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Connective tissue pelvic organ prolapse

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https://www.readbyqxmd.com/read/28831274/biomechanical-paradigm-and-interpretation-of-female-pelvic-floor-conditions-before-a-treatment
#1
Vincent Lucente, Heather van Raalte, Miles Murphy, Vladimir Egorov
BACKGROUND: Further progress in restoring a woman's health may be possible if a patient with a damaged pelvic floor could undergo medical imaging and biomechanical diagnostic tests. The results of such tests could contribute to the analysis of multiple treatment options and suggest the optimal one for that patient. AIM: To develop a new approach for the biomechanical characterization of vaginal conditions, muscles, and connective tissues in the female pelvic floor...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28762694/pelvic-organ-prolapse
#2
REVIEW
Cheryl B Iglesia, Katelyn R Smithling
Pelvic organ prolapse is the descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus (cervix), or the apex of the vagina (vaginal vault or cuff scar after hysterectomy). Prevalence increases with age. The cause of prolapse is multifactorial but is primarily associated with pregnancy and vaginal delivery, which lead to direct pelvic floor muscle and connective tissue injury. Hysterectomy, pelvic surgery, and conditions associated with sustained episodes of increased intra-abdominal pressure, including obesity, chronic cough, constipation, and repeated heavy lifting, also contribute to prolapse...
August 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28705367/dynamic-magnetic-resonance-imaging-of-the-pelvic-floor
#3
Sindhura Alapati, Kedar Jambhekar
Pelvic floor dysfunction is a widespread condition affecting up to 50% of elderly women. It markedly compromises the quality of life owing to various disabling symptoms such as pelvic pain, pelvic organ prolapse, and urinary and fecal incontinence. Although age and female sex are the main risk factors, others include multiparity, obesity, and connective tissue disorders. Pelvic floor dysfunction is frequently multicompartmental, and failure to diagnose it accurately often leads to treatment failure. Dynamic pelvic floor magnetic resonance imaging is a robust tool that enables simultaneous visualization of the 3 pelvic floor compartments and is indispensable for precise preoperative evaluation...
June 2017: Seminars in Ultrasound, CT, and MR
https://www.readbyqxmd.com/read/28696484/vaginal-changes-due-to-varying-degrees-of-rectocele-prolapse-a-computational-study
#4
Arnab Chanda, Isuzu Meyer, Holly E Richter, Mark E Lockhart, Fabia R D Moraes, Vinu U Unnikrishnan
Pelvic organ prolapse (POP), downward descent of the pelvic organs resulting in a protrusion of the vagina, is a highly prevalent condition, responsible for 300,000 surgeries in the United States annually. Rectocele, a posterior vaginal wall prolapse of the rectum is the second most common type of POP after cystocele. A rectocele usually manifests itself along with other types of prolapse with multi-compartment pelvic floor defects. To date, the specific mechanics of rectocele formation are poorly understood, which does not allow its early stage detection and progression prediction over time...
July 11, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28306603/current-treatment-of-pelvic-organ-prolapse-correlated-with-chronic-pelvic-pain-bladder-and-bowel-dysfunction
#5
Bernhard Liedl, Klaus Goeschen, Leopold Durner
PURPOSE OF REVIEW: The purpose of this review is to critically analyze the relationship between symptoms of abnormal emptying of the bladder, urgency, pelvic pain, anorectal dysfunction and pelvic organ prolapse (POP) and to present evidence in order to show how many of the above mentioned symptoms can be cured or substantially improved by repair of specific pelvic ligaments. RECENT FINDINGS: In this review, we provide evidence to show how often these dysfunctions occur and how they can be cured in 42-94% by appropriate pelvic floor surgery in the longer term, up to 2 years...
May 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28306194/electrospun-biodegradable-microfibers-induce-new-collagen-formation-in-a-rat-abdominal-wall-defect-model-a-possible-treatment-for-pelvic-floor-repair
#6
Cecilie Glindtvad, Menglin Chen, Jens Vinge Nygaard, Lise Wogensen, Axel Forman, Carl Christian Danielsen, Mehmet Berat Taskin, Karl-Erik Andersson, Susanne Maigaard Axelsen
Half of the female population over age 50 years will experience pelvic organ prolapse. We suggest a new approach based on tissue engineering principles to functionally reconstruct the anatomical structures of the pelvic floor. The aim of this study is to investigate the mechanical performance and effect on collagen and elastin production of a degradable mesh releasing basic fibroblast growth factor (bFGF). Implantation of biodegradable mesh with or without bFGF in their core has been conducted in 40 rats in an abdominal wall defect model...
March 17, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28267057/female-pelvic-floor-biomechanics-bridging-the-gap
#7
Deanna C Easley, Steven D Abramowitch, Pamela A Moalli
PURPOSE OF REVIEW: The pelvic floor is a complex assembly of connective tissues and striated muscles that simultaneously counteracts gravitational forces, inertial forces, and intra-abdominal pressures while maintaining the position of the pelvic organs. In 30% of women, injury or failure of the pelvic floor results in pelvic organ prolapse. Surgical treatments have high recurrence rates, due, in part, to a limited understanding of physiologic loading conditions. It is critical to apply biomechanics to help elucidate how altered loading conditions of the pelvis contribute to the development of pelvic organ prolapse and to define surgeries to restore normal support...
May 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28073797/physical-and-cultural-determinants-of-postpartum-pelvic-floor-support-and-symptoms-following-vaginal-delivery-a-protocol-for-a-mixed-methods-prospective-cohort-study
#8
Ingrid E Nygaard, Erin Clark, Lauren Clark, Marlene J Egger, Robert Hitchcock, Yvonne Hsu, Peggy Norton, Ana Sanchez-Birkhead, Janet Shaw, Xiaoming Sheng, Michael Varner
INTRODUCTION: Pelvic floor disorders (PFDs), including pelvic organ prolapse (POP), stress and urgency urinary incontinence, and faecal incontinence, are common and arise from loss of pelvic support. Although severe disease often does not occur until women become older, pregnancy and childbirth are major risk factors for PFDs, especially POP. We understand little about modifiable factors that impact pelvic floor function recovery after vaginal birth. This National Institutes of Health (NIH)-funded Program Project, 'Bridging physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery', uses mixed-methods research to study the influences of intra-abdominal pressure, physical activity, body habitus and muscle fitness on pelvic floor support and symptoms as well as the cultural context in which women experience those changes...
January 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/27855713/microrna-29-facilitates-transplantation-of-bone-marrow-derived-mesenchymal-stem-cells-to-alleviate-pelvic-floor-dysfunction-by-repressing-elastin
#9
Minfei Jin, Yuelin Wu, Jun Wang, Weiping Ye, Lei Wang, Peipei Yin, Wei Liu, Chenhao Pan, Xiaolin Hua
BACKGROUND: Pelvic floor dysfunction (PFD) is a condition affecting many women worldwide, with symptoms including stress urinary incontinence (SUI) and pelvic organ prolapse (POP). We have previously demonstrated stable elastin-expressing bone marrow-derived mesenchymal stem cells (BMSCs) attenuated PFD in rats, and aim to further study the effect of microRNA-29a-3p regulation on elastin expression and efficacy of BMSC transplantation therapy. METHODS: We inhibited endogenous microRNA-29a-3p in BMSCs and investigated its effect on elastin expression by RT-PCR and Western blot...
November 17, 2016: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/27636223/transcriptional-regulation-of-connective-tissue-metabolism-genes-in-women-with-pelvic-organ-prolapse
#10
Ali Borazjani, Nathan Kow, Samantha Harris, Beri Ridgeway, Margot S Damaser
OBJECTIVE: The aim of this study was to compare differences in expressions and relationships between key genes involved in extracellular matrix metabolism and tissue cellularity in women with and without pelvic organ prolapse (POP). METHODS: A total of 80 biopsies (anterior cuff, posterior cuff, and/or leading edge) were obtained from 30 women: n = 10 premenopausal without POP (controls), n = 10 premenopausal with POP, and n = 10 postmenopausal with POP. Quantitative reverse-transcriptase polymerase chain reaction was used to assess gene expression of bone morphogenetic protein 1 (BMP1), collagen types I (COL1) and III (COL3), relaxin family peptide receptor 1 (RXFP1), matrix metallopeptidase 2, and TIMP metallopeptidase inhibitors 2 and 3...
January 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27632406/risk-for-exfoliation-syndrome-in-women-with-pelvic-organ-prolapse-a-utah-project-on-exfoliation-syndrome-upexs-study
#11
MULTICENTER STUDY
Barbara M Wirostko, Karen Curtin, Robert Ritch, Samuel Thomas, Kristina Allen-Brady, Ken R Smith, Gregory S Hageman, R Rand Allingham
Importance: Exfoliation syndrome, an inherited systemic disorder of elastin and extracellular matrix (ECM), is associated with the LOXL1 gene locus. Pelvic organ prolapse is a common connective tissue disorder that affects women. The presence of an association between exfoliation syndrome (exfoliation of the lens capsule) and pelvic organ prolapse was investigated as part of the Utah Project on Exfoliation Syndrome (UPEXS). Objective: To examine the association between exfoliation syndrome and pelvic organ prolapse using the Utah Population Database, a comprehensive resource linked to medical records...
November 1, 2016: JAMA Ophthalmology
https://www.readbyqxmd.com/read/27588175/matrix-metalloproteinase-3-gene-promoter-polymorphisms-a-potential-risk-factor-for-pelvic-organ-prolapse
#12
Charalampos Karachalios, Panagiotis Bakas, Georgios Kaparos, Styliani Demeridou, Ilias Liapis, Charalampos Grigoriadis, Aggelos Liapis
Pelvic organ prolapse (POP) is a common multifactorial condition. Matrix metalloproteinases (MMPs) are enzymes capable of breaking down various connective tissue elements. Single-nucleotide polymorphisms (SNPs) in regulatory areas of MMP-encoding genes can alter their transcription rate, and therefore the possible effect on pelvic floor supporting structures. The insertion of an adenine (A) base in the promoter of the MMP-3 gene at position -1612/-1617 produces a sequence of six adenines (6A), whereas the other allele has five (5A)...
September 2016: Biomedical Reports
https://www.readbyqxmd.com/read/27517338/what-s-new-in-the-functional-anatomy-of-pelvic-organ-prolapse
#13
John O L DeLancey
PURPOSE OF REVIEW: Provide an evidence-based review of pelvic floor functional anatomy related to pelvic organ prolapse. RECENT FINDINGS: Pelvic organ support depends on interactions between the levator ani muscle and pelvic connective tissues. Muscle failure exposes the vaginal wall to a pressure differential producing abnormal tension on the attachments of the pelvic organs to the pelvic sidewall. Birth-induced injury to the pubococcygeal portion of the levator ani muscle is seen in 55% of women with prolapse and 16% of women with normal support...
October 2016: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27124299/pelvic-organ-support-in-animals-with-partial-loss-of-fibulin-5-in-the-vaginal-wall
#14
Kathleen Chin, Cecilia Wieslander, Haolin Shi, Sunil Balgobin, T Ignacio Montoya, Hiromi Yanagisawa, R Ann Word
Compromise of elastic fiber integrity in connective tissues of the pelvic floor is most likely acquired through aging, childbirth-associated injury, and genetic susceptibility. Mouse models of pelvic organ prolapse demonstrate systemic deficiencies in proteins that affect elastogenesis. Prolapse, however, does not occur until several months after birth and is thereby acquired with age or after parturition. To determine the impact of compromised levels of fibulin-5 (Fbln5) during adulthood on pelvic organ support after parturition and elastase-induced injury, tissue-specific conditional knockout (cKO) mice were generated in which doxycycline (dox) treatment results in deletion of Fbln5 in cells that utilize the smooth muscle α actin promoter-driven reverse tetracycline transactivator and tetracycline responsive element-Cre recombinase (i...
2016: PloS One
https://www.readbyqxmd.com/read/27091643/comparative-histology-of-mouse-rat-and-human-pelvic-ligaments
#15
COMPARATIVE STUDY
Ritsuko Iwanaga, David J Orlicky, Jameson Arnett, Marsha K Guess, K Joseph Hurt, Kathleen A Connell
INTRODUCTION AND HYPOTHESIS: The uterosacral (USL) and cardinal ligaments (CL) provide support to the uterus and pelvic organs, and the round ligaments (RL) maintain their position in the pelvis. In women with pelvic organ prolapse (POP), the connective tissue, smooth muscle, vasculature, and innervation of the pelvic support structures are altered. Rodents are commonly used animal models for POP research. However, the pelvic ligaments have not been defined in these animals. In this study, we hypothesized that the gross anatomy and histological composition of pelvic ligaments in rodents and humans are similar...
November 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27048404/transplantation-of-bone-marrow-derived-mesenchymal-stem-cells-expressing-elastin-alleviates-pelvic-floor-dysfunction
#16
Minfei Jin, Ying Chen, Yun Zhou, Yan Mei, Wei Liu, Chenhao Pan, Xiaolin Hua
BACKGROUND: Pelvic floor dysfunction (PFD) is a group of clinical conditions including stress urinary incontinence (SUI) and pelvic organ prolapse (POP). The abnormality of collagen and elastin metabolism in pelvic connective tissues is implicated in SUI and POP. METHODS: To reconstitute the connective tissues with normal distribution of collagen and elastin, we transduced elastin to bone marrow-derived mesenchymal stem cells (BMSC). Elastin-expressing BMSCs were then differentiated to fibroblasts using bFGF, which produced collagen and elastin...
April 5, 2016: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/26820994/nanofibrous-biomimetic-mesh-can-be-used-for-pelvic-reconstructive-surgery-a-randomized-study
#17
Jing Ding, Mou Deng, Xiao-Chen Song, Chun Chen, Kui-Lin Lai, Guo-Shuai Wang, Yu-Yu Yuan, Tao Xu, Lan Zhu
BACKGROUND: Implantation of nonabsorbable polypropylene (PP) mesh in the vagina is the main surgical treatment for pelvic organ prolapse (POP); however, clinical outcomes remain controversial and far from satisfactory. In particular, reducing the exposure or erosion of vaginal implants to obtain improved functional reconstruction is challenging. There is an urgent need for the development of new materials and/or products for POP treatment. A nanofibrous biomimetic mesh was recently developed to address this issue...
August 2016: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/26732347/a-biofidelic-computational-model-of-the-female-pelvic-system-to-understand-effect-of-bladder-fill-and-progressive-vaginal-tissue-stiffening-due-to-prolapse-on-anterior-vaginal-wall
#18
Arnab Chanda, Vinu Unnikrishnan, Holly E Richter, Mark E Lockhart
Treatment of anterior vaginal prolapse (AVP), suffered by over 500,000 women in the USA, is a challenge in urogynecology because of the poorly understood mechanics of AVP. Recently, computational modeling combined with finite element method has been used to model AVP through the study of pelvic floor muscle and connective tissue impairments on the anterior vaginal wall (AVW). Also, the effects of pelvic organ displacements on the AVW were studied numerically. In our current work, an MRI-based full-scale biofidelic computational model of the female pelvic system composed of the urinary bladder, vaginal canal, and the uterus was developed, and a novel finite element method framework was employed to simulate vaginal tissue stiffening and also bladder filling due to expansion for the first time...
November 2016: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/26656625/identifying-distinct-nanoscopic-features-of-native-collagen-fibrils-towards-early-diagnosis-of-pelvic-organ-prolapse
#19
Taeyoung Kim, Indumathi Sridharan, Yin Ma, Bofan Zhu, Naiwei Chi, William Kobak, Jacob Rotmensch, Jay D Schieber, Rong Wang
UNLABELLED: Pelvic organ prolapse (POP) is characterized by weakening of the connective tissues and loss of support for the pelvic organs. Collagen is the predominant, load-bearing protein within pelvic floor connective tissues. In this study, we examined the nanoscopic structures and biomechanics of native collagen fibrils in surgical, vaginal wall connective tissues from healthy women and POP patients. Compared to controls, collagen fibrils in POP samples were bulkier, more uneven in width and stiffer with aberrant D-period...
April 2016: Nanomedicine: Nanotechnology, Biology, and Medicine
https://www.readbyqxmd.com/read/26448995/-management-of-vaginal-cones-in-the-treatment-of-pelvic-floor-rehabilitation
#20
Maialen Onandia Garate, Ana María Luces Lago, Lucía Mosquera Pan, Eva Tizón Bouza
The pelvic floor (PF) is a sheet of muscles and other tissues that support the pelvic organs in their physiological positions. Throughout women's lives, these structures can become weak or be injured by events such as pregnancy, childbirth, surgery, overweight or constipation. PF dysfunction includes a group of disorders causing urinary incontinence, as well as genital prolapse or pelvic pain, and can significantly deteriorate women's quality of life. Vaginal cones (VC) represent a non-pharmacological, economical, safe and non-invasive method for the treatment of PF dysfunction; they allow the patient to increase the physiological consciousness of the musculature of the PF while promoting an increase in the muscle tone...
July 2015: Revista de Enfermería
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