Genital prolapse in women

Area of Science:

• Urogynecology
• Pelvic Floor Disorders
• Women's Health

Background:

• Pelvic organ prolapse, including uterine and vaginal prolapse, results from diminished pelvic support, often presenting with non-specific symptoms.
• Prevalence increases with parity, age, higher birth weight, and hysterectomy, affecting a significant portion of women aged 50-59.
• Spontaneous regression is possible, but understanding treatment efficacy is crucial.

Purpose of the Study:

• To systematically review the effects of non-surgical treatments for genital prolapse.
• To evaluate surgical interventions for anterior, posterior, and upper vaginal wall prolapse.
• To compare the outcomes of different surgical materials used in genital prolapse repair.

Main Methods:

• A systematic review of medical literature was conducted, searching databases like Medline, Embase, and The Cochrane Library up to June 2009.
• Included randomized controlled trials (RCTs) and observational studies, alongside safety alerts from regulatory agencies (FDA, MHRA).
• GRADE methodology was employed to assess the quality of evidence for each intervention.

Main Results:

• Fourteen systematic reviews, RCTs, or observational studies met the inclusion criteria for the review.
• A comprehensive evaluation of evidence quality was performed using the GRADE system.
• Data on a wide range of interventions, from conservative measures to complex surgeries, were analyzed.

Conclusions:

• The review synthesizes evidence on the effectiveness and safety of numerous interventions for pelvic organ prolapse.
• Interventions discussed include pelvic floor muscle exercises, vaginal pessaries, estrogen therapy, and various surgical procedures.
• Surgical options range from traditional repairs like anterior/posterior colporrhaphy to advanced techniques using mesh, native tissue, or laparoscopic approaches.