Symptoms of voiding dysfunction and other coexisting pelvic floor dysfunctions: the impact of transvaginal, mesh-augmented sacrospinous ligament fixation

Himmler, M; Köhl, Martin; Rakhimbayeva, Aidana; Witczak, Magdalena; Yassouridis, Alexander; Liedl, Bernhard

doi:10.1007/s00192-020-04649-y

Cited by 10 publications

(10 citation statements)

References 18 publications

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“…Ramanah et al 25 found that the improved effect of urinary symptoms on routine life had independent associations with SSLF. Significant improvement in items 11–16 and 31 in the PFDI questionnaire at 2 years after SSLF was identified in a study by Himmler et al 26 Our results also showed a significant improvement at the 3‐year follow up after SSLF according to PFDI‐20; further analysis showed improvement with urinary symptoms and prolapse symptoms. A possible explanation was that POP induced an inability of adequate bladder neck opening and then caused obstructive micturition 27 ; effective POP surgery could improve or even cure these symptoms directly or indirectly associated with POP.…”

Section: Discussionsupporting

confidence: 83%

“…Ramanah et al 25 found that the improved effect of urinary symptoms on routine life had independent associations with SSLF. Significant improvement in items 11-16 and 31 in the PFDI questionnaire at 2 years after SSLF was identified in a study by Himmler et al 26 Our results also showed a significant improvement at the 3-year follow up after SSLF according to PFDI-20;…”

Section: Ta B L Esupporting

confidence: 84%

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Results of sacrospinous ligament fixation using conventional instruments for symptomatic stage 2 and 3 apical prolapse over 3 years

Ren

Zhang

Tian

et al. 2023

Intl J Gynecology & Obste

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Objective To evaluate the long‐term efficacy and quality of life concerning sacrospinous ligament fixation (SSLF) using conventional instruments for Chinese women with symptomatic stage 2 and 3 apical prolapse. Methods This single‐arm prospective cohort study was conducted at our hospital between October 2011 and December 2018. Eligible participants were followed up over 3 years after surgery. The primary surgical outcome was composite surgical failure. Secondary outcomes included rate of satisfaction, quality of life (QoL) scores, and long‐term complications. Results Fifty‐nine patients were enrolled (mean age 57.1 years), of whom 55 (93.22%) completed the 3‐year follow up. At year 3, the composite failure rate was 21.34% (95% confidence interval [CI] 9.30%–31.79%), and satisfaction rate was 81.40% (95% CI 66.09%–91.08%). Right thigh pain and de novo dyspareunia occurred in 1.8% and 14.6% patients after year 1, respectively, but at year 3 there were no complications. Lower urinary tract symptoms were present in 5.5% of patients. Improvement was found in urinary symptoms and prolapse symptoms, but sexual function showed no significant change. Conclusions Compared with results at year 1, complication rates of SSLF decreased at year 3. The composite failure rate was relatively low and satisfaction rate was relatively high at year 3. Prolapse and urinary symptoms improved significantly after surgery.

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Section: Discussionsupporting

confidence: 83%

Section: Ta B L Esupporting

confidence: 84%

Results of sacrospinous ligament fixation using conventional instruments for symptomatic stage 2 and 3 apical prolapse over 3 years

Ren

Zhang

Tian

et al. 2023

Intl J Gynecology & Obste

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“…Strengthening the USL, if possible, non-surgically ( 7 ), or surgically ( 15 , 17 - 20 ), can cure or improve UAB symptoms, presumably by restoring the contractile power of LP/LMA which contract against the USLs. The LP/LMA now more easily opens out the posterior urethral wall to reduce resistance to urine flow by bladder contraction.…”

Section: Surgical and Non-surgical Treatment Of Non-iatrogenic Urinar...mentioning

confidence: 99%

“…In urodynamically validated surgical studies, Goeschen et al ( 18 ), Petros ( 15 , 17 ), and Himmler et al ( 20 ) followed PFS protocols for diagnosis and surgery to repair USL laxity, using posterior slings. All reported high surgical cure rates for the PFS conditions ( Figure 1 , red rectangle).…”

Section: Surgical and Non-surgical Treatment Of Non-iatrogenic Urinar...mentioning

confidence: 99%

Underactive bladder, Fowler’s syndrome are potentially curable by uterosacral ligament repair

Wenk,

Bush,

Swash

et al. 2024

Ann Transl Med

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Underactive bladder (UAB) is essentially an inability of the bladder to properly empty. UAB symptoms, when they co-occur with posterior fornix syndrome (PFS) symptoms (urge, frequency, nocturia, chronic pelvic pain), can be cured/improved, surgically by uterosacral ligament (USL) repair, non-surgically, by devices which give mechanical support of the USLs or strengthening pelvic muscle and ligaments with squatting-based exercises. The pathogenic pathway from weak USLs to UAB (and PFS) is that, when the muscles which externally open the posterior wall of the urethra contract against lax USLs, their contractile force weakens, and they cannot open the urethra adequately. The detrusor then contracts against a relatively unopened urethra to cause obstructive symptoms (i.e., UAB) such as slow stream, intermittent stream (stopping and starting), hesitancy (difficulty starting), feeling of incomplete emptying, and post-micturition dribble. Co-occurrence of PFS symptoms indicates that UAB may be part of the PFS, with USL causation, which can be tested by a tampon or probe in the posterior fornix. If the emptying (and other) PFS symptoms improve, it is a sign that UAB, and Fowler’s syndrome (FS) can potentially be cured or improved by USL repair. Following USL repair, many studies have recorded very significant improvement in emptying symptoms, and objective tests, for example, postvoid residual (PVR), decreased natural bladder volume, and decreased emptying time. FS and UAB are most likely a part of the PFS and, therefore, potentially curable by USL repair.

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“…Female pelvic floor dysfunction (FPFD) mainly refers to the patient's pelvic floor support failure or loss due to childbirth, which leads to vaginal relaxation, stress urinary incontinence (SUI), and pelvic organ prolapse (POP), decreased sexual activity, and mental depression and other clinical symptoms [1]. Pelvic floor dysfunction can cause great harm to patients [2,3]. If nursing care is not resumed in time, it is easy to cause other complications, which will seriously affect the physical health, psychological status and daily life of patients.…”

Section: Introductionmentioning

confidence: 99%

The Value of Postpartum Pelvic Floor Rehabilitation Nursing to Prevent Pelvic Floor Dysfunction

Li¹,

Baohua²,

Huang³

2021

JGO

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Female pelvic floor dysfunctions are the most common diseases after pregnancy. Vaginal relaxation, stress urinary incontinence (SUI), and pelvic organ prolapse (POP), decreased sexual activity, and mental depression and other clinical symptoms, are the most normal results of childbirth which leading to cause various problems for the mother. We aim to explore the clinical situation and effect of postpartum pelvic floor rehabilitation nursing for patients with postpartum pelvic floor dysfunction. In this study, 100 patients with postpartum pelvic floor dysfunction randomly selected from January 2018 to December 2019. They were randomly divided into two groups for nursing care, including control group and observation group. The control group received routine care, and the observation group received postpartum pelvic floor rehabilitation care. We carry out comparison of the clinical nursing effects of the two groups. After analysis and statistics, the total clinical effectiveness (94.0%) and nursing satisfaction (92.0%) of the observation group were significantly higher than those of the control group (80.0%, 72.0%), and the differences between the groups were significant (P<0.05). In conclusion, implementing pelvic floor rehabilitation nursing for patients with postpartum pelvic floor dysfunction can better promote the rehabilitation of patients' pelvic floor function, improve clinical effects and nursing satisfaction.

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Symptoms of voiding dysfunction and other coexisting pelvic floor dysfunctions: the impact of transvaginal, mesh-augmented sacrospinous ligament fixation

Cited by 10 publications

References 18 publications

Results of sacrospinous ligament fixation using conventional instruments for symptomatic stage 2 and 3 apical prolapse over 3 years

Results of sacrospinous ligament fixation using conventional instruments for symptomatic stage 2 and 3 apical prolapse over 3 years

Underactive bladder, Fowler’s syndrome are potentially curable by uterosacral ligament repair

The Value of Postpartum Pelvic Floor Rehabilitation Nursing to Prevent Pelvic Floor Dysfunction

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