Osteopenic syndrome in women with genital prolapse

• Il’nur I. Musin
• Al’fiya G. Yaschuk
• Lyala A. Musina
• Timur B. Minasov
• Raisa М. Zaynullina
• Anzhella R. Molokanova
• Ksenia N. Yaschuk

Abstract

Aim - to study the relationship between pelvic floor descent and bone mineral density of the Lumbar spine and femoral neck in postmenopausal women.

Material and methods. Material for morphological studies was obtained intraoperatively by biopsy of the uterine ligaments for diagnostic purposes with the informed consent of patients. Inclusion criteria: pelvic organ prolapse (with anterior, apical prolapse, posterior prolapse, and rectocele) according to POP-Q stage III-IV, patient consent for surgical treatment. The bone mineral density of the lumbar spine and femoral neck was measured using dual energy X-ray absorptiometry (DXA) for histological examination, tissue pieces were fixed in 10% neutral formalin, dehydrated in ascending alcohols and embedded in standard paraffin wax methodology. Histological sections were stained with hematoxylin and eosin and according to the Van Gieson method. Weigert histochemical staining of preparations was carried out according to Weigert to detect elastic fibers were studied and photographed under a light microscope DM 300 (Leica, Germany).

Results. In the group with pelvic prolapse, osteopenic syndrome was detected from the lumbar spine (-1.39±0.88), in contrast to the proximal femur (-0.14±1.1), while the duration of postmenopause was 10.5±12.2 years. Thus, pelvic prolapse with a postmenopausal duration of more than 10 years can be evaluated as a marker that allows predicting osteopenic syndrome (a decrease in bone mineral density).

Conclusions. The "aggravation" of the stage of genital prolapse in women is due to a decrease in the composition of the ligamentous apparatus of muscle tissue and elastic fibers with elastic properties and elasticity, and an increase in the amount of connective tissue. In our studies, we also revealed the relationship of genital prolapse of stage III and IV POP-Q with osteopenic syndrome, which worsens the quality of life of postmenopausal women.

Keywords:bone density, osteoporosis, pelvic organ prolapse

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