Pelvic organ prolapse: review of the aetiology, presentation, diagnosis and management

Machin, Sarah Elizabeth; Mukhopadhyay, Sambit

doi:10.1258/mi.2011.011108

Cited by 45 publications

(26 citation statements)

References 31 publications

(40 reference statements)

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“…A variation of this phenomenon is also seen in humans in pelvic organ prolapse, where loss of integrity of the female reproductive organs causes prolapse of the pelvic floor. This is often accompanied by incontinence and is strongly associated with obesity (Machin and Mukhopadhyay 2011). In a sense, it can be argued that Avid is a phenotype analogous to obesity in higher organisms.…”

Section: Discussionmentioning

confidence: 99%

Age-associated vulval integrity is an important marker of nematode healthspan

Leiser

Jafari

Primitivo

et al. 2016

AGE

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Improving healthspan, defined as the period where organisms live without frailty and/or disease, is a major goal of biomedical research. While healthspan measures in people are relatively easy to identify, developing robust markers of healthspan in model organisms has proven challenging. Studies using the nematode Caenorhabditis elegans have provided vital information on the basic mechanisms of aging; however, worm health is difficult to define, and the impact of interventions that increase lifespan on worm healthspan has been controversial. Here, we describe a marker of population healthspan in C. elegans that we term age-associated vulval integrity defects, or Avid, frequently described elsewhere as rupture or exploding. We connect the presence of this phenotype with temperature, reproduction, diet, and longevity. Our results show that Avid occurs in post-reproductive worms under common laboratory conditions at a frequency that correlates negatively with temperature; Avid is rare in worms kept at 25°C and more frequent in worms kept at 15°C. We describe the kinetics of Avid, link the phenotype to oocyte production, and describe how Avid involves the ejection of worm proteins and/or internal organ(s) from the vulva. Finally, we find that Avid is preventable by removing worms from food, suggesting that Avid results from the intake, digestion, and/or absorption of food. Our results show that Avid is a significant cause of death in worm populations maintained under laboratory conditions and that its prevention often correlates with worm longevity. We propose that Avid is a powerful marker of worm healthspan whose underlying molecular mechanisms may be conserved.

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Section: Discussionmentioning

confidence: 99%

Age-associated vulval integrity is an important marker of nematode healthspan

Leiser

Jafari

Primitivo

et al. 2016

AGE

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“…The prevalence of pelvic organ prolapse (POP) is increasing probably due to the aging of the world population (1). The estimated lifetime risk of surgery for POP is reported to be 12% by the age of 80 years (2).…”

Section: Introductionmentioning

confidence: 99%

Robotic Surgery for the Treatment of Apical Pelvic Organ Prolapse at a Single Institution

Toptaş

Uysal

2017

Gynecol Obstet Reprod Med

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OBJECTIVE:We sought to present implementation of robotic surgery for the treatment of apical pelvic organ prolapse at our clinic, with short-term outcomes.STUDY DESIGN: Clinical data of 11 consecutive patients with apical pelvic organ prolapse, who underwent robotic sacrocolpopexy or hysteropexy between July 2015 and August 2016, were collected prospectively. Primary endpoint of the study was anatomic cure and the secondary endpoint was symptomatic cure. Anatomic cure was defined as lack of anterior or posterior prolapse beyond the hymen and apical prolapse beyond the midvagina. Symptomatic cure was lack of vaginal bulge sensation. RESULTS:Of the 11 patients, 9 underwent sacrocolpopexy and two underwent hysteropexy. Sacrocolpopexy was performed concomitantly with hysterectomy in 7 of the 9 patients. Mean operating time for all procedures was 254±65 minutes. No conversion to open surgery was required and no intraoperative complication was observed in any of the patients. The median hospital stay was 3 days. Four complications occurred postoperatively: 1 case of pulmonary thromboembolism, 2 cases of vaginal vault cellulitis and 1 case of mesh erosion. In total, 10 of 11 patients (90.9%) met the criteria for anatomic and symptomatic cure. CONCLUSION:Robotic pelvic support procedures can be readily adopted to routine clinical practice with high anatomic and symptomatic cure rates.

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“…In our opinion, only symptomatic prolapse is of clinical interest and was diagnosed using a validated five-item questionnaire where the sensitivity and specificity for 'feeling a vaginal bulge' correctly identified prolapse according to the POP-Q system in 66.5% and 94.2%, respectively. 4 Although every third woman with prolapse was a false negative, 72.5% of the missed cases were Stage I prolapses. 4 Misclassification affected both cohorts to the same extent in our study.…”

mentioning

confidence: 99%

“…4 Although every third woman with prolapse was a false negative, 72.5% of the missed cases were Stage I prolapses. 4 Misclassification affected both cohorts to the same extent in our study.…”

mentioning

confidence: 99%