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Impact of preoperative pelvic floor muscle function on the success of surgical treatment of pelvic organ prolapse.
Szymanski, Jacek Krzysztof; Starzec-Proserpio, Malgorzata; Bartosinska-Raczkiewicz, Dorota; Krawczyk, Agata; Kukulski, Piotr; Jakiel, Grzegorz.
  • Szymanski JK; 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Zelazna 90 Str., 01-004, Warsaw, Poland. jkszymanski2@gmail.com.
  • Starzec-Proserpio M; Department of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland.
  • Bartosinska-Raczkiewicz D; Department of Medical Statistics, Centre of Postgraduate Medical Education, School of Public Health, Warsaw, Poland.
  • Krawczyk A; Department of Rehabilitation, Medical University of Warsaw, Warsaw, Poland.
  • Kukulski P; 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Zelazna 90 Str., 01-004, Warsaw, Poland.
  • Jakiel G; 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Zelazna 90 Str., 01-004, Warsaw, Poland.
Int Urogynecol J ; 35(1): 85-93, 2024 Jan.
Article en En | MEDLINE | ID: mdl-37819368
ABSTRACT
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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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Diafragma Pélvico / Prolapso de Órgano Pélvico Tipo de estudio: Observational_studies / Prognostic_studies Límite: Female / Humans Idioma: En Año: 2024 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Diafragma Pélvico / Prolapso de Órgano Pélvico Tipo de estudio: Observational_studies / Prognostic_studies Límite: Female / Humans Idioma: En Año: 2024 Tipo del documento: Article