Prevention and treatment of pelvic floor dysfunction (literature review)
https://doi.org/10.58708/2074-2088.2025-1(33)-22-28
Abstract
Treatment and prevention of pelvic floor dysfunction (PFD) depends on the degree of genital prolapse, possible conditions associated with it, the patient's age, her complaints and medical history. Symptomatic and complicated genital prolapse should be treated. Patients with PFD can be managed both conservatively and surgically. When selected correctly, the effectiveness of a pessary is 60-80%. Surgical interventions with or without mesh implants are strictly individual. The use of a mesh prosthesis has proven to be a more reliable method in relation to relapse of the disease. Preventive measures for PFD should be carried out at the initial stages of the disease, while the patient's motivation and lifestyle modifications are important.
About the Authors
O. V. Murashko
State Institution "Russian Scientific Research Center for Radiation Medicine and Human Ecology"
Belarus
Belarus
Gomel
A. S. Podgornaya
State Institution "Russian Scientific Research Center for Radiation Medicine and Human Ecology"
Belarus
Belarus
Gomel
A. Yu. Zakharko
State Institution "Russian Scientific Research Center for Radiation Medicine and Human Ecology"
Belarus
Belarus
Gomel
References
1. Self-Reported Vaginal Laxity-Prevalence, Impact, and Associated Symptoms in Women [Attending a Urogynecology Clinic] / Р. Campbell [et al.] // J Sexual Medicine. – 2018. – Vol. 15(11). – P. 1515–1517. DOI: 10.1016/j.jsxm.2018.08.015
2. Alexander, J.W. Is vaginal laxity anearly symptom of pelvic organ prolapse? / J.W .Alexander, M Gillor, H.P. Dietz // International Urogynecology Journal. – 2021. DOI: 10.1007/s00192-021-04927-3
3. Vaginal laxity: what does this symptom mean? / H.P. Dietz [et al] // International Urogynecology Journal. – 2018. – Vol. 29(5). – Р. 723–728. DOI: 10.1007/s00192-017-3426-0.
4. Pelvic organ prolapse in nulliparae / H.P. Dietz [et al] // Aust N Z J Obstet Gynaecol. – 2022. – Vol. 62(3). – Р. 420-425. doi: 10.1111/ajo.13481.
5. Moderate or intensive management of the active phase of second-stage labor and risk of urinary and anal incontinence: results of the randomized controlled trial PASST / N. Dupuis [et al.] // Am J Obstet Gynecol. – 2023. PMID: 37499991 Clinical Trial.
6. Female pelvic organ prolaps using pessaries : systematic revier / S.C. De Albuquerque [et аl.] // Int. Urogynecol. J. – 2016. – Vol. 27(12). – P. 1797–1803.
7. Pelvicorgan prolaps stage and the relationship to genital hiatus and perineal body measurements / С. Dumoulin [et аl.] // Female Pelvic Med. Reconstr. Surg. – 2016. – Vol. 22(6). – P. 497–500.
8. What is the evidence for abdominal and pelvic floor muscle training to treat diastasis recti abdominis postpartum? A systematic review with meta-analysis / S. Gluppe [et аl.] // Braz. J Phys. Ther. – 2021. – Vol. 25(6). – P. 664–675. doi: 10.1016/j.bjpt.2021.06.006. E
9. Minimally invasive non-ablative Er: YAG laser treatment of stress urinary incontinencein women – a pilot study / N. Fistonic [et аl.] // Lasers Med. Sci. – 2016. – Vol. 31(4). – P. 635–643.
10. The truth behind transvaginal mesh litigation: devices, timelines, and provider characteristics./ C.P. Souders [et al.] // Female Pelvic Med Reconstr Surg. – 2018. – Vol. 24(1). – P. 21–25.
11. Шкарупа, Д.Д. Методические рекомендации по реконструкции тазового дна с применением синтетических материалов / Д.Д., Шкарупа, Н.Д. Кубин [и др.]. – 6-е изд., 2023, Санкт-Петербург. – 13–23 с.
12. Petition Women’s Health Physicians: Ensure Ethical and Fair FDA Mesh Research. Available at: https://www.change.org/p/women-s-healthphysicians-ensure-ethical-and-fair-fda-mesh-research / Accessed: 01. 08. 2021
13. Mesh, graft, or standard repair for women having primary transvaginal anterior or posterior compartment prolapse surgery: two parallel-group, multicentre, randomised, controlled trials (PROSPECT) / C.M. Glazener [et al.] // Lancet. – 2017. – Vol. 389(10067). – Р. 381–392.
14. Opinion on the safety of surgical meshes used in urogynecological surgery. European Commission, Directorate General for Health & Consumers (2015) SCENIHR-Available at: https://ec.europa.eu/health/sites/default/files/scientific_committees/emerging/docs/scenihr_o_049.pdf/ Accessed: 01. 08. 2021.
15. AWMF: Leitlinien. Leitlinien-Detailansicht. Weiblicher Descensus genitalis Diagnostik und Therapie. Available at: https://www.awmf.org/uploads/tx_szleitlinien/015-006l_S2e_Descensus_genitalis-DiagnostikTherapie_2016-11-abgelaufen.pdf/ Accessed: 01. 08. 2021.
16. Consensus Statement of the European Urology Association and the European Urogynaecological Association on the Use of Implanted Materials for Treating Pelvic Organ Prolapse and Stress Urinary Incontinence / C.R. Chapple [et al.] // Eur Urol. – 2017. – Vol. 72(3). – Р. 424–431.
17. Seventeen years’ follow-up of the tension-free vaginal tape procedure for female stress urinary incontinence / C.G. Nilsson [et al.] // Int Urogynecol J. – 2013. – Vol. 24(8). – Р. 1265–1269.
18. Liapis, A Long-term efficacy of tension-free vaginal tape in the management of stress urinary incontinence in women: Efficacy at 5- and 7-year follow-up / A. Liapis, P. Bakas, G. Creatsas // Int Urogynecol J Pelvic Floor Dysfunct. – 2008 – Vol. 19(11). – Р.1509-1512.
19. Пушкарь, Д.Ю. Отдаленные результаты использования свободной синтетической петли в лечении недержания мочи у женщин (восьмилетние результаты) / Д.Ю. Пушкарь, Г.Р. Касян // Урология. – 2010. – Т. 2. – С. 32.
20. A long-term comparative study of Uphold™ transvaginal mesh kit against anterior colporrhaphy / M. Gillor [et al.] // Int Urogynecol J. – 2020. – Vol. 31(4). – Р. 793–797.
21. The resurrection of sacrospinous fixation: unilateral apical sling hysteropexy / D. Shkarupa, N. Kubin, E. Shapovalova, A. Zaytseva // Int Urogynecol J. – 2020. – Vol. 31(2). – Р. 351–357.
22. Опыт лечения апикального пролапса тазовых органов у женщин с использованием сетчатых имплантов / Ю.А Болдырева, В.Б. Цхай, А.М. Полстяной [и др.] // Медицинский вестник Юга России. – 2024. – Т. 15(3). – С. 7-11.
23. Суханов, А.А. Сила мышц тазового дна у женщин после родов и влияние на неё консервативных методов лечения / А.А. Суханов, Г.Б. Дикке, И.И. Кукарская // Медицинский совет. – 2019. – Т. 6. – С. 142–147. doi: 10.21518/2079-701x-2019-6-142-147.
24. Пролапс тазовых органов у женщин. Современные методы коррекции / В.А. Сейкина, Н.А. Жаркин, Н.А. Бурова, С.А. Прохватилов // Вестник ВолГМУ. – 2017. – Т. 4(64). – С. 8-12. doi: 10.19163/1994-9480-2017-4(64)-8-12.
25. Результаты исследования метода биологической обратной связи с тестовой электростимуляцией мышц тазового дна в качестве монотерапии и в сочетании с экстракорпоральной магнитной стимуляцией мышц тазового дна при функциональной инфравезикальной обструкции / Л.Ю. Борисенко, А.В. Сивков, В.В. Ромих, А.В. Захарченко [и др.] // Экспериментальная и клиническая урология. – 2019. – Т. 2. – С. 146-151. doi: 10.29188/2222-8543-2019-11-2-146-150
26. Therapeutic exercise to improve pelvic floor muscle function in a female sporting population : a systematic review and meta-analysis / N. Romero-Franco [et al.] // Physiotherapy. – 2021. – Vol. 113. – Р. 44-52. doi: 10.1016/j.physio.2021.04.006
27. Effectiveness of physiotherapy for lower urinary tract symptoms in postpartum women : systematic review and meta-analysis / D. Zhu [et al.] // International Urogynecology Journal. – 2022. – Vol. 33(3). – Р. 507-521. doi: 10.1007/s00192-021-04939-z
28. Electrical stimulation with non-implanted devices for stress urinary incontinence in women / F. Stewart, B. Berghmans [et al.] // Cochrane Database Syst Rev. – 2017. – Vol. 12(12). – CD012390 doi: 10.1002/14651858.CD012390.pub2
29. Navarro-Brazález B. What Influences women to Adhere to Pelvic Floor Exercises after Physiotherapy Treatment? A Qualitative Study for Individualized Pelvic Health Care / Navarro- B. Brazález [et al.] // Journal of Personalized Medicine. – 2021. – Vol. 11(12). – Р. 1368. doi: 10.3390/jpm11121368
30. Treating Vaginal Laxity Using Nonablative Er:YAG Laser: A Retrospective Case Series of Patients From 2.5 Years of Clinical Practice / M. Mitsuyuki [et al.] // Sexual Medicine. – 2020. – Vol. 8(2). – Р. 265-273. doi: 10.1016/j.esxm.2020.01.001.
31. he efficacy of erbium-doped yttrium aluminum garnet (Er:YAG) laser in the treatment of decreased sexual sensation: a randomized, placebocontrolled trial / A. Sathaworawong [et al.] // Lasers in Medical Science. – 2022. – Vol. 37(1). – Р. 581–588. doi: 10.1007/s10103-021-03305-1
32. Saunders, K. Recent Advances in Understanding Pelvic-Floor Tissue of women with and without Pelvic Organ Prolapse: Considerations for Physical Therapists / K. Saunders // Physical Therapy. – 2017. – Vol. 97(4). – Р. 455–463. doi: 10.1093/ptj/pzx019
Review
For citations:
Murashko O.V., Podgornaya A.S., Zakharko A.Yu. Prevention and treatment of pelvic floor dysfunction (literature review). Medical and Biological Problems of Life Activity. 2025;(1):22-28. (In Russ.) https://doi.org/10.58708/2074-2088.2025-1(33)-22-28
Views:
77
Email this article 