Genital prolapse in women of reproductive age: structural changes in the pelvic floor support system

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Objective: This study aimed to examine the structural characteristics of pelvic floor muscles using ultrasound and histological examinations.

Materials and methods: In this study, 31 patients with POP-Q grade I–II genital prolapse and 30 women without pelvic organ prolapse were evaluated using pelvic floor ultrasound. The histological study involved examining muscle tissue samples from the m. levator ani obtained during the surgical correction of severe genital prolapse in 10 women.

Results: Among patients with genital prolapse, there was a significant decrease in the height of the perineal tendon center as well as the thickness of the bulbocavernosus and puborectalis muscles (p<0.05). The study group also exhibited an increase in the area of the levator fissure and levator-urethra gap. Histological examination of five m. levator ani samples revealed varying degrees of fibrosis and a decrease in the cross-sectional area of the muscle fibers.

Conclusion: Pathognomonic signs of genital prolapse include pelvic floor dysfunction and disruption of the integrity and structure of muscle fibers, characterized by the replacement of normal tissue with fibrosis and dystrophic changes.

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Sobre autores

Ol'ga Remneva

Altai State Medical University, Ministry of Health of Russia

Autor responsável pela correspondência
Email: rolmed@yandex.ru
ORCID ID: 0000-0002-5984-1109

Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology

Rússia, Barnaul

Irina Ivanyuk

Altai State Medical University, Ministry of Health of Russia

Email: Ivanukirina@yandex.ru
ORCID ID: 0000-0002-6895-7103

PhD Student at the Department of Obstetrics and Gynecology

Rússia, Barnaul

Anzhelika Gal'chenko

Altai State Medical University, Ministry of Health of Russia

Email: rolmed@yandex.ru
ORCID ID: 0000-0003-3013-7764

PhD, Associate Professor at the Department of Obstetrics and Gynecology

Rússia, Barnaul

Natalya Semenikhina

Altai State Medical University, Ministry of Health of Russia

Email: rolmed@yandex.ru
ORCID ID: 0000-0003-4954-1716

PhD, Associate Professor at the Department of Anatomy

Rússia, Barnaul

Bibliografia

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2. Fig. 1. Assessment of the pelvic floor condition in B-mode: a) normal ultrasound image of the bulbocavernous muscles and the perineal tendon center; b) pelvic floor insufficiency. Thinning of the bulbocavernous muscle bundles, decrease in the height of the tendon center

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3. Fig. 2. Measurement of the levator-urethral interval: a) normal ultrasound image; b) translabial tomographic echography at rest. Left-sided defect of the levator ani muscle.

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