Pelvic reconstruction improves pelvic floor strength in pelvic organ prolapse patients

Guan, Zhong; Li, Huaifang; Xiang, Yang; Guo, Lili

doi:10.1016/j.tjog.2014.07.009

Cited by 4 publications

(7 citation statements)

References 17 publications

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“…A total of 5 randomized controlled trials, 14 prospective cohort studies and 2 retrospective cohort studies were included (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…In eight studies, some participants had undergone previous pelvic surgery, with hysterectomy the most common procedure. Participants in six studies had not undergone any previous pelvic surgery . Only three studies reported participants’ previous experience with PFM training: in one study participants had no prior PFM training; in another study 9% had completed PFM training before participation in the study; and in the third study over 59% had done previous PFM training .…”

Section: Resultsmentioning

confidence: 99%

“…A wide range of surgical interventions was represented in the studies (Table ). A total of 3 studies investigated procedures for UI and 12 studies reported on vaginal prolapse repair . Combined POP/UI procedures were performed in four studies .…”

Section: Resultsmentioning

confidence: 99%

“…Participants in six studies had not undergone any previous pelvic surgery. 27,37,41,42,46,48 Only three studies reported participants' previous experience with PFM training: in one study participants had no prior PFM training 46 ; in another study 9% had completed PFM training before participation in the study 40 ; and in the third study over 59% had done previous PFM training. 32 A single study reported the presence of levator avulsion preoperatively.…”

Section: Participant Characteristicsmentioning

confidence: 99%

“…A total of 3 studies investigated procedures for UI 27,39,45 and 12 studies reported on vaginal prolapse repair. 28,32,34,37,[40][41][42][43][44][46][47][48] Combined POP/UI procedures were performed in four studies. 31,33,35,49 One study reported perineal levatorplasty and transrectal repair surgery to correct anterior rectocele.…”

Section: Interventionsmentioning

confidence: 99%

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The impact of pelvic organ prolapse and/or continence surgery on pelvic floor muscle function in women: A systematic review

Mastwyk

McClelland

Rosamilia

et al. 2019

Neurourology and Urodynamics

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Aims To systematically review the evidence for the effect of pelvic organ prolapse (POP) and/or continence surgery on pelvic floor muscle (PFM) morphometry and function in women, and to investigate whether a relationship exists between PFM measures and clinician‐reported objective pelvic floor outcomes postoperatively. Methods Six electronic databases were searched until March 2018. Studies were included if they examined the effect of POP and/or continence surgery on the PFM in women, and reported pre‐ and postoperative data. Methodological quality was assessed using a modified Downs and Black checklist. Three meta‐analyses were planned based on postoperative follow‐up time. Results Twenty‐one studies met the inclusion criteria. Varied surgical interventions and 33 different PFM measures were represented. The methodological quality of included studies varied considerably. The 0 to 6 weeks postoperative meta‐analysis showed no statistically significant change in PFM function (SMD = 0.04; 95% confidence interval [CI] = −0.26 to 0.33). This was consistent at 3 and 6 or more months (SMD = 1.13; 0.35 95% CI = −0.34 to 2.60, − 0.42 to 1.12 respectively). None of the included studies investigated the relationship between PFM measures and clinician‐reported objective outcomes postoperatively. Conclusions This review did not show a clear effect of POP and/or continence surgery on PFM morphometry or function in women and was unable to show a relationship with outcomes such as objective prolapse score and urodynamic findings. This could be because surgery does not measurably impact on the PFM or due to the poor quality and heterogeneity of studies. Future well‐designed research is needed to specifically investigate change in the PFM following surgery.

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“…A total of 5 randomized controlled trials, 14 prospective cohort studies and 2 retrospective cohort studies were included (Table ).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Participant Characteristicsmentioning

confidence: 99%

Section: Interventionsmentioning

confidence: 99%

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The impact of pelvic organ prolapse and/or continence surgery on pelvic floor muscle function in women: A systematic review

Mastwyk

McClelland

Rosamilia

et al. 2019

Neurourology and Urodynamics

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Impact of preoperative pelvic floor muscle function on the success of surgical treatment of pelvic organ prolapse

Szymański,

Starzec-Proserpio,

Bartosińska-Raczkiewicz

et al. 2023

Int Urogynecol J

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Introduction and hypothesis The objective of this study was to identify the potential characteristics of pelvic floor muscles (PFM) in the preoperative assessment that could be associated with post-surgical prolapse severity. We hypothesized that the same variables, if identified, could be addressed in preoperative rehabilitation to improve surgical results. Methods This was a single-center prospective observational study that included women who underwent surgical pelvic organ prolapse repair between 2020–2022. Genital prolapse was evaluated according to the Pelvic Organ Prolapse Quantification (POP-Q) system. All the participants underwent a PFM assessment, including a vaginal digital assessment and manometry (Peritron™ 9300 V) before surgery and at 1-, 3-, and 6-month follow-ups. Several PFM variables were recorded: vaginal resting pressure, vaginal pressure during maximal voluntary contraction (MVC), area under the curve during a 10-second MVC, ability to correctly contract the PFMs, and reflexive activation during cough and relaxation. The primary endpoint of the analysis was objective surgical success defined as POP-Q 0 or 1 at the 6-month follow-up. Additionally, a change in pelvic floor muscle function was recorded during postoperative visits. Results A total of 106 females were included in the study. Fifty-one were lost during the 6-month follow-up, which is a major limitation of the study. None of the examined parameters evaluating PFM were associated with surgical success. No statistically significant difference was found in MVC and PFM endurance before and after surgery. Post-surgery, a significant change was observed in the vaginal resting pressure and the ability to correct PFM activation and relaxation. Conclusions Preoperative PFM function is not associated with surgical success 6 months after surgery.

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Prolongation of the pelvic organs. Literature review

Kravchenko,

Lautenschleger,

Lautenschleger

2024

Rus. J. Hum. Repro.

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Pelvic reconstruction improves pelvic floor strength in pelvic organ prolapse patients

Abstract: The modified pelvic reconstruction procedure could improve pelvic floor muscle strength in POP patients, which remains lower when compared with the normal population. Pelvic floor muscle strength should be included in the assessment of surgical outcomes in POP.

Cited by 4 publications

References 17 publications

The impact of pelvic organ prolapse and/or continence surgery on pelvic floor muscle function in women: A systematic review

The impact of pelvic organ prolapse and/or continence surgery on pelvic floor muscle function in women: A systematic review

Impact of preoperative pelvic floor muscle function on the success of surgical treatment of pelvic organ prolapse

Prolongation of the pelvic organs. Literature review

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