- The main criteria for conducting surgical treatment of prolapse of pelvic organs and associated with it stress urinary incontinence
The main criteria for conducting surgical treatment of prolapse of pelvic organs and associated with it stress urinary incontinence
HEALTH OF WOMAN. 2017.8(124):40–43; doi 10.15574/HW.2017.124.40
Lulko A. O.
SI «Zaporozhye Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine»
The objective: is to determine the main criteria for the conduct of surgical treatment of prolapse of pelvic organs (POP) and associated with it stress urinary incontinence (SUI).
Patients and methods. 85 women were examined with with prolapse of pelvic organs (POP) and stress urinary incontinence (SUI). They were divided into the following groups: 2nd group – 32 patients with prolapse of pelvic organs 1–2 degrees of severity and incontinence 2a, 2b types, mild and moderate severity; 3rd group (primary) – 53 patients with prolapse of pelvic organs of 3–4 degrees of severity and SUI of type 3, moderate and severe severity. The main group included: 3a group – 28 women with prolapse of pelvic organs 3–4 degrees of severity and with SUI 3 type, moderate and severe severity, without delay with urination; 3b group – 25 women with prolapse of pelvic organs 3–4 degrees of severity and with SUI 3 type, moderate and severe severity, with urinary retention (chronic or acute). The control group (group 1) consisted of 15 women without urologic and gynecological pathology. Methods: clinical-anamnestic, instrumental, radiographic, statistical.
Results. It was determined that in patients with SUI there are changes in the posterior urethro-vesic angle (PUVU), bladder vesication, signs of connective tissue dysplasia (CTD), and obesity.
Conclusions. The combination of such criteria as an increase in the PUVU greater than 114° and the vesiculation of bladder type 2a and above is the main criterion for conducting an operative intervention.
Key words: prolapse of pelvic organs, stress urinary incontinence, diagnostics.
1. Bezhenar VF, BogatyirYova EV, Pavlova NG, red. Aylamazyan EK. 2010. Prolaps tazovyih organov u zhenschin: etiologiya, patogenez, printsipyi diagnostiki. Prolapse of pelvic organs in women: etiology, pathogenesis, principles of diagnosis. Posobie dlya vrachey: 48.
2. Bai SW, Choe BH, Kim JY, Park KH. 2002. Pelvic organ prolapse and connective tissue abnormalitirs in Korean women. J. Reprod Med. 47(3): 231− 234. PMid:11933689
3. Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A. 2002. Pelvic organ prolapse in the Women’s Health Initiative: gravity and gravidit. Am J Obstet Gynecol. 186:1160–1166. https://doi.org/10.1067/mob.2002.123819; PMid:12066091
4. Paul Abrams, Linda Cardozo, Saad Khoury, Alan Wein. 2013. Incontinence: Fifth Edition: 1880.
5. Radzinskiy VE, Shalaev ON, Durandin YuM, Semyatov SM, Toktar LR, Salimova LYa. 2008. Perineologiya. Opuschenie i vyipadenie polovyih organov. Perineology. Prolapse of genital organs. Uchebnoe posobie: 256.
6. Korshunov MYu, Sazyikina EI. 2008. Oprosnik PD-KZh – validirovannyiy sposob otsenki simptomov disfunktsiy tazovogo dna i kachestva zhizni u patsientok s prolapsom tazovyih organov. The PD-QL questionnaire is a validated way of valuation of the symptoms of pelvic floor dysfunction and quality of life in patients with pelvic prolapse. Zhurnal akusherstva i zhenskih bolezney 57 (3):86–93.
7. Smolnova TYu, Buyanova SN, Savelev SV. 2003. Fenotipicheskiy simptomokompleks displazii soedinitelnoy tkani u zhenschin. Phenotypic complex of symptoms of connective tissue dysplasia in women. Klinicheskaya meditsina 81(8):42-48.
8. Nevrologiya. Natsionalnoe rukovodstvo. Kratkoe izdanie. Neurology. National leadership. Short Edition. pod red. EI Guseva, AN Konovalova, AB Geht. 2016: 688.
9. Ginekologiya: natsionalnoe rukovodstvo. Gynecology: national leadership. pod obsch. red. Savelevoy GM, Suhih GT, Serova VN, Manuhina IB, Radzinskogo VE. 2017: 1048.