Clinical and anatomical features of patients with apical prolapse

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Objective: To study clinical and anatomical features of patients with apical prolapse (AP).

Materials and methods: 230 medical records of patients with pelvic organ prolapse who underwent examination and treatment from 2019 to 2024 at the University Clinic "I am healthy!" were analyzed. The main patient group consisted of 130 women with apical prolapse, the comparison group included 100 patients with anterior/posterior vaginal wall prolapse without apical prolapse. Evaluation was performed according to the POP-Q classification, using standard questionnaires (POPDI-6, UDI-6) and clinical examination.

Results: Patients with apical prolapse more often reported incomplete bladder emptying and the need to reduce prolapse to ease voiding. In the comparison group, stress urinary incontinence and lower abdominal pressure were more common. In almost half of the patients with apical prolapse, the leading point was Ba (44.6%). In patients without apical prolapse, prolapse of the posterior vaginal wall (point Bp) occurred most often (62%). No significant differences in symptoms were found between the groups, which complicates the early diagnosis of apical prolapse.

Conclusion: When examining the patients with pelvic organ prolapse and collecting their history, it is necessary to take into account the "pitfalls" that complicate objective diagnosis of apical prolapse. It is necessary to improve the technique of physical examination of gynecological patients for early detection of first-level support defects, which will allow timely prescription of adequate treatment with the best long-term results.

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作者简介

Е. Dubinskaya

Patrice Lumumba Peoples' Friendship University of Russia, Ministry of Education and Science

编辑信件的主要联系方式.
Email: eka-dubinskaya@yandex.ru
ORCID iD: 0000-0002-8311-0381

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

俄罗斯联邦, Moscow

A. Gasparov

Patrice Lumumba Peoples' Friendship University of Russia, Ministry of Education and Science

Email: 13513520@mail.ru
ORCID iD: 0000-0001-6301-1880

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

俄罗斯联邦, Moscow

Е. Matskevich

Patrice Lumumba Peoples' Friendship University of Russia, Ministry of Education and Science

Email: liza151196chik@mail.ru
ORCID iD: 0009-0000-3315-7408

Department of Obstetrics, Gynecology and Perinatology, Teaching Assistant at the Department of Obstetrics, Gynecology and Reproductive Medicine, Faculty of Postgraduate Education

俄罗斯联邦, Moscow

参考

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2. Fig. 1. Study design

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3. Fig. 2. Severity of pelvic organ prolapse symptoms at different stages of apical prolapse (POP-Q), POPDI-6 scores

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