Pelvic floor dysfunction in women: clinical presentation, diagnosis, and principles of treatment

Objective. To improve the results of surgical treatment in patients with pelvic floor dysfunction, by comprehensively evaluating of anatomical and functional abnormalities. Subjects and methods. A total of299patients with Pelvic Organs Prolapse Quantification (POP-Q) Stages II- IV genital prolapse were examined and operated on at the Department of Endoscopic Surgery, Moscow Regional Research Institute of Obstetrics and Gynecology. Results. The frequency of recurrent prolapses amounted to 21.4%; that ofposthysterectomic one was 13.7%. The investigators detected a high frequency (67.9%) and wide range of urination problems (stress urinary incontinence (32.5%), isolated overactive bladder (21.6%), mixed urinary incontinence (45.8%), latent urinary incontinence (11.1%)), and defecation problems (40.8%). The procedures of sacrospinous fixation, vaginal extraperitoneal colpopexy using synthetic prostheses, laparoscopic sacrovaginopexy, traditional vaginal operations were comparable by the efficiency/safety criterion: 93.3 and 95.6%, 95.6and 93.4%; 93 and 98.8%; 90.4 and 100%, respectively, with a minimum number of complications and with an average reduced hospital length of stay of as long as 3 days. Conclusion. Our developed program that includes conservative and surgical approaches (with the use of current minimally invasive techniques and traditional surgery) in patients with pelvic floor dysfunction can significantly improve quality of life with a minimal number of complications, with no fatal and disabling outcomes, and with an average reduced hospital length of stay of as long as 3 days.

pelvic floor dysfunction in women, genital prolapse, stress incontinence, sacrospinous fixation, vaginal extraperitoneal colpopexy using synthetic prostheses, laparoscopic sacrovaginopexy