EH, Hobbs G. A prospective cohort study of pelvic support changes among nulliparous, multiparous, and pre- and post-menopausal women. Eur J Obstet Gynecol Reprod Biol. 2012 Feb;160(2):232-5. doi: 10.1016/j.ejogrb.2011.11.016. Epub 2011 Dec 10. PMID: 22154667.
Raju R, Linder BJ. Evaluation and Management of Pelvic Organ Prolapse. Mayo Clin Proc. 2021 Dec;96(12):3122-3129. doi: 10.1016/j.mayocp.2021.09.005. PMID: 34863399.
Karjalainen PK, Mattsson NK, Nieminen K, Tolppanen AM, Jalkanen JT. The relationship of defecation symptoms and posterior vaginal wall prolapse in women undergoing pelvic organ prolapse surgery. Am J Obstet Gynecol. 2019 Nov;221(5):480.e1-480.e10. doi: 10.1016/j.ajog.2019.05.027. Epub 2019 May 22. PMID: 31128111.
Deval B, Vulierme MP, Poilpot S, Menu Y, Levardon M. Imagerie du prolapsus génito-urinaire [Imaging pelvic floor prolapse]. J Gynecol Obstet Biol Reprod (Paris). 2003 Feb;32(1):22-9. French. PMID: 12592178.
Collins S, Lewicky-Gaupp C. Pelvic Organ Prolapse. Gastroenterol Clin North Am. 2022 Mar;51(1):177-193. doi: 10.1016/j.gtc.2021.10.011. Epub 2022 Jan 8. PMID: 35135661.
Diwadkar GB, Barber MD, Feiner B, Maher C, Jelovsek JE. Complication and reoperation rates after apical vaginal prolapse surgical repair: a systematic review. Obstet Gynecol. 2009 Feb;113(2 Pt 1):367-73. doi: 10.1097/AOG.0b013e318195888d. Erratum in: Obstet Gynecol. 2009 Jun;113(6):1377. PMID: 19155908.
Wilson P., Berghmans B., Hagen S., et. al.: Adult conservative management. Incontinence 2005; 2: pp. 855-964.
Piya-Anant M, Therasakvichya S, Leelaphatanadit C, Techatrisak K. Integrated health research program for the Thai elderly: prevalence of genital prolapse and effectiveness of pelvic floor exercise to prevent worsening of genital prolapse in elderly women. J Med Assoc Thai. 2003 Jun;86(6):509-15. PMID: 12924798.
Bø K, Anglès-Acedo S, Batra A, Brækken IH, Chan YL, Jorge CH, Kruger J, Yadav M, Dumoulin C. Are hypopressive and other exercise programs effective for the treatment of pelvic organ prolapse? Int Urogynecol J. 2023 Jan;34(1):43-52. doi: 10.1007/s00192-022-05407-y. Epub 2022 Nov 23. PMID: 36418569; PMCID: PMC9834161.
Giarenis I, Tsiapakidou S, Zacche M, Mukhopadhyay S, Mahmood T. European Board and College of Obstetrics and Gynaecology (EBCOG) position statement on the use of laser vaginal devices for treatment of genitourinary syndrome of menopause, vaginal laxity, pelvic organ prolapse and stress urinary incontinence. Eur J Obstet Gynecol Reprod Biol. 2024 Aug;299:342-344. doi: 10.1016/j.ejogrb.2024.05.021. Epub 2024 May 21. PMID: 38811292.
Xiao T, Du J, Geng J, Li L. Meta-analysis of the comparison of laparoscopic pectopexy and laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse. Int J Gynaecol Obstet. 2024 Oct 23. doi: 10.1002/ijgo.15954. Epub ahead of print. PMID: 39441550.
Qin Y, Liu J, Wu J. Advancements in surgical treatment for pelvic organ prolapse. Asian J Surg. 2024 Jul;47(7):3218-3219. doi: 10.1016/j.asjsur.2024.03.061. Epub 2024 Apr 10. PMID: 38604865.
Ren J, Murray R, Wong CS, Qin J, Chen M, Totsika M, Riddell AD, Warwick A, Rukin N, Woodruff MA. Development of 3D Printed Biodegradable Mesh with Antimicrobial Properties for Pelvic Organ Prolapse. Polymers (Basel). 2022 Feb 16;14(4):763. doi: 10.3390/polym14040763. PMID: 35215676; PMCID: PMC8877663.
Matak L, Baekelandt J, Šimičević M, Matak M, Mikuš M, Orešković S. Comparison between fascia lata and rectus fascia in treatment of pelvic organ prolapse: a systematic review. Arch Gynecol Obstet. 2024 Jun;309(6):2395-2400. doi: 10.1007/s00404-024-07531-0. Epub 2024 May 4. PMID: 38703280.
Paek J, Lee M, Kim BW, Kwon Y. Robotic or laparoscopic sacrohysteropexy versus open sacrohysteropexy for uterus preservation in pelvic organ prolapse. Int Urogynecol J. 2016 Apr;27(4):593-9. doi: 10.1007/s00192-015-2869-4. Epub 2015 Oct 29. PMID: 26514118.
Costantini E, Mearini L, Lazzeri M, Bini V, Nunzi E, di Biase M, Porena M. Laparoscopic Versus Abdominal Sacrocolpopexy: A Randomized, Controlled Trial. J Urol. 2016 Jul;196(1):159-65. doi: 10.1016/j.juro.2015.12.089. Epub 2016 Jan 11. PMID: 26780167.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Aneta Klaudia Wojtas, Aleksandra Cygnarowicz, Karolina Sacher, Krystyna Zabojska, Urszula Korotko, Aneta Mandziuk, Kinga Witowska, Mariola Turemka, Mikolaj Biskupski, Negar Hosseinnejad
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 55
Number of citations: 0