Clinical and anamnestic characteristics of patients of reproductive age with pelvic floor syndrome descents

Pelvic organ prolapse (POP) is a pressing medical and social problem that significantly affects the quality of life of women of reproductive age. According to epidemiological studies, the incidence of this pathology in women under 40 years reaches 15-20%, while there is a tendency for POP to become younger. However, other pelvic floor disorders, such as urinary incontinence and sexual dysfunction, are often ignored. All these pathologies are combined into pelvic descent syndrome (PDS). Research into risk factors for PDS development and identification of target groups is necessary for early diagnosis and successful treatment. The aim of the study. To evaluate clinical and anamnestic risk factors for the development of pelvic floor syndrome degradation in women of reproductive age. Study design. A prospective study was conducted. a cohort study that included 88 women of reproductive age (18-49 years). The patients were divided into 2 groups: Group I — women with pelvic descent syndrome (n=58), Group II — control (n=30). Within the framework of this study, an assessment of anthropometric parameters, obstetric and gynecological history and concomitant somatic diseases was carried out. To assess sexual function, was used validated self-administered questionnaire “Female Sexual Function Index” (The Female Sexual Function Index, FSFI). The function of the urinary tract was studied using uroflowmetry. The study was conducted on the TRITON urodynamic system (Laborie Medical Technologies, Canada). Research results. Significant clinical and anamnestic predictors of pelvic descent syndrome are the number of pregnancies more than three, the number of births more than two, the presence of perineal injuries during childbirth, childbirth with a large fetus, obesity. Patients with pelvic descent syndrome have pronounced sexual dysfunction, but do not actively complain about the quality of sexual life.

1. Данилина О.А., Волков В.Г. Распространенность пролапса тазовых органов среди женщин репродуктивного возраста. ВНМТ. 2022; 1: 29-33. https://doi.org/10.24412/1609-2163-2022-1-29-33 [Danilina O.A., Volkov V.G. The prevalence of pel vic organ prolapse among women of reproductive age. VNMT. 2022; 1: 29-33. (in Russian) https://doi.org/10.24412/1609-2163-2022-1-29-33]

2. Токтар Л.Р., Оразов М.Р., Лологаева М.С., Арютин Д.Г., Самсонова И.А., Гайфуллин Р.Ф., Достиева Ш.М., Камарова З.Н. Клинико-анамнестический портрет пациентки с генитальным пролапсом. Клинический разбор в общей медицине. 2023; 4 (9): 59-64. https://doi.org/10.47407/^2023.4.9.00309 [Toktar L.R., Orazov M.R., Lologaeva M.S., Aryutin D.G., Samsonova I.A., Gaifullin R.F., Dostieva Sh.M., Kamarova Z.N. Clinical and anamnestic portrait of a patient with genital prolapse. Clinical analysis in general medicine. 2023; 4 (9): 59-64. (in Russian) https://doi.org/10.47407/^2023.4.9.00309]

3. Буянова С.Н., Щукина Н.А., Зубова Е.С., Сибряева В.А., Рижинашвили И.Д. Пролапс гениталий. Российский вестник акушера-гинеколога. 2017;17(1):37–45. https: //doi.org/10.17116/rosakush201717137-45 [Buyanova S. N.N., Shchukina N.A., Zubova E. N.I., Sibryaeva V.A.,Rizhinashvili I.Others. Genital prolapse. Russian Bulletin of the obstetrician-gynecologist. 2017;17(1):37 45. (in Russian) https://doi.org/10.17116/rosakush201717137-45]

4. Ремнёва О. В., Иванюк И. С., Гальченко А. И. Дисфункция тазового дна у женщин: современные представления о проблеме (обзор литературы). Фундаментальная и клиническая медицина. 2022; 7(1): 92–101. https://doi.org/10.23946/2500-0764-2022-7-1-92-101 [Remneva O. V., Ivanyuk I. S., Galchenko A. I. Pelvic floor dysfunction in women: current views on the problem (literature review). Fundamental and clinical medicine. 2022; 7(1): 92–101. (in Russian) https://doi.org/10.23946/2500-0764-2022-7-1-92-101]

5. Rashidi F, Mirghafourvand M. Pelvic floor disorder and relevant factors in Iranian women of reproductive age: a cross-sectional study. BMC Womens Health. 2023; 23(1):71. https://doi.org/10.1186/s12905-023-02226-1

6. Hambisa HD, Birku Z, Gedamu S. Magnitude of Symptomatic Pelvic Floor Dysfunction and Associated Factors Amongst Women in Western Ethiopia: A Cross-Sectional Study. Inquiry. 2023;60:469580231171309. https://doi.org/10.1177/00469580231171309

7. Мурашко О. В., Подгорная А. С., Захарко А. Ю. Этиология и патогенез дисфункции тазового дна (обзор литературы). Медико-биологические проблемы жизнедеятельности. 2024; (1): 16–21. https://doi.org/10.58708/2074-2088.2024-1(31)-16-21 [Murashko O. V., Podgornaya A. S., Zakharko A. Y. Etiology and pathogenesis of pelvic floor dysfunction ( literature review). Medical and biological problems of vital activity. 2024; (1): 16–21. (in Russian) https://doi.org/10.1016/j.ejogrb.2021.08.026]

8. Quaghebeur J, Petros P, Wyndaele JJ, De Wachter S. Pelvic-floor function, dysfunction, and treatment. Eur J Obstet Gynecol Reprod Biol. 2021;265:143-149. https://doi.org/10.1016/j.ejogrb.2021.08.026

9. Zhang S, Li B, Liu J, Yang L, Li H, Hong L. The causal effect of reproductive factors on pelvic floor dysfunction: a Mendelian randomization study. BMC Womens Health. 2024 Jan 28;24(1):74. https://doi.org/10.1186/s12905-024-02914-6

10. Falah-Hassani K, Reeves J, Shiri R, Hickling D, McLean L. The pathophysiology of stress urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 2021;32(3):501-552. https://doi.org/10.1007/s00192-020-04622-9

11. Михельсон А.А., Луговых Е.В., Лазукина М.В., Вараксин А.Н., Лукьянова К.Д., Миняйло Е.М. Клинико-анамнестические предикторы развития стрессового недержания мочи у женщин. Гинекология. 2022;24(1):51–56. https://doi.org/10.26442/20795696.2022.1.201333 [Mikhelson A.A., Lugovykh E.V., Lazukina M.V., Varaksin A.N., Lukyanova K.D., Minyailo E.M. Clinical and anamnestic predictors of stress urinary incontinence in women. Gynecology. 2022;24(1):51–56. (in Russian) https://doi.org/10.26442/20795696.2022.1.201333]

12. Eggebø TM, Volløyhaug I. The pelvic floor during pregnancy and delivery: Can pelvic floor trauma and disorders be prevented? Acta Obstet Gynecol Scand. 2024;103(6):1012-1014. https://doi.org/10.1111/aogs.14875

13. Tim S, Mazur-Bialy AI. The Most Common Functional Disorders and Factors Affecting Female Pelvic Floor. Life (Basel). 2021;11(12):1397. https://doi.org/10.3390/life11121397

14. Михельсон А.А., Лазукина М.В., Мелкозерова О.А. Малоинвазивные методы коррекции тазовых и уродинамических нарушений у женщин репродуктивного возраста. Лечение и профилактика. 2022; 12(2): 39-45. eLIBRARY ID: 49300694 EDN: XDCLVQ [Mikhelson A.A., Lazukina M.V., Melkozerova O.A. Minimally invasive methods of correction of pelvic and urodynamic disorders in women of reproductive age. Treatment and prevention. 2022; 12(2): 39-45. eLIBRARY ID: 49300694 EDN: XDCLVQ (in Russian)]

15. Dietz HP, Chavez-Coloma L, Friedman T, Turel F. Pelvic organ prolapse in nulliparae. Aust N Z J Obstet Gynaecol. 2022;62(3):420-425. https://doi.org/10.1111/ajo.13481

16. Михельсон А.А., Мальгина Г.Б., Лукьянова К.Д., Лазукина М.В., Луговых Е.В., Вараксин А.Н., Лукач М.А., Нестерова Э.А. Ранняя диагностика и профилактика тазовых и уродинамических дисфункций у женщин после родоразрешения. Гинекология. 2022;24(4):295– 301. https://doi.org/10.26442/20795696.2022.4.201782 [Mikhelson A.A., Malgina G.B., Lukyanova K.D., Lazukina M.V., Lugovykh E.V., Varaksin A.N., Lukach M.A., Nesterova E.A. Early diagnosis and prevention of pelvic and urodynamic dysfunctions in women after delivery. Gynecology. 2022;24(4):295–301. (in Russian) https://doi.org/10.26442/20795696.2022.4.201782]

17. Sinha S. The Use of Uroflowmetry as a Diagnostic Test. Curr Urol Rep. 2024 May;25(5):99-107. https://doi.org/10.1007/s11934-024-01200-0

18. Fatton B, de Tayrac R, Letouzey V, Huberlant S. Pelvic organ prolapse and sexual function. Nat Rev Urol. 2020 Jul;17(7):373-390. https://doi.org/10.1038/s41585-020-0334-8

19. Подзолкова Н.М., Осадчев В.Б., Глазкова О.Л., Бабков К.В., Денисова Ю.В. Влияние пролапса тазовых органов и различных вариантов его коррекции на женскую сексуальную функцию. Гинекология. 2023;25(1):31-38. https://doi.org/10.26442/20795696.2023.1.201899 [Podzolkova N.M., Osadchev V.B., Glazkova O.L., Babkov K.V., Denisova Yu.V. The effect of pelvic organ prolapse and various options for its correction on female sexual function. Gynecology. 2023;25(1):31-38. (in Russian) https://doi.org/10.26442/20795696.2023.1.201899]

20. Li J, Zhao X, Li J, Liu Y, Li T. Pelvic organ prolapse after delivery: effects on sexual function, quality of life, and psychological health. J Sex Med. 2023;20(12):1384-1390. https://doi.org/10.1093/jsxmed/qdad120

21. Van der Vaart LR, Vollebregt A, Pruijssers B, Milani AL, Lagro-Janssen AL, Roovers JWR, van der Vaart CH. Female Sexual Functioning in Women With a Symptomatic Pelvic Organ Prolapse; A Multicenter Prospective Comparative Study Between Pessary and Surgery. J Sex Med. 2022;19(2):270-279. https://doi.org/10.1016/j.jsxm.2021.11.008

22. Burzynski B, Gibala P, Soltysiak-Gibala Z, Jurys T, Przymuszala P, Rzymski P, Stojko R. How Urinary Incontinence Affects Sexual Activity in Polish Women: Results from a Cross-Sectional Study. Int J Environ Res Public Health. 2022;19(21):13818. https://doi.org/10.3390/ijerph192113818

23. Самсонова И. А., Крестинин М. В. Факторы риска развития пролапса тазовых органов. Актуальные вопросы современной науки и практики: Сборник научных статей по материалам X Международной научно-практической конференции. 2023; 2: 158-162. EDN: DFBKNJ. [Samsonova I. A., Krestinin M. V. Risk factors for pelvic organ prolapse. Current issues of modern science and practice: A collection of scientific articles based on the materials of the X International Scientific and Practical Conference. 2023; 2: 158-162. EDN: DFBKNJ. (in Russian)]

24. Оразов М.Р., Токтар Л.Р., Достиева Ш.М. и др. Пролапс тазовых органов — проблема, не имеющая идеального решения. Трудный пациент. 2019; 17 (8-9): 23-27. https://doi.org/10.24411/2074-1995-2019-10058 [Orazov M.R., Toktar L.R., Dostieva Sh.M. and others. Pelvic organ prolapse is a problem that does not have an ideal solution. A difficult patient. 2019; 17 (8-9): 23-27. (in Russian) https://doi.org/10.24411/2074-1995-2019-10058]

25. Краснопольская И.В. Нарушения мочеиспускания у женщин с дисфункцией тазового дна. Акушерство и гинекология: новости, мнения, обучение. 2018; 1: 62-7. https://doi.org/10.24411/2303-9698-2018-00008 [Krasnopolskaya I.V. Urinary disorders in women with pelvic floor dysfunction. Obstetrics and gynecology: news, opinions, training. 2018; 1: 62-7. (in Russian) https://doi.org/10.24411/2303-9698-2018-00008]

26. AlQuaiz AM, Kazi A, AlYousefi N, Alwatban L, AlHabib Y, Turkistani I. Urinary Incontinence Affects the Quality of Life and Increases Psychological Distress and Low Self-Esteem. Healthcare (Basel). 2023;11(12):1772. https://doi.org/10.3390/healthcare11121772