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Exosomes from umbilical cord mesenchymal stromal cells promote the collagen production of fibroblasts from pelvic organ prolapse
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作者 Lei-Mei Xu Xin-Xin Yu +1 位作者 Ning Zhang Yi-Song Chen 《World Journal of Stem Cells》 SCIE 2024年第6期708-727,共20页
BACKGROUND Pelvic organ prolapse(POP)involves pelvic organ herniation into the vagina due to pelvic floor tissue laxity,and vaginal structure is an essential factor.In POP,the vaginal walls exhibit abnormal collagen d... BACKGROUND Pelvic organ prolapse(POP)involves pelvic organ herniation into the vagina due to pelvic floor tissue laxity,and vaginal structure is an essential factor.In POP,the vaginal walls exhibit abnormal collagen distribution and decreased fibroblast levels and functions.The intricate etiology of POP and the prohibition of trans-vaginal meshes in pelvic reconstruction surgery present challenges in targeted therapy development.Human umbilical cord mesenchymal stromal cells(hucMSCs)present limitations,but their exosomes(hucMSC-Exo)are promising therapeutic tools for promoting fibroblast proliferation and extracellular matrix remodeling.suppressed inflammation in POP group fibroblasts,stimulated primary fibroblast growth,and elevated collagen I(Col1)production in vitro.High-throughput RNA-seq of fibroblasts treated with hucMSC-Exo and miRNA sequencing of hucMSC-Exo revealed that abundant exosomal miRNAs downregulated matrix metalloproteinase 11(MMP11)expression.CONCLUSION HucMSC-Exo normalized the growth and function of primary fibroblasts from patients with POP by promoting cell growth and Col1 expression in vitro.Abundant miRNAs in hucMSC-Exo targeted and downregulated MMP11 expression.HucMSC-Exo-based therapy may be ideal for safely and effectively treating POP. 展开更多
关键词 pelvic organ prolapse EXOSOMES FIBROBLASTS Human umbilical cord mesenchymal stromal cells Extracellular matrix Collagen I
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Clinically significant changes in anal sphincter hiatal area in patients with gestational diabetes mellitus and pelvic organ prolapse
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作者 Qing-Hong Wang Li-Hua Liu +3 位作者 Hua Ying Ming-Xu Chen Chang-Jiang Zhou Hui Li 《World Journal of Diabetes》 SCIE 2024年第8期1726-1733,共8页
BACKGROUND The prevalence of pelvic organ prolapse(POP)increases with age and parity.Specifically,the prevalence of POP among women aged 20 to 39 is 9.7%,while it rises to 49%among women over 80 years old.Additionally... BACKGROUND The prevalence of pelvic organ prolapse(POP)increases with age and parity.Specifically,the prevalence of POP among women aged 20 to 39 is 9.7%,while it rises to 49%among women over 80 years old.Additionally,as the number of deliveries increases,the prevalence of POP also rises accordingly,with a rate of 12.8%for women with one delivery history,18.7%for those with two deliveries,and 24.6%for women with three or more deliveries.It causes immense suffering for pregnant women.AIM To evaluate the relationship between the levator ani muscle’s hiatus(LH)area and POP in patients with gestational diabetes mellitus(GDM)using perineal ultrasound.METHODS The study cohort comprised 104 patients aged 29.8±3.7 years who sought medical care at our institution between January 2021 and June 2023.All were singleton pregnancies consisting of 75 primiparas and 29 multiparas,with an average parity of 1.7±0.5.According to the POP diagnostic criteria,the 104 subjects were divided into two groups with 52 members each:POP group(patients with GDM combined with POP)and non-POP group(patients with GDM without POP).Perineal ultrasound was used to measure differences in the anteroposterior diameter,transverse diameter,and LH area.Receiver operating characteristic curves were drawn to determine the optimal cutoff values for the LH anteroposterior diameter,transverse diameter,and area for diagnosing POP.RESULTS Statistically significant increase in the LH area,anteroposterior diameter,and lateral diameter were observed in the POP group compared with the non-POP group(P<0.05).Both groups exhibited markedly elevated incidence rates of macrosomia and stress urinary incontinence.For the POP group,the area under the curve(AUC)for the LH area was 0.906 with a 95%confidence interval(CI):0.824-0.988.The optimal cutoff was 13.54cm²,demonstrating a sensitivity of 83.2%and a specificity of 64.4%.The AUC for the anteroposterior diameter reached 0.836 with a 95%CI:0.729-0.943.The optimal cutoff was 5.53 cm with a sensitivity of 64.2%and a specificity of 73.4%.For the lateral diameter,its AUC was 0.568 with a 95%CI:0.407-0.729.The optimal cutoff was 4.67 cm,displaying a sensitivity of 65.9%and a specificity of 69.3%.Logistic regression analysis unveiled that age,body weight,number of childbirths,total number of pregnancies,and gestational weight gain constituted the independent risk factors for the cooccurrence of GDM and POP.CONCLUSION Three-dimensional perineal ultrasonography of LH size and shape changes can effectively diagnose POP.Age,weight,number of births,number of pregnancies,and weight gain during pregnancy are independent risk factors affecting the cooccurrence of GDM and POP.GDM can increase the LH area in patients,and an enlarged LH leads to an increased incidence of POP. 展开更多
关键词 ULTRASOUND Levator ani muscle hiatus Gestational diabetes mellitus pelvic organ prolapse
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Evaluation of the Clinical Advantages of Laparoscopic Transverse Abdominal Wall Suspension in the Treatment of Pelvic Organ Prolapse
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作者 Chao Wang Shuo Feng 《Journal of Clinical and Nursing Research》 2024年第4期197-202,共6页
Objective:To evaluate the clinical advantages of laparoscopic transverse abdominal wall suspension in treating pelvic organ prolapse.Methods:Sixty patients diagnosed with moderate to severe pelvic organ prolapse and u... Objective:To evaluate the clinical advantages of laparoscopic transverse abdominal wall suspension in treating pelvic organ prolapse.Methods:Sixty patients diagnosed with moderate to severe pelvic organ prolapse and underwent surgical treatment in our hospital between January 2022 and December 2023 were selected.According to different surgical methods,they were divided into an observation group(given laparoscopic transverse abdominal wall suspension)and a control group(given transvaginal mesh implantation),with 30 subjects/group.The data on perioperative-related indicators,quality of life scores,postoperative recurrence,and complications of the two groups of patients were collected.Results:The postoperative hospitalization days and intraoperative bleeding volume of the observation group were significantly lower than those of the control group,but had longer operation time than that of the control group(P<0.05).The differences between the two groups were statistically significant 6 months after surgery,and the Pelvic Floor Disease Quality of Life Impact Questionnaire(PFIQ-7)score of the observation group was significantly higher than the control group(P<0.05).Both groups of patients completed 12 months of follow-up without any postoperative recurrence.The number of complications in the observation group was slightly lower than that of the control group(P>0.05).Conclusion:Laparoscopic transverse abdominal wall suspension was more effective in treating pelvic organ prolapse and is an ideal surgical procedure. 展开更多
关键词 pelvic organ prolapse Laparoscopic transverse abdominal wall suspension Clinical advantages
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New native tissue repair for pelvic organ prolapse:Medium-term outcomes of laparoscopic vaginal stump-round ligament fixation 被引量:1
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作者 Toshiyuki Kakinuma Ayaka Kaneko +3 位作者 Kaoru Kakinuma Ken Imai Nobuhiro Takeshima Michitaka Ohwada 《World Journal of Clinical Cases》 SCIE 2023年第15期3457-3463,共7页
BACKGROUND Laparoscopic sacrocolpopexy for pelvic organ prolapse(POP)is a new and widely used approach;however,ever since the United States Food and Drug Administration warned against the use of surgical mesh,repairs ... BACKGROUND Laparoscopic sacrocolpopexy for pelvic organ prolapse(POP)is a new and widely used approach;however,ever since the United States Food and Drug Administration warned against the use of surgical mesh,repairs performed using patients’tissues[i.e.native tissue repair(NTR)]instead of mesh have attracted much attention.At our hospital,laparoscopic sacrocolpopexy(the Shull method)was introduced in 2017.However,patients with more severe POP who have a long vaginal canal and overextended uterosacral ligaments may not be candidates for this procedure.AIM To validate a new NTR treatment for POP,we examined patients undergoing laparoscopic vaginal stump–round ligament fixation(the Kakinuma method).METHODS The study patients were 30 individuals with POP who underwent surgery using the Kakinuma method between January 2020 and December 2021 and who were followed up for>12 mo after surgery.We retrospectively examined surgical outcomes for surgery duration,blood loss,intraoperative complications,and incidence of recurrence.The Kakinuma method involves round ligament suturing and fixation on both sides,effectively lifting the vaginal stump after laparoscopic hysterectomy.RESULTS The patients’mean age was 66.5±9.1(45-82)years,gravidity was 3.1±1.4(2-7),parity was 2.5±0.6(2-4)times,and body mass index was 24.5±3.3(20.9-32.8)kg/m2.According to the POP quantification stage classification,there were 8 patients with stage Ⅱ,11 with stage Ⅲ,and 11 with stage Ⅳ.The mean surgery duration was 113.4±22.6(88-148)min,and the mean blood loss was 26.5±39.7(10-150)mL.There were no perioperative complications.None of the patients exhibited reduced activities of daily living or cognitive impairment after hospital discharge.No cases of POP recurrence were observed 12 mo after the operation.CONCLUSION The Kakinuma method,similar to conventional NTR,may be an effective treatment for POP. 展开更多
关键词 pelvic organ prolapse Native tissue repair Laparoscopic surgery Round ligament Kakinuma method
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Medium-term outcomes of laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with posterior approach for a pelvic organ prolapse:A retrospective study of 124 cases
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作者 Yunshan Zhu Xiao Zhang +4 位作者 Danxia Chen Guangxiao Li Shanliang Shang Jianqiong Li Jianhua Yang 《Laparoscopic, Endoscopic and Robotic Surgery》 2023年第4期154-159,共6页
Objective:Pelvic organ prolapse(POP)is a common gynecological disease in middle-aged and older women that seriously affects patients'physical health and quality of life,increases the financial burden for patients,... Objective:Pelvic organ prolapse(POP)is a common gynecological disease in middle-aged and older women that seriously affects patients'physical health and quality of life,increases the financial burden for patients,and becomes a major public health concern.The aim of this study was to investigate the medium-term outcomes of laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach for patients with severe POP.Methods:Patients with severe POP quantitation stage III-IV who underwent laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach at the Department of Obstetrics and Gynecology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine between September 2016 and December 2020 were enrolled in this study.The results and complications were recorded.Data were retrospectively reviewed.Results:In total,124 patients were analyzed.Patients were followed up for 32.2712.90 months.The objective cure rate for patients who underwent hysterectomy was 917%(100/109),with 7(6.4%)patients had anterior vaginal wall prolapse and 2(1.8%)patients had posterior vaginal wall prolapse.The objective cure rate for patients who retained uterus was 66.7%(10/15).All 5 patients with recurrence had uterine prolapse,and 3(20.0%)of them also had anterior vaginal wall prolapse.Conchusions:Laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with the posterior approach is a safe,minimally invasive,and effective method for patients with severe POP.Long-term follow-up is needed to confirm the clinical effects. 展开更多
关键词 pelvic organ prolapse LAPAROSCOPY Pubocervical fascia reconstruction Sacrospinous ligament fixation
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Pelvic Organs Prolapse in Low-Resources Countries: Epidemiology, Risk Factors, Quality of Life. Narrative Review
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作者 Eloge Ilunga-Mbaya Dénis Mukwege +3 位作者 Prosper Lukusa Tshilobo Kenny Raha Maroyi Rahma Rashid Tozin Dieudonné Sengeyi Mushengezi 《Open Journal of Urology》 2023年第7期238-250,共13页
Objective: Pelvic organ prolapse is an emerging public health problem affecting adult women of all ages with a negative impact on social, physical well-being, and psychological. Its presents several challenges in coun... Objective: Pelvic organ prolapse is an emerging public health problem affecting adult women of all ages with a negative impact on social, physical well-being, and psychological. Its presents several challenges in countries with low resources. This literature review aims to examine POP in its epidemiological aspects, risk factors, and staging by taking up the challenges associated with low-resource settings and identifying some avenues for future research. Methods: We searched the PubMed, Google Scholar, and Scopus databases. The other studies were identified by checking the secondary references in the original citation. We have collected studies on adult women published in English for the last 30 years. In total, 71 articles were read. We excluded studies from all newspaper articles, Studies presenting co-morbidities (fistulas, cervical cancer, pregnancy), those evaluating treatment, letters, comments, case reports, practice guidelines, news, historical articles, legal cases, published erratum, and congresses. Results: 16 studies examining the epidemiology have been identified with 11 in countries defined by the World Bank as limited or intermediate resources. 18 on risk factors whose 10 in countries with limited or intermediate resources, 10 on staging and 27 on physiopathology. Conclusion: POP affects the young more in low-resource settings. Its prevalence remains underestimated for several reasons. Several risk factors found are the same as those of women in countries with a high standard of living. However, there are some specific risk factors for these resource-limited settings. 展开更多
关键词 EPIDEMIOLOGY Low Resources-Countries pelvic organs prolapse Risk Factors
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Plasma Levels of Transforming Growth Factor-Beta 1 in Women with Pelvic Organ Prolapse
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作者 Kimio Sugaya Katsumi Kadekawa +2 位作者 Katsuhiro Ashitomi Saori Nishijima Seiji Matsumoto 《Open Journal of Urology》 2023年第5期133-142,共10页
Objective: In women with pelvic organ prolapse (POP), decreased expression of transforming growth factor-beta 1 (TGF-β1) has been shown in POP tissues. However, no studies have evaluated plasma TGF-β1 levels in pati... Objective: In women with pelvic organ prolapse (POP), decreased expression of transforming growth factor-beta 1 (TGF-β1) has been shown in POP tissues. However, no studies have evaluated plasma TGF-β1 levels in patients with POP, so it is unknown whether they are also changed or not. Therefore, we compared plasma TGF-β1 levels in women with and without POP. Methods: Participants were 49 women with POP and 23 healthy control women. All participants were postmenopausal. We measured plasma TGF-β1 and compared data between patients with POP and controls, and between patients with uterine prolapse (UP, n = 19) and those with a cystocele (CC, n = 30). In addition, in patients, we assessed the POP quantification system (POP-Q) stage. Results: Plasma TGF-β1 levels were significantly lower in patients than in healthy controls. POP-Q stage was not significantly different between the UP and CC subgroups, but POP-Q stage IV was diagnosed in 63% of patients with UP and 7% of those with CC. Plasma TGF-β1 levels were significantly lower in the CC subgroup than in the UP subgroup. Conclusion: Plasma TGF-β1 is decreased in POP. It remains unclear whether the lower levels indicate a reduction in systemic TGF-β1 activity, but they can be assumed to reflect reduced TGF-β1 expression in POP tissues. 展开更多
关键词 CYSTOCELE pelvic organ prolapse Transforming Growth Factor-Beta 1 (TGF-β1) Uterine prolapse
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Endometrial mesenchymal stem cells as a cell based therapy for pelvic organ prolapse 被引量:11
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作者 Stuart J Emmerson Caroline E Gargett 《World Journal of Stem Cells》 SCIE CAS 2016年第5期202-215,共14页
Pelvic organ prolapse(POP) occurs when the pelvic organs(bladder, bowel or uterus) herniate into the vagina, causing incontinence, voiding, bowel and sexual dysfunction, negatively impacting upon a woman's quality... Pelvic organ prolapse(POP) occurs when the pelvic organs(bladder, bowel or uterus) herniate into the vagina, causing incontinence, voiding, bowel and sexual dysfunction, negatively impacting upon a woman's quality of life. POP affects 25% of all women and results from childbirth injury. For 19% of all women, surgical reconstructive surgery is required for treatment, often augmented with surgical mesh. The surgical treatment fails in up to 30% of cases or results in adverse effects, such as pain and mesh erosion into the bladder, bowel or vagina. Due to these complications the Food and Drug Administration cautioned against the use of vaginal mesh and several major brands have been recently been withdrawn from market. In this review we will discuss new cell-based approaches being developed for the treatment of POP. Several cell types have been investigated in animal models, including a new source of mesenchymal stem/stromal cells(MSC) derived from human endometrium. The unique characteristics of endometrial MSC, methods for their isolation and purification and steps towards their development for good manufacturing practice production will be described. Animal models that could be used to examine the potential for this approach will also be discussed as will a rodent model showing promise in developing an endometrial MSC-based therapy for POP. The development of a preclinical large animal model for assessing tissue engineering constructs for treating POP will also be mentioned. 展开更多
关键词 ENDOMETRIUM MESENCHYMAL STEM CELLS ENDOMETRIAL MESENCHYMAL STEM CELLS pelvic organ prolapse Mesh Tissue engineering Regenerative medicine
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Tailor-Made Mesh for Pelvic Organ Prolapses: Correlation between Patient’s Height and Mesh Size 被引量:2
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作者 Hideki Kobayashi Yaburu Haneda +3 位作者 Satoru Kira Takayuki Tsuchida Isao Araki Masayuki Takeda 《Open Journal of Urology》 2013年第2期121-123,共3页
Tension-free vaginal mesh (TVM) surgery is a common and minimally invasive procedure for pelvic organ prolapses. Since commercial kits are not readily available in Japan, we have planned tailor-made mesh by informatio... Tension-free vaginal mesh (TVM) surgery is a common and minimally invasive procedure for pelvic organ prolapses. Since commercial kits are not readily available in Japan, we have planned tailor-made mesh by information of each patient before every TVM surgery. The aim of this report is to inform methods to design mesh for individual patients with pelvic organ prolapses. We also investigated the correlations among mesh size and height, weight, and body mass index (BMI). Before the operation, we obtained a KUB (abdominal X-ray). Three factors were measured from this X-ray: the first was the distance between the bilateral ischial spine, the second was the distance between the obturator foramen, and the third was the length of the arcus tendineus fascia pelvis (ATFP). These three factors always should be considered for designing of mesh. The correlations among the bilateral ischial spine distance, obturator foramen distance, ATFP length, height, weight, and BMI were assessed using the Pearson correlation coefficient. Although these three factors described above are necessary to design a mesh for individual patients, the bilateral ischial spine and obturator foramen distance correlated with the height of the patient. On the other hand, since the length of ATFP differs in each patient and is not correlated with height, we should consider this length when we design the mesh. Well-designed, tailor-made mesh will probably fit each pelvic organ prolapsed patient very well. 展开更多
关键词 pelvic organ prolapses SURGERY Tension Free VAGINAL MESH Tailor-Made MESH MESH Size
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Prevalence of Female Sexual Dysfunction among Women with Pelvic Organ Prolapse Diagnosed by Pisq-12 and Related Factors in Hung Vuong Hospital, Vietnam 被引量:1
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作者 Huynh Nguyen Khanh Trang Pham Hung Cuong Hoang Thi Diem Tuyet 《Open Journal of Obstetrics and Gynecology》 2019年第7期1005-1018,共14页
Pelvic organ prolapsed is a common problem today, and it has been gradually increasing because of the longevity of women. Pelvic organ prolapse can result in negative psychological feelings that affect on women’s sex... Pelvic organ prolapsed is a common problem today, and it has been gradually increasing because of the longevity of women. Pelvic organ prolapse can result in negative psychological feelings that affect on women’s sexual activity. Methods: There is a cross-sectional study on sexual dysfunction in 296 women with pelvic organ prolapse grade II and III followed up at gynecological-pelvic floor unit of Hung Vuong hospital from 09/2017 to 06/2018. Results: The prevalence of female sexual dysfunction in PISQ-12 was 76.4% and 95% CI [71.6 - 81.2]. The rate of female sexual dysfunction in turn is: 1) Behavioral-Emotional: 93.6% 95% CI [90.8 - 96.4]. 2) Physiology: 62.2% CI 95% [56.7 - 67.7]. 3) Relationship to partner: 89.5% 95% CI [86.0 - 93.0]. Factor related to sexual dysfunction in women with pelvic organs (p < 0.05) is general sexual dysfunction: 1) Age group: women over age 55 increased generally the risk of sexual dysfunction, OR = 5.89, 95% CI [1.38 - 25.20]. 2) Diabetes mellitus increased the risk of sexual dysfunction with OR = 5.03, 95% CI [1.42 - 17.82]. 3) Patients with previous abortions reduced the risk of sexual dysfunction with OR = 0.49 95% CI [0.27 - 0.90]. Conclusion: Research on quality of life in pelvic organ prolapse should be considered more in the future. 展开更多
关键词 pelvic organ prolapse Sexual Dysfunction pelvic organ prolapse Quantification System (pop-Q) pelvic organ prolapse/Urinary INCONTINENCE Sexual Function Questionnaire-12 (PISQ-12)
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Current Situation of Transvaginal Mesh Repair for Pelvic Organ Prolapse 被引量:1
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作者 Lan Zhu Lei Zhang 《Chinese Medical Sciences Journal》 CAS CSCD 2014年第3期188-190,共3页
SURGICAL mesh is a metallic or polymeric screen intended to be implanted to reinforce soft tissue or bone where weakness exists. Surgical mesh has been used since the 1950s to repairabdominal hernias. In the using sur... SURGICAL mesh is a metallic or polymeric screen intended to be implanted to reinforce soft tissue or bone where weakness exists. Surgical mesh has been used since the 1950s to repairabdominal hernias. In the using surgical mesh products 1970s, gynecologists began to indicate the repair of pelvic organ prolapse (POP), and in the 1990s, gynecologists began using surgical mesh for POP. Then the U.S. Food andDrug Administration (FDA) approved the first surgical mesh product specifically for use in POP. 展开更多
关键词 pelvic organ prolapse vaginal mesh COMPLICATION
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The role of lysyl oxidase-like 1 and fibulin-5 in the development of atherosclerosis and pelvic organ prolapse 被引量:4
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作者 Fabrizio Dal Moro 《The Journal of Biomedical Research》 CAS 2013年第3期242-242,共1页
Dear Editor: I would like to congratulate Zhou et al.[1] on their study of the correlation between expression of lysyl oxidase-like 1 (LOX-1) and fibulin-5 (F5) in the car- dinal ligament tissue and pelvic organ ... Dear Editor: I would like to congratulate Zhou et al.[1] on their study of the correlation between expression of lysyl oxidase-like 1 (LOX-1) and fibulin-5 (F5) in the car- dinal ligament tissue and pelvic organ prolapse (POP). In their elegant work, they evaluated the levels of LOX-1 and F5 in connective tissue of the cardinal ligament in order to demonstrate signs of elastinopa- thy in women with POP. They stress the concept that several environmental risk factors could cause qualitative and quantitative changes in the connective tissue promoting POP. The above authors conclude that the specific mechanism of LOXL1 and F5 involved in the development of POP is unclear. 展开更多
关键词 The role of lysyl oxidase-like 1 and fibulin-5 in the development of atherosclerosis and pelvic organ prolapse
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Management of recto-vaginal fistulas after prosthetic reinforcement treatment for pelvic organ prolapse
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作者 Mehdi Ouassi Silvia Cresti +6 位作者 Urs Giger Igor Sielezneff Nicolas Pirrò Bruno Berthet Philippe Grandval Bernard Consentino Bernard Sastre 《World Journal of Gastroenterology》 SCIE CAS CSCD 2010年第24期3011-3015,共5页
AIM: To communicate our findings on successful treat-ment of recto-vaginal fistulas (RVFs) after prosthetic reinforcement surgery of pelvic organ prolapse (POP). METHODS: A retrospective single center study between 19... AIM: To communicate our findings on successful treat-ment of recto-vaginal fistulas (RVFs) after prosthetic reinforcement surgery of pelvic organ prolapse (POP). METHODS: A retrospective single center study between 1998 and 2008 was performed. A total of 80 patients with RVF were identified, of which five patients (6%), with a mean age of 65 years (range: 52-73), had undergone previous surgery for POP with pros-thetic reinforcement. RESULTS: All patients complained about ongoing vaginal infections and febrile episodes. These symptomswere reported after a mean period of 18 mo after POP repair. As a first intervention, three patients underwent ablation of the prosthetic material (PM). As a second intervention, open proctectomy with a primary anas-tomosis, an omental patch, and a protective ileostomy were performed in two patients. One patient required a terminal colostomy due to complete destruction of the anal sphincters. In two other patients, ablation of the PM and proctectomy was performed as a one-step procedure. The postoperative course in all patients was uneventful, with a mean length of hospitalization of 20 d (range: 15-30). Closure of the ileostomy was achieved in all four patients within four months. After a mean period of 35 mo (range: 4-60) of follow-up, no recurrence was observed with normal continence in four patients.CONCLUSION: In our experience, the definitive treat-ment of high RVFs after PM repair for POP necessitates ablation of the PM, proctectomy with a primary colo-rectal anastomosis, an omental patch interposition, and a temporary ileostomy. 展开更多
关键词 pelvic organ prolapse Recto-vaginal fistula Prosthetic treatment
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Severe Pelvic Organ Prolapse with Large Vaginal Mucosal Defect Underwent Laparoscopic Shull’s Uterosacral Ligament Colpo-Suspension and TVM Operation by Two Stage Surgery
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作者 Yasuyuki Kinjo Kazuaki Yoshimura +2 位作者 Hitomi Nakagawa Kazuaki Nishimura Toru Hachisuga 《Open Journal of Obstetrics and Gynecology》 2017年第4期395-399,共5页
A 75-year-old woman complained of anuria and a sense of discomfort with severe pelvic organ prolapse (POP). We planned tension-free vaginal mesh (TVM) surgery after curing mucosal defects and completing treatment for ... A 75-year-old woman complained of anuria and a sense of discomfort with severe pelvic organ prolapse (POP). We planned tension-free vaginal mesh (TVM) surgery after curing mucosal defects and completing treatment for diabetes mellitus. Anuria and pyelonephritis relapsed repeatedly due to the failure of ring pessary therapy. Surgical treatment was required emergently. We performed a total laparoscopic hysterectomy and uterosacral ligament colpo-suspension (Shull’s method). Although the vaginal apex was supported to a good position, cystocele occurred six months after the initial surgery. A TVM procedure for recurrent cystocele was performed after curing the mucosal defects, and after the improvement of glycemic control. Transvaginal native tissue repair has the advantages of low risk of ureter injury, firm colpo-suspension, and no need for mesh usage. On the other hand, it is not good at treating cystocele. Transvaginal native tissue repair should prove to be a useful surgical option for apical support without mesh. 展开更多
关键词 pelvic organ prolapse INTRAVAGINAL Mucosal DEFECT LAPAROSCOPIC Native Tissue Repair TRANSVAGINAL Mesh SURGERY
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Image based measurements for evaluation of pelvic organ prolapse
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作者 Sinan Onal Susana Lai-Yuen +2 位作者 Paul Bao Alfredo Weitzenfeld Stuart Hart 《Journal of Biomedical Science and Engineering》 2013年第1期45-55,共11页
Magnetic resonance imaging (MRI) measurements are essential for the diagnosis of pelvic organ prolapse given the inaccuracy of clinical examination. However, MRI pelvic floor measurements are currently performed manua... Magnetic resonance imaging (MRI) measurements are essential for the diagnosis of pelvic organ prolapse given the inaccuracy of clinical examination. However, MRI pelvic floor measurements are currently performed manually and can be inconsistent and time-consuming. In this paper, we present a scheme for semi-automatic measurement modeling on MRI based on image segmentation and intersecting point identification methods. The segmentation algorithm is a multi-stage mechanism based on block grouping, support vector machine classification, morphological operation and prior shape information. Block grouping is achieved by classifying blocks as bone or background based on image texture features. The classified blocks are then used to find the initial segmentation by the first phase morphological opening. Prior shape information is incorporated into the initial segmentation to obtain the final segmentation using registration with the similarity type transformation. After segmentation, points of reference that are used for pelvic floor measurements are identified using morphological skeleton operation. The experiments on the MRI images show that the presented scheme can detect the points of reference on the pelvic floor structure to determine the reference lines needed for the assessment of pelvic organ prolapse. This will lead towards more consistent and faster pelvic organ prolapse diagnosis on dynamic MRI studies, and possible screening procedures for predicting predisposition to pelvic organ prolapse by radiologic evaluation of pelvic floor measurements. 展开更多
关键词 pelvic organ prolapse pelvic FLOOR MEASUREMENTS MRI Statistical Pattern Recognition MORPHOLOGICAL Operations
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The Utility of Endovaginal Ultrasound in the Design of a Sacrospinous Ligament Anchoring Device in Patients with and without Pelvic Organ Prolapse
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作者 Jonia Alshiek Qi Wei +3 位作者 Lieschen H. Quiroz Mikio A. Nihira Menahem Neuman S. Abbas Shobeiri 《Open Journal of Obstetrics and Gynecology》 2019年第8期1103-1113,共11页
Objective: To determine whether endovaginal ultrasound is a reliable measure in visualization of the sacrospinous ligament among women with prolapse versus women without prolapse, and thus might be clinically applicab... Objective: To determine whether endovaginal ultrasound is a reliable measure in visualization of the sacrospinous ligament among women with prolapse versus women without prolapse, and thus might be clinically applicable in the design of an ultrasound-guided device for performing sacrospinous ligament anchor placement as a treatment for pelvic organ prolapse. Methods: In the first phase of this study we performed a sacrospinous anchor placement in four normal fresh-frozen female pelves. Afterwards, an endovaginal ultrasound was performed to visualize the anchor localization which was validated by dissection of the cadaveric pelves. In the second phase of the study: two groups of volunteer females with and without pelvic organ prolapsed (POP-group, vs NON-POP group) were evaluated by endovaginal ultrasound to localize the sacrospinous ligament. Results: Cadaveric dissection demonstrated accurate anchor placement into the 8/8 sacrospinous ligament. We performed endovaginal ultrasound in a total of 17 N-POP and 10 (POP) patients. Among the N-POP group, the right and left ischial spines were visible in 6/17 (35%) and (6/17) 35% vs 0/10 (0%) for both right and left sides in POP group (p = 0.008). The right sacrospinous ligament was visualized in 4/17 (23%) N-POP subjects and 0/10 POP subjects (p = 0.27) and the left sacrospinous ligament was visualized in 7/17 (41%) N-POP subjects and 2/10 POP subjects (p = 0.48). Conclusions: Sacrospinous ligament and the ischial spines couldn’t be reliably visualized among women with or without pelvic organ prolapse using endovaginal ultrasound, although the structures are visualized more in some of the non-prolapsed women. The sacrospinous anchoring device demonstrated accurate placement by cadaveric dissections. 展开更多
关键词 Sacrospinous LIGAMENT pelvic organ prolapse Endovaginal Ultrasound
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Prospective Evaluation of Outcomes of Mechanical Devices in Women with Symptomatic Pelvic Organ Prolapse in Ogbomoso, South-Western Nigeria
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作者 Akintunde Olusegun Fehintola Olufemi Timothy Awotunde +5 位作者 Olumuyiwa Ayotunde Ogunlaja Lawrence Olujire Olujide Samuel Eniola Akinola Sunday Adekunle Oladeji Babatola Bakare Olurotimi Idowu Aaron 《Open Journal of Obstetrics and Gynecology》 2021年第4期461-473,共13页
<strong>Background:</strong><span style="font-family:Verdana;"> Symptomatic pelvic organ prolapse (POP) impacts the sufferers</span><span style="font-family:Verdana;">... <strong>Background:</strong><span style="font-family:Verdana;"> Symptomatic pelvic organ prolapse (POP) impacts the sufferers</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;"> quality of life negatively. There is a preference for a mechanical device in certain conditions though the definitive management of POP is surgical</span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""> <b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:Verdana;">We conducted the study to evaluate the outcome of management of POP using mechanical devices.</span></span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">It was a prospective study. It took place in the gynecology unit of the Bowen University Teaching Hospital Ogbomoso between May 2014 and April 2019. We followed up </span><span style="font-family:Verdana;">with </span><span style="font-family:Verdana;">eligible patients who opted for pessary use for a median duration of 18 months (Range 12</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">84</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">months). We excluded those who refuse to participate in the study. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Of the</span><b> </b><span style="font-family:Verdana;">127 patients</span><b> </b><span style="font-family:Verdana;">with</span><b> </b><span style="font-family:Verdana;">symptomatic POP, seventy-five (59.1%) opted for the use of mechanical devices, and 70 successfully retained them four weeks after insertion. We lost Six (9.2%) patients to follow up. Of the 64 women included in the analysis, 16 (25%) discontinued use at some point after four weeks, whereas 36 (56.3%) used the pessary successfully throughout the follow-up period. Overall, 12.1% of the women experienced minor complications (6.9% pain or discomfort, 3.2% excoriation or bleeding, and 2.0% dis-impaction or constipation). After cessation of pessary use, 12 (25%) of the 48 women chose surgery, and 10 (20.8%) chose no further treatment. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">This study concluded that pessary use for pelvic organ prolapse is safe in low resource settings. Therefore, it is justifiable to offer pessaries in the initial management of uterovaginal prolapse to all patients who opt for conservative management and those awaiting surgery.</span></span> 展开更多
关键词 Mechanical Device Symptomatic pelvic organ prolapse COMPLICATIONS Dis-continuation
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Laparoscopic surgical repair of pelvic organ prolapse and female stress urinary incontinence
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作者 Panagiotis I Mourmouris Andreas Skolarikos +2 位作者 Iraklis C Mitsogiannis Vasileios Migdalis Athanasios G Papatsoris 《World Journal of Obstetrics and Gynecology》 2013年第3期47-52,共6页
Pelvic organ prolapse(POP) occurs in a relatively big population of women which is continuously increasing and is associated with a variety of urinary bowel and sexual symptoms. As this problem magnifi es, the need fo... Pelvic organ prolapse(POP) occurs in a relatively big population of women which is continuously increasing and is associated with a variety of urinary bowel and sexual symptoms. As this problem magnifi es, the need for surgical repair is increasing relatively. The main goals of surgical repair for POP include: no anatomic prolapse, no functional symptoms, patient satisfaction and avoidance of complications, goals that cannot always be fully achieved. The decision for the type of surgery depends of various factors such as patient characteristics and prolapsed compartment but also by the surgeon expertise. The laparoscopic approach is already the gold standard procedure for many urologic procedures and can also be used for the treatment of POP and stress urinary incontinence. Herein, we review the literature about the available data concerning laparoscopic surgery techniques for treating POP. 展开更多
关键词 pelvic organ prolapse LAPAROSCOPIC Minimal invasive REPAIR
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Surgical repair of pelvic organ prolapse and follow-up: An institutional multi-center experience
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作者 Sarah Gustapane Martina Leombroni +5 位作者 Eleonora Falò Alessandro Santarelli Franco Frondaroli Marco Liberati Emanuele Perrone Andrea Tinelli 《World Journal of Obstetrics and Gynecology》 2013年第4期176-180,共5页
AIM: To investigate the effects of the Elevate Anterior and Posterior transvaginal mesh procedure on 30 patients affected by pelvic organ prolapse(POP) at 12 mo follow-up.METHODS: Between September 2011 and September ... AIM: To investigate the effects of the Elevate Anterior and Posterior transvaginal mesh procedure on 30 patients affected by pelvic organ prolapse(POP) at 12 mo follow-up.METHODS: Between September 2011 and September 2012, a prospective multicenter observational study enrolled 30 consecutive patients with POP-Q ≥ stage Ⅱ. After a preoperative evaluation, patients underwent prolapse repair utilizing the Elevate Anterior and Posterior Prolapse Repair System(American Medical Systems, Minnetonka, MN, United States). Operative technique was standardized and performed by the same surgical team under spinal or general anesthesia. Patients were evaluated postoperatively at 1, 3, 6 and 12 mo.RESULTS: All 30 patients completed the 12 mo followup. The mean age was 65.3 years(range 49-81 years) and average hospital stay was 4.5 d. The mean operative time was 65 min(range 40-120 min). Related adverse events reported were mesh extrusions(6.7%) and post void residual urine volume(13.3%). There were no visceral injuries, no infection of the mesh, and no symptoms of recurrent prolapse. All quality-of-life scores signifi cantly improved from baseline. CONCLUSION: One year's follow-up of our 30 patients confi rms the safety and the effi cacy of the Elevate Anterior and Posterior transvaginal mesh procedure for POP treatment. Our fi nal results are comforting but longer term follow-up is ongoing. 展开更多
关键词 pelvic organ prolapse pelvic organ prolapse MESH Vaginal mesh erosion
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Inflammatory response, stress response and urodynamic changes after total pelvic floor reconstruction in patients with pelvic organ prolapse
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作者 Ying Zhang Xiao-Yun Liu 《Journal of Hainan Medical University》 2017年第23期54-57,共4页
Objective: To investigate the changes of inflammatory response, stress response and urodynamic changes after total pelvic floor reconstruction in patients with pelvic organ prolapse. Methods: According to random data ... Objective: To investigate the changes of inflammatory response, stress response and urodynamic changes after total pelvic floor reconstruction in patients with pelvic organ prolapse. Methods: According to random data table method, 80 cases of pelvic organ prolapse were randomly divided into the control group (n=40) and observation group (n=40), patients in the control group were given conventional vaginal hysterectomy plus vaginal wall repair sugery and the observation group received total pelvic floor reconstruction. The levels of the serum inflammatory factor,oxidative stress before and after surgery, and postoperative urodynamic changes were compared. Results: The levels of serum hs-CRP, IL-1β,TNF-α, NE, E and Ins in the two groups before treatment were not statistically significant. Compared with the group before treatment, the levels of hs-CRP, IL-1β, TNF-α, NE, E were significantly increased in both groups after treatment, and the observation group levels were significantly lower than those in the control group after treatment;in terms of urodynamics, the postoperative maximal bladder volume and Qmax were significantly higher in the observation group than in the control group, the postoperative levels of PdetQMax, PdetMax and PVR in the observation group were significantly lower than those in the control group. Conclusion: Compared with vaginal hysterectomy plus vaginal wall repair sugery, total pelvic floor reconstruction can light the patient's inflammation, stress response and improve the patient's urinary function, and the overall effect is better which has important clinical value. 展开更多
关键词 Total pelvic floor reconstruction pelvic organ prolapse INFLAMMATORY factor OXIDATIVE stress URODYNAMIC
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