Preview

Bulletin of maternal and child care

Advanced search

Preoperative preparation of reproductive age patients with genital prolapse (literature review)

https://doi.org/10.69964/BMCC-2025-2-1-21-29

Abstract

Pelvic organ prolapse (POP) is a common condition affecting women of all ages. Undoubtedly, surgical treatment of symptomatic pelvic floor prolapse should combine reliable restoration of anatomical structures, pelvic floor functions and high efficiency in the long term. The recurrence rate of pelvic organ prolapse after surgical treatment is still high and can be up to 50%, while 30% of patients will require repeated surgical treatment. The reasons for the unsatisfactory result of surgical restoration of the pelvic floor are still unknown. Some authors are inclined to the hypothesis that the recurrence of POP occurs due to impaired tissue regeneration. It is necessary to use techniques aimed at improving regenerative activity in the perioperative period to improve the outcome of surgical inter ventions on the pelvic floor. The aim of the study. To analyze the methods of preoperative preparation of patients with pelvic organ prolapse. Study design. An analysis of evidence was conducted that was published in 2015-2025 in the electronic libraries Cochrane Library, PubMed, ELibrary, Science Direct, Scopus, Web of Science, Google Scholar, using the keywords pelvic organ prolapse / pelvic organ prolapse, preoperative preparation / preoperative preparation. Results of the study. Tissue regeneration includes several phases: hemostasis, inflammation, proliferation and remodeling. Impact on these phases helps to improve the outcomes of surgical treatment. Pelvic floor muscle training has not shown its effectiveness as a perioperative intervention. Local application of estrogens, often in combined forms, in postmenopausal women, according to the literature, shows good results as a preoperative preparation based on subjective data, histological examination and postoperative recurrence. Women of reproductive age should receive minimally invasive preoperative preparation aimed at improving the anatomical and functional result. Patients with severe tissue trophism (decubital ulcers) need complex multicomponent preparation for surgical treatment.

About the Authors

A. V. Yuminova
Federal State Budgetary Institution “Ural Research Institute of Maternity and Child Care” of the Ministry of Health of the Russian Federation
Russian Federation

Alisa V. Yuminova — obstetrician-gynecologist department of department reproductive functions preservation

Address: st. Repina, 1, Ekaterinburg, 620028

Phone: (343) 371-24-27; mobile phone 8-922-181-05-38



A. A. Mikhelson
Federal State Budgetary Institution “Ural Research Institute of Maternity and Child Care” of the Ministry of Health of the Russian Federation
Russian Federation

Anna A. Mikhelson — MD, Head of department reproductive functions preservation, Head of the Department of Gynecology

Address: st. Repina, 1, Ekaterinburg, 620028

Phone: +7 (343) 371-24-27



M. V. Lazukina
Federal State Budgetary Institution “Ural Research Institute of Maternity and Child Care” of the Ministry of Health of the Russian Federation
Russian Federation

Maria V. Lazukina — Ph.D., obstetrician-gynecologist, department of department reproductive functions preservation

Address: st. Repina, 1, Ekaterinburg, 620028

Phone: +7 (904) 388-83-24



References

1. Оразов М.Р., Радзинский В.Е., Миннуллина Ф.Ф. Механизмы рецидивирования пролапса тазовых органов. Практическая медицина. 2024;22(6):23-28. https://doi.org/10.32000/2072-1757-2024-6-23-28 [Orazov M.R., Radzinsky V.E., Minnullina F.F. Mechanisms of recurrence of pelvic organ prolapse. Practical medicine. 2024;22(6):23-28. (In Russ.) https://doi.org/10.32000/2072-1757-2024-6-23-28]

2. Zhou Q, Lu M, Li GS, Peng GL, Song YF. Identification of potential molecular mechanisms and therapeutic targets for recurrent pelvic organ prolapse. Heliyon. 2023;9(9):e19440. https://doi.org/10.1016/j.heliyon.2023.e19440

3. Wu JM, Matthews CA, Conover MM, Pate V, Jonsson Funk M. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014;123(6):1201-1206. https://doi.org/10.1097/AOG.0000000000000286

4. Larouche M, Belzile E, Geoffrion R. Surgical Management of Symptomatic Apical Pelvic Organ Prolapse: A Systematic Review and Meta-analysis. Obstet Gynecol. 2021;137(6):1061-1073. https://doi.org/10.1097/AOG.0000000000004393

5. Guler Z, Roovers JP. Role of Fibroblasts and Myofibroblasts on the Pathogenesis and Treatment of Pelvic Organ Prolapse. Biomolecules. 2022;12(1):94. https://doi.org/10.3390/biom12010094

6. Михельсон А.А., Юминова А.В., Лазукина М.В., Тимерханова Е.О. Перспективы и возможности использования PRP-терапии в лечении синдрома тазовой десценции. Лечение и профилактика. 2023;13(3):25-32. EDN: TVJYOW. [Mikhelson A.A., Yuminova A.V., Lazukina M.V., Timerkhanova E.O. Prospects and possibilities of using PRP therapy in the treatment of pelvic descension syndrome. Treatment and prevention.2023;13(3):25-32. EDN: TVJYOW. (In Russ.)]

7. Haya N, Feiner B, Baessler K, Christmann-Schmid C, Maher C. Perioperative interventions in pelvic organ prolapse surgery. Cochrane Database Syst Rev. 2018;8(8):CD013105. https://doi.org/10.1002/14651858.CD013105

8. Nyhus MØ, Mathew S, Salvesen Ø, Salvesen KÅ, Stafne S, Volløyhaug I. Effect of preoperative pelvic floor muscle training on pelvic floor muscle contraction and symptomatic and anatomical pelvic organ prolapse after surgery: randomized controlled trial. Ultrasound Obstet Gynecol. 2020;56(1):28-36. https://doi.org/10.1002/uog.22007

9. Duarte TB, Bø K, Brito LGO, Bueno SM, Barcelos TM, Bonacin MA, Ferreira CH. Perioperative pelvic floor muscle training did not improve outcomes in women undergoing pelvic organ prolapse surgery: a randomised trial. J Physiother. 2020;66(1):27-32. https://doi.org/10.1016/j.jphys.2019.11.013

10. Brufani M, Rizzi N, Meda C, Filocamo L, Ceccacci F, D’Aiuto V, Bartoli G, Bella A, Migneco LM, Bettolo RM, Leonelli F, Ciana P, Maggi A. Novel Locally Active Estrogens Accelerate Cutaneous Wound Healing-Part 2. Sci Rep. 2017;7(1):2510. https://doi.org/10.1038/s41598-017-02820-y

11. Vodegel EV, Kastelein AW, Jansen CHJR, Limpens J, Zwolsman SE, Roovers JWR, Hooijmans CR, Guler Z. Theeffects of oestrogen on vaginal wound healing: A sys tematic review and meta-analysis. Neurourol Urodyn. 2022;41(1):115-126. https://doi.org/10.1002/nau.24819

12. Calvin M. Oestrogens and wound healing. Maturitas. 2000;34(3):195-210. https://doi.org/10.1016/s0378-5122(99)00079-1

13. Horng HC, Chang WH, Yeh CC, Huang BS, Chang CP, Chen YJ, Tsui KH, Wang PH. Estrogen Effects on Wound Healing. Int J Mol Sci. 2017;18(11):2325. https://doi.org/10.3390/ijms18112325

14. Mukai K, Urai T, Asano K, Nakajima Y, Nakatani T. Evaluation of Effects of Topical Estradiol Benzoate Application on Cutaneous Wound Healing in Ovariectomized Female Mice. PLoS One. 2016;11(9):e0163560. https://doi.org/10.1371/journal.pone.0163560

15. Rahn DD, Richter HE, Sung VW, Pruszynski JE. Three year outcomes of a randomized clinical trial of peri operative vaginal estrogen as adjunct to native tissue vaginal apical prolapse repair. Am J Obstet Gynecol. 2024;231(2):263.e1-263.e10. https://doi.org/10.1016/j.ajog.2024.04.042

16. Хашукоева АЗ, Носова ЛА, Дмитрашко ТЕ, Беслан гурова ЗА, Ляфишева ДМ, Шокулова ЗХ. Опыт применения эстриола у пациенток с пролапсом гениталий в периоперационном периоде. Медицинский Совет. 2023;(5):156-163. https://doi.org/10.21518/ms2023-101 [Khashukoeva AZ, Nosova LA, Dmitrashko TE, Beslangurova ZA, Lyafisheva DM, Shokulova ZK. The estriol use in the perioperative period by patients with genital prolapse. Meditsinskiy sovet = Medical Council. 2023;(5):156-163. (In Russ.) https://doi.org/10.21518/ms2023-101]

17. Лазукина М.В., Михельсон А.А., Башмакова Н.В. Влияние предоперационной подготовки на архитектонику влагалища женщин с пролапсом гениталий тяжелой степени в постменопаузе. Гинекология. 2 020; 22 (4): 33–38. https://doi.org/10.26442/20795696.2020.4.200155 [Lazukina M.V., Mikhelson A.A., Bashmakova N.V. Influence of preoperative preparation on the vaginal architectonics of postmenopausal women with severe genital prolapse. Gynecology. 2020; 22 (4): 33–38. DOI: 10.26442/20795696.2020.4.200155 (in Russ.) https://doi.org/10.26442/20795696.2020.4.200155]

18. Доброхотова Ю.Э., Лапина И.А., Тян А.Г., Таранов В.В., Чирвон Т.Г., Глебов Н.В., Кайкова О.В., Малахова А.А., Гомзикова В.М., Махонина Е.С., Ольховская М.А. Комбинированное лечение пациенток постменопаузального периода с пролапсом тазовых органов и генитоуринарным синдромом. Гинекология. 2024;26(1):68-74. https://doi.org/10.26442/20795696.2024.1.202641 [Dobrokhotova Yu.E., Lapina I.A., Tyan A.G., Taranov V.V., Chirvon T.G., Glebov N.V., Kaikova O.V., Malakhova A.A., Gomzikova V.M., Makhonina E.S., Olkhovskaya M.A. Combined treatment of postmenopausal patients with pelvic organ prolapse and genitourinary syndrome. Gynecology. 2024;26(1):68-74. (In Russ.) https://doi.org/10.26442/20795696.2024.1.202641]

19. Оразов М.Р., Радзинский В.Е., Миннуллина Ф.Ф. Клинико-анамнестические факторы риска рецидивирующего пролапса тазовых органов. Практическая медицина. 2024;22(6):18-22. https://doi.org/10.32000/2072-1757-2024-6-18-22 [Orazov M.R., Radzinskiy V.E., Minnullina F.F. Clinical and anamnestic risk factors for recurrent pelvic organ prolapse. Practical medicine. 2024; 22 (6):18-22 (in Russ.) https://doi.org/10.32000/2072-1757-2024-6-18-22]

20. Юминова А.В., Михельсон А.А., Семенов Ю.А., Лазукина М.В., Гришкина А.А., Чистякова Г.Н., Вараксин А.Н. Роль предоперационной подготовки слизистой оболочки влагалища у женщин ре продуктивного возраста с пролапсом тазовых органов. Фарматека. 2024;31(3):48-58. https://doi.org/10.18565/pharmateca.2024.3.48-58 [Yuminova A.V., Mikhelson A.A., Semenov Yu.A., Lazukina M.V., Grishkina A.A., Chistyakova G.N., Varaksin A.N. The role of preoperative preparation of the vaginal mucosa in women of reproductive age with pelvic organ prolapse. Pharmaceutical library. 2024;31(3): 48-58 (In Russ.) https://doi.org/10.18565/pharmateca.2024.3.48-58]

21. Глухов Е.Ю., Дикке Г.Б., Нефф Е.И., Рощина М.О. Подготовка к хирургическому лечению пациенток с тяжелыми формами пролапса тазовых органов, осложненного трофическими нарушениями. Фарматека. 2020; 27(6):54-60. https://doi.org/10.18565/pharmateca.2020.6.54-60 [Glukhov E.Yu., Dikke G.B., Neff E.I., Roshchina M.O. Preparation for surgical treatment of patients with severe forms of pelvic organ pro lapse complicated by trophic disorders. Pharmaceutical library. 2020;27(6):54-60 (In Russ.) https://doi.org/10.18565/pharmateca.2020.6.54-60]

22. Маковская Д. С., Аполихина И. А., Горбунова Е. А. Консервативные методы лечения декубитальных язв у женщин с пролапсом тазовых органов. Медицинский оппонент. 2023; 2 (22): 67–74. — EDN: MXHOGO. [Makovskaya D.S., Apolikhina I.A., Gorbunova E.A. et al. Conservative treatments of decubitus ulcers in women with pelvic organ prolapse. Medical Opponent. 2023; 2 (22): 67–74.(In Russ.) — EDN: MXHOGO.]


Review

For citations:


Yuminova A.V., Mikhelson A.A., Lazukina M.V. Preoperative preparation of reproductive age patients with genital prolapse (literature review). Bulletin of maternal and child care. 2025;2(1):21-29. (In Russ.) https://doi.org/10.69964/BMCC-2025-2-1-21-29

Views: 74


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 3034-395X (Online)