Are hypertension and diabetes mellitus risk factors for pelvic organ prolapse?

Işık, Hatice; Aynıoğlu, Öner; Şahbaz, Ahmet; Selimoglu, Refika; Tımur, Hakan; Harma, Müge

doi:10.1016/j.ejogrb.2015.11.035

Cited by 28 publications

(22 citation statements)

References 23 publications

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“…While individual risk factors affecting the prevalence of POP such as age, vaginal deliveries and race are well identified, comorbidities such as DM together with hypertension must be considered in the development of the condition (49).…”

Section: A) Menopausementioning

confidence: 99%

Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse

2020

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The exact prevalence of pelvic organ prolapse is diffi cult to establish. The anatomical changes do not always consist with the severity or the symptoms associated with prolapse. There are many risk factors associated with pelvic organ prolapse and this review aims to identify the epidemiology and pathophysiology while looking at the known risk factors for pelvic organ prolapse. PubMed search involved a number of terms including: epidemiology, risk factors, reoccurrence indicators, management and evaluation. Several risk factors have been associated with pelvic organ prolapse, all contribute to weakening of the pelvic fl oor connective tissue/collagen, allowing the pelvic organs to prolapse through the vaginal walls. Among the risk factors are genetic background, childbirth and mode of delivery, previous hysterectomy, menopausal state and the ratio between Estrogen receptors. The "Integral theory" of Petros and the "Levels of Support" model of Delancey enable us to locate the defect, diagnose and treat pelvic organ prolapse. The currently available demographic data is not reliable enough to properly estimate the true extent of pelvic organ prolapse in the population. However, standardization of the diagnosis and treatment may signifi cantly improve our ability to estimate the true incidence and prevalence of this condition in the coming years.

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Section: A) Menopausementioning

confidence: 99%

Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse

2020

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“…Furthermore, the weighted prevalence rate of one or more PFDs was 25.0% of adult women in the U.S., including 17.1% of women with moderate-to-severe urinary incontinence (UI), 9.4% with fecal incontinence, and 2.9% with prolapse [2]. Moreover, the association between DM and PFD has been recently described in epidemiologic studies [3] and reviews [4], and it has been shown that urinary tract symptoms are present in 75% of DM patients [5] and that worsening glycemic control is associated with an increased risk for stress incontinence [6] and pelvic organ prolapse [7] in women.…”

Section: Introductionmentioning

confidence: 99%

The influence of hyperglycemia on the remodeling of urethral connective tissue in pregnant rats

Marini

Pículo

Vesentini

et al. 2018

European Journal of Obstetrics & Gynecology and Reproductiv

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This study provides the first line of experimental evidence supporting a metabolic relationship between hyperglycemia and urethral remodeling of connective tissue in pregnant rats. The different organization of the collagen fibrils and the profile of glycosaminoglycans found in urethral samples suggest that the pathology of the urethral fibromuscular system could be related to hyperglycemia-induced pelvic floor dysfunction in women, which has direct clinical implications with the possibility to develop new multidisciplinary treatments for improving the health care of these women.

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“…Furthermore, little information has been reported concerning a positive correlation between GDM and longterm UI [5,35,39,[42][43][44][45]. An outline of our proposed analysis is described in Fig.…”

Section: Potential Mediators and Moderators Of Gdm And Uimentioning

confidence: 99%

Study protocol to investigate biomolecular muscle profile as predictors of long-term urinary incontinence in women with gestational diabetes mellitus

Rudge¹,

Abbade²,

Hallur³

et al. 2020

BMC Pregnancy Childbirth

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Background: Pelvic floor muscles (PFM) and rectus abdominis muscles (RAM) of pregnant diabetic rats exhibit atrophy, co-localization of fast and slow fibers and an increased collagen type I/III ratio. However, the role of similar PFM or RAM hyperglycemic-related myopathy in women with gestational diabetes mellitus (GDM) remains poorly investigated. This study aims to assess the frequency of pelvic floor muscle disorders and pregnancy-specific urinary incontinence (PS-UI) 12 months after the Cesarean (C) section in women with GDM. Specifically, differences in PFM/ RAM hyperglycemic myopathy will be evaluated. Methods: The Diamater is an ongoing cohort study of four groups of 59 pregnant women each from the Perinatal Diabetes Research Centre (PDRC), Botucatu Medical School (FMB)-UNESP (São Paulo State University), Brazil. Diagnosis of GDM and PS-UI will be made at 24-26 weeks, with a follow-up at 34-38 weeks of gestation. Inclusion in the study will occur at the time of C-section, and patients will be followed at 24-48 h, 6 weeks and 6 and 12 months postpartum. Study groups will be classified as (1) GDM plus PS-UI; (2) GDM without PS-UI; (3) Non-GDM plus PS-UI; and (4) Non-GDM without PS-UI. We will analyze relationships between GDM, PS-UI and hyperglycemic myopathy at 12 months after C-section. The mediator variables to be evaluated include digital palpation, vaginal squeeze pressure, 3D pelvic floor ultrasound, and 3D RAM ultrasound. RAM samples obtained during C-section will be analyzed for ex-vivo contractility, morphological, molecular and OMICS profiles to further characterize the hyperglycemic myopathy. Additional variables to be evaluated include maternal age, socioeconomic status, educational level, ethnicity, body mass index, weight gain during pregnancy, quality of glycemic control and insulin therapy. Discussion: To our knowledge, this will be the first study to provide data on the prevalence of PS-UI and RAM and PFM physical and biomolecular muscle profiles after C-section in mothers with GDM. The longitudinal design allows for the assessment of cause-effect relationships between GDM, PS-UI, and PFMs and RAMs myopathy. The findings may reveal previously undetermined consequences of GDM.

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Are hypertension and diabetes mellitus risk factors for pelvic organ prolapse?

Cited by 28 publications

References 23 publications

Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse

Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse

The influence of hyperglycemia on the remodeling of urethral connective tissue in pregnant rats

Study protocol to investigate biomolecular muscle profile as predictors of long-term urinary incontinence in women with gestational diabetes mellitus

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