Study of the role of uterine leiomyoma in prognosis andtreatment of genital prolapse

Authors

DOI:

https://doi.org/10.15574/HW.2023.167.27

Keywords:

genital prolapse, risk factors, uterine leiomyoma

Abstract

Uterine leiomyoma is one of the most common benign pelvic neoplasms in women. Uterine leiomyoma is diagnosed in perimenopausal or postmenopausal periods in more than 60% of cases. That is age category of women with a high frequency of genital prolapse with causes the frequent combination of these two pathologies.

Purpose - to determine the role of uterine leiomyoma in the development and progression of genital prolapse.

Materials and methods. A retrospective cohort study was conducted. It included 240 consecutively recruited patients, including: 117 women with prolapses of the internal genital organs, who made up the study group, and 123 women with normal pelvic anatomy - the comparison group. Analysis of life history, family, somatic, reproductive, gynecological and obstetric history, definition of anthropometric data was carried out. Statistical data processing was carried out using the SPSS 21 program.

Results. According to the results of multivariate regression analysis, significant risk factors for the development of genital prolapse are: age, sedentary lifestyle, excessive physical activity, family history of genital prolapse, chronic obstructive pulmonary disease, uterine leiomyoma, number of pregnancies, spontaneous miscarriages in the early stages, number of deliveries, age of first childbirth, total number of intrauterine manipulations, perineal tears.

Conclusions. Uterine leiomyoma is an independent risk factor for the development of genital prolapse (odds ratio: 5.93; 95% confidence interval: 1.77-19.91).

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.

References

Al-Hendy A, Myers ER, Stewart E. (2017). Uterine Fibroids: Burdenand Unmet Medical Need. Semin Reprod Med. 35 (6): 473-480. https://doi.org/10.1055/s-0037-1607264; PMid:29100234 PMCid:PMC6193285

Baryshnikova OP, Chaika KV, Tytarenko NV, Vozniuk AV, Sydorchuk TM. (2023). Porivnialna efektyvnist metodiv khirurhichnoho likuvannia henitalnykh prolapsiv, poiednanykh iz leiomiomoiu matky. Ukrainian Journal Health of Woman. 2 (165): 10-15. https://doi.org/10.15574/HW.2023.165.10

Bradley CS, Zimmerman MB, Qi Y, Nygaard IE. (2007). Natural history of pelvic organ prolapse in postmenopausal women. Obstet Gynecol. 109 (4): 848-854. https://doi.org/10.1097/01.AOG.0000255977.91296.5d; PMid:17400845

Chen J, Zhu L, Lang JH, Shi HH, Lou WJ, Sun ZJ et al. (2012). Prospective study on total pelvic reconstruction surgery with Prosimain the treatment of pelvic organ prolapse stage III. Zhonghua Fu Chan Ke Za Zhi. 47 (9): 664-668.

Collins S, Lewicky-Gaupp C. (2022). Pelvic Organ Prolapse. Gastroenterol Clin North Am. 51 (1): 177-193. https://doi.org/10.1016/j.gtc.2021.10.011; PMid:35135661

Daucher JA, Ellison RE, Lowder JL. (2010). Pelvic support and urinary function improve in women after surgically induced weight reduction. Female Pelvic Med Reconstr Surg. 16 (5): 263-267. https://doi.org/10.1097/SPV.0b013e3181eedb30; PMid:22453503

De Lancey JO, Kearney R, Chou Q, Speights S, Binno S. (2003). The appearance of levator ani muscle abnormalities in magnetic resonance images after vaginal delivery. Obstet Gynecol. 101 (1): 46-53. https://doi.org/10.1097/00006250-200301000-00012; PMid:12517644

Golyanovskiy OV, Kachur OYu, Budchenko MА, Supruniuk KV, Frolov SV. (2021). Uterine leiomyoma: modern aspects of clinic, diagnosis and treatment. Reproductive health of woman. 5 (5): 7-18. https://doi.org/10.30841/2708-8731.5.2021.240017

Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A. (2002). Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity. Am J Obstet Gynecol. 186 (6): 1160-1166. https://doi.org/10.1067/mob.2002.123819; PMid:12066091

Iglesia CB, Smithling KR. (2017). Pelvic Organ Prolapse. Am Fam Physician. 96 (3): 179-185.

Jackson SR, Avery NC, Tarlton JF, Eckford SD, Abrams P, Bailey AJ. (1996). Changes in metabolism of collagen in genitourinary prolapse. Lancet. 347 (9016): 1658-1661. https://doi.org/10.1016/S0140-6736(96)91489-0; PMid:8642960

Jørgensen S, Hein HO, Gyntelberg F. (1994). Heavy lifting at work and risk of genital prolapse and herniated lumbar disc in assistant nurses. Occup Med (Lond). 44: 47. https://doi.org/10.1093/occmed/44.1.47; PMid:8167320

Kudish BI, Iglesia CB, Sokol RJ, Cochrane B, Richter HE, Larson J et al. (2009). Effect of weight change on natural history of pelvic organ prolapse. Obstet Gynecol. 113 (1): 81-88. https://doi.org/10.1097/AOG.0b013e318190a0dd; PMid:19104363 PMCid:PMC2684063

Lapalus MG, Henry L, Barth X, Mellier G, Gautier G, Mion F et al. (2004). Enterocele: clinical risk factors and association with others pelvic floor disorders (about 544 defecographies). Gynecol Obstet Fertil. 32 (8): 595-600. https://doi.org/10.1016/j.gyobfe.2004.05.012; PMid:15450257

Moalli PA, Jones Ivy S, Meyn LA, Zyczynski HM. (2003). Risk factors associated with pelvic floor disorders in women undergoing surgical repair. Obstet Gynecol. 101 (5 Pt 1): 869-874. https://doi.org/10.1097/00006250-200305000-00008; PMid:12738142

Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J et al. (2008). Prevalence of symptomatic pelvic floor disorder sin US women. JAMA. 300 (11): 1311-1316. https://doi.org/10.1001/jama.300.11.1311; PMid:18799443 PMCid:PMC2918416

Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. (1997). Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 89 (4): 501-566. https://doi.org/10.1016/S0029-7844(97)00058-6; PMid:9083302

Pacilli M, Spitz L, Kiely EM, Curry J, Pierro A. (2005). Staged repair, of giant omphalocele in the neonatal period. Pediatr Surg. 40 (5): 785-788. https://doi.org/10.1016/j.jpedsurg.2005.01.042; PMid:15937814

Patel DA, Xu X, Thomason AD, Ransom SB, Ivy JS, De Lancey JO. (2006). Childbirth and pelvic floor dysfunction: an epidemiologic approach to the assessment of prevention opportunities at delivery. Am J Obstet Gynecol. 195 (1): 23-28. https://doi.org/10.1016/j.ajog.2006.01.042; PMid:16579934 PMCid:PMC1486798

Polat C, Dervisoglu A, Senyurek G, Bilgin M, Erzurumlu K, Ozkan K. (2005). Umbilical hernia repair with the prolenehernia system. Am J Surg. 190 (1): 61-64. https://doi.org/10.1016/j.amjsurg.2004.09.021; PMid:15972174

Samuelsson EC, Victor FT, Tibblin G, Svärdsudd KF. (1999). Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol. 180 (2 Pt 1): 299-305. https://doi.org/10.1016/S0002-9378(99)70203-6; PMid:9988790

Smith FJ, Holman CD, Moorin RE, Tsokos N. (2010). Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol. 116 (5): 1096-1100. https://doi.org/10.1097/AOG.0b013e3181f73729; PMid:20966694

Spence-Jones C, Kamm MA, Henry MM, Hudson CN. (1994). Bowel dysfunction: a pathogenic factor in uterovaginal prolapse and urinary stress incontinence. Br J Obstet Gynaecol. 101 (2): 147-152. https://doi.org/10.1111/j.1471-0528.1994.tb13081.x; PMid:8305390

Swift S, Woodman P, O'Boyle A, Kahn M, Valley M, Bland D et al. (2005). Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol. 192 (3): 795-806. https://doi.org/10.1016/j.ajog.2004.10.602; PMid:15746674

Wallace K, Zhang S, Thomas L, Stewart EA, Nicholson WK, Wegienka GR et al. (2020). Comparative effectiveness of hysterectomy versus myomectomy on-one-year-health-related quality of life in women with uterine fibroids. Fertil Steril. 113 (3): 618-626. https://doi.org/10.1016/j.fertnstert.2019.10.028; PMid:32192594

Ward RM, Velez Edwards DR, Edwards T, Giri A, Jerome RN, Wu JM. (2014). Genetic epidemiology of pelvic organ prolapse: a systematic review.Am J Obstet Gynecol. 211 (4): 326-335. https://doi.org/10.1016/j.ajog.2014.04.006; PMid:24721264 PMCid:PMC4213176

Woodman PJ, Swift SE, O'Boyle AL, Valley MT, Bland DR, Kahn MA et al. (2006). Prevalence of severe pelvic organ prolapse in relation to job description and socio economic status: a multicentercross-sectionalstudy. Int Urogynecol J Pelvic Floor Dysfunct. 17 (4): 340-345. https://doi.org/10.1007/s00192-005-0009-2; PMid:16261426

Zalewski M, Kołodyńska G, Mucha A, Bełza Ł, Nowak K, Andrzejewski W. (2020). he assessment of quality of life and satisfaction with life of patients before and after surgery of an isolated apical defect using synthetic materials. BMC Urol. 20: 104. https://doi.org/10.1186/s12894-020-00666-7; PMid:32689981 PMCid:PMC7370467

Zhelezov DM. (2021). Osoblivostі MRT-vіzualіzacії mіom matki na pered operacіjnomu etapі. Vіsnik medichnih і bіologіchnih doslіdzhen'. 1 (7): 62-65.

Published

2023-09-28