Perineal design

• Devyatova E.A.

Abstract

Objective. Pelvic organ prolapse (POP) is ageassociated widely spread problem, which face 50–94 % of women, depending of its degree. The most common risk factors are: postmenopausal age, obesity, smoking, connective tissue disease, inheritance, perineal trauma. Methods of therapy include: surgical correction, pessary usage, change of lifestyle including routine рelvic floor muscle exercise. Annually more than 338 000 operations in POP correction are performed in the USA. Surgical correction of pelvic organ prolapse underwent transformation. Training in pelvic organ prolapse surgery, the ease of MESH kit and sling usage (combination of operative POP correction with anti-incontinent operations). At-time and postoperative risks of complications after surgical correction of POP and recurrence POP risk are negative points of pelvic surgery. Anyway pelvic floor muscle exercise stays the reserve of pelvic floor muscles support.

Aims: 1) to evaluate the effect of episiotomy during vaginal delivery on POP forming through further period; 2) review and comparison of complications using combination of operative POP correction with anti-incontinent operations; 3) to estimate factors that affect adherence рelvic floor muscle training in women with POP.

Materials and methods. To form the review devoted to POP problem PubMed, EMBASE, MedLine and the Cochrane Library were searched for randomised trials from 2013 to 2014 years, limited to the English literature.

Results. Episiotomy has no effect on POP, but large baby, parity and postmenopausal age are independent prognostic factors of POP stage.

The number of pelvic organ prolapse operations increased with a similar increase in MESH use which led to MESH revision. The number of complications is higher in these cases. These results support a policy that insertion of a sling in women with POP and stress urinary incontinence, may decrease its incidence in further period.

We revealed patients’ awareness in pelvic floor muscle training patterns and behaviours in the POP treatment as close as medical stuff’s privity in patient’s individual lifestyle and family style peculiarities.

Keywords:review, metaanalysis, pelvic organ prolapse, еpisiotomy, surgical mesh, midurethral sling, Burch colposuspension, stress urinary incontinence, рessarу, рelvic floor muscle exercise

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