Reproductive factors, family history, occupation and risk of urogenital prolapse

Chiaffarino, Francesça; Chatenoud, Liliane; Dindelli, M; Meschìa, Michele; Buonaguidi, Arturo; Amicarelli, Fabio; Surace, M; Bertola, E.; Cintio, Elisabetta Di; Parazzini, Fabio

doi:10.1016/s0301-2115(98)00175-4

Cited by 175 publications

(123 citation statements)

References 14 publications

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“…21 Other risk factors that have been identified are parity, body mass index, chronic lung disease and coughing. [21][22][23] This was consistent with findings in our study where apart from advanced age and high parity (commonest parity being 4 and above), high prevalence of smoking (24.54%) was seen in geriatric age group.…”

supporting

confidence: 92%

Gynecological disorders in geriatric women regarding their frequency, diagnosis and management in the state of Himachal Pradesh, India

Sood

Chandra

Dhiman

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONThe word Geriatrics was coined by Dr. Ignatz Natcher an Austrian physician in 1909. However, it was in 1935 that a British doctor Marjory Warren, working in USA first developed the practical concept of geriatric rehabilitation. With her initiation the elderly patients were gradually taken over by teaching hospitals. 1Many studies from developed countries defined older persons as those aged more than 65 years, whereas some use the cut off of 60 yrs. Life expectancy of India is 61 years as compared to 72 to 82 years in the developed countries. Thus, the cutoff of 65 years may not be appropriate in Indian context and therefore a lower cut off of greater than and equal to 60 years is used. 2A major challenge for the world in the 21 st century is the ageing of its population 2 . The world's elderly population is growing at a rate of 2.4% per year. The age shift is the result of reduced birth rates, improvement in health and nutrition and increased longevity. The aging population ABSTRACT Background: Geriatric gynaecological problems have not received adequate attention in India. This study was undertaken to assess gynaecological disorders in geriatric women regarding their frequency, diagnosis and management in Himachal Pradesh, India. Methods: It was a prospective observational study of patients aged above 60 years, admitted in Gynecology ward, IGMC Shimla over one year. Spectrum of gynecological disorder, comorbidities, diagnosis and management were noted and analyzed. Results: 224 patients aged 60 years and above were admitted over a period of one year. The commonest presenting complaint was postmenopausal bleeding in 41.07% of patients. 80.80% patients had one or more comorbid conditions. Malignancy was the most frequent diagnosis 54% followed by uterovaginal prolapse in 30.35%. Ovarian cancer constituted 47.93% followed by cervical cancer 31.40%. 89.65% patients of ovarian cancer had surgical treatment whereas only 21.05% of cervical cancer patients underwent surgical treatment and rest were referred for radiation. In 62 out of 68 cases of pelvic organ prolapse had definitive surgical treatment. Conclusions: Pelvic organ prolapse and genital malignancy are the major gynecological causes of hospital admissions in the patients above 60 years. Ovarian and endometrial cancer are showing a rising trend in this age group. Cervical cancer was the second most common malignancy in this group and most of these patients presented at advanced stage. Therefore, recommendations to discontinue screening in older age groups must be viewed with caution.

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supporting

confidence: 92%

Gynecological disorders in geriatric women regarding their frequency, diagnosis and management in the state of Himachal Pradesh, India

Sood

Chandra

Dhiman

2017

Int J Reprod Contracept Obstet Gynecol

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“…When a mother has POP, the relative risk for the daughter of developing POP is 3.2. With a sister's positive medical history, this relative risk is 2.4 [9]. In combination with the finding that women with joint hypermobility have a significant higher prevalence of POP [10], it is hypothesised that a connective tissue factor is involved.…”

Section: Introductionmentioning

confidence: 99%

Changes in connective tissue in patients with pelvic organ prolapse—a review of the current literature

2008

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Little is known about the pathophysiology of pelvic organ prolapse (POP). In 1996, Jackson presented a hypothesis on pelvic floor connective tissue that tried to explain the development of POP on a molecular level. The objective of this review is to test the hypothesis against recent literature. The method used was a review of literature. The association between POP and connective tissue metabolism is well established. However, the causality of this association is unclear. The characteristics of the pelvic floor connective tissue of POP patients relate to tissue repair. To resolve the question of cause and effect, the role of fibroblasts in producing the extracellular matrix should be clarified. With these data, the use of autologous or allogenic stem cells in the treatment of POP may come in sight. Recent literature supports the hypothesis of Jackson but does not resolve long-standing questions on the aetiology of POP.

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“…This speculation can be further supported by the higher incidence of prolapse in women whose mother (3.2 times higher) or sister (2.4 times higher) presented this condition [9]. Higher incidence of prolapse has also been shown in patients with hip disorders [10].…”

Section: Introductionmentioning

confidence: 83%

“…Many of the recognized risk factors that lead to the appearance of POP are not always identifi ed in the group of patients suffering from it, therefore leading us to hypothesize the existence of a genetic predisposition or other factors arising from the connective tissue [4][5][6][7][8][9][10]. The later consists of elastin and collagen fi bers, components that play a vital role in the support mechanism of the tissues [13].…”

Section: Discussionmentioning

confidence: 99%

Distribution and immunoexpression of LOX, PCP and Myofi broblasts in Vaginal Tissue of Postmenopausal Women with and without Pelvic Organ Prolapse

Kleanthis¹,

Kondi-Pafiti²,

Liapis³

et al. 2017

J Gynecol Res Obstet

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Aim: of the study was to investigate the difference of distribution and expression of the lysyl oxidase enzymes (LOX), the pro-collagen C proteinase (PCP) and the myofi broblasts in the vaginal tissue of postmenopausal women, with and without prolapse. Materials and Methods:This was a prospective closely matched controlled clinicopathological study. Samples were obtained from the anterior vaginal wall of postmenopausal patients that underwent hysterectomy for benign conditions. The immunohistochemical study of the samples was performed on paraffi n embedded specimens with the semi-automatic Ventana method according to the manufacturer's instructions. We have also examined the correlation between prolapse and parity, age and body weight in the same population. Results:We have examined vaginal tissue from 44 postmenopausal patients: 21 with prolapse and 23 without (control group). LOX enzymes were observed in all samples, but they were strongly expressed only in the control group (P<0.005). Similarly PCP and myofi broblasts were positive in all tissues but no statistically important difference in their expression was observed between the two groups. Linear correlation between older age and higher parity with prolapse, was observed. There was no correlation between prolapse and body weight. Conclusion:LOX enzymes are strongly expressed in the vaginal tissue of postmenopausal women without prolapse and may play an important role in the pathophysiology of POP. There is no statististical difference in the expression of PCP and fi broblasts between the control group and the patients with prolapse. Higher parity and older age are associated with prolapse, but the same doesn't apply for higher body weight.

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Reproductive factors, family history, occupation and risk of urogenital prolapse

Cited by 175 publications

References 14 publications

Gynecological disorders in geriatric women regarding their frequency, diagnosis and management in the state of Himachal Pradesh, India

Gynecological disorders in geriatric women regarding their frequency, diagnosis and management in the state of Himachal Pradesh, India

Changes in connective tissue in patients with pelvic organ prolapse—a review of the current literature

Distribution and immunoexpression of LOX, PCP and Myofi broblasts in Vaginal Tissue of Postmenopausal Women with and without Pelvic Organ Prolapse

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