The role of preoperative preparation of the vaginal mucosa in women of reproductive age with pelvic organ prolapse

Alisa V. Yuminova; Юминова Алиса Владимировна; A. A. Mikhelson; Михельсон А. А.; Yu. A. Semenov; Семенов Ю. А.; M. V. Lazukina; Лазукина М. В.; A. A. Grishkina; Гришкина А. А.; G. N. Chistyakova; Чистякова Г. Н.; A. N. Varaksin; Вараксин А. Н.

doi:10.18565/pharmateca.2024.3.48-58

The role of preoperative preparation of the vaginal mucosa in women of reproductive age with pelvic organ prolapse

作者: Yuminova A.V.¹, Mikhelson A.A.¹, Semenov Y.A.¹, Lazukina M.V.¹, Grishkina A.A.¹, Chistyakova G.N.¹, Varaksin A.N.²
隶属关系:
1. Ural Research Institute for the Protection of Maternity and Infancy
2. Institute of Industrial Ecology, Ural Branch of the Russian Academy of Sciences
期: 卷 31, 编号 3 (2024)
页面: 48-58
栏目: Original articles
URL: https://journals.eco-vector.com/2073-4034/article/view/634886
DOI: https://doi.org/10.18565/pharmateca.2024.3.48-58
ID: 634886

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Background. Pelvic organ prolapse (POP) is detected in a third of patients of reproductive age during examination The main treatment method for the symptomatic form of POP is surgical correction with elimination of the anatomical defect. Despite solving the problem of correcting the anatomical defect, it is important to restore the woman’s quality of life, including her sexual function in the postoperative period.

Objective. Evaluation of the effect of preoperative preparation using dynamic quadripolar radiofrequency (DQRF) and PRP therapy on the sexual health of patients and the morphological structure of the vaginal mucosa of women of reproductive age with POP.

Methods. A randomized comparative prospective study included 52 sexually active women of reproductive age with stage II–III pelvic organ prolapse according to POP-Q (Pelvic Organ Prolapse Quantification) aged 31 to 49 years. The patients were divided into 3 groups using a random number generator. Group I (n=17) of patients underwent preoperative preparation using DQRF before surgical treatment, group II (n=14) – using PRP therapy, group III (n=21) – control. All patients underwent surgical treatment: anterior colporrhaphy, cystocele repair with own tissues and/or posterior colporrhaphy, levatoroplasty. Intraoperatively, histological material (vaginal mucosa) was obtained. Before the start of preoperative preparation and 4 months after surgical treatment, a survey using the FSFI questionnaire (The Female Sexual Function Index) was conducted.

Results. All patients who underwent surgical treatment of POP showed an increase in the sexual function index, but women in the group with preoperative preparation had better indicators in the domains of lubrication, desire and satisfaction with sexual life. According to histological examination, signs of mild chronic inactive inflammation and fibrosis were noted in the vaginal mucosa of the control group. In the preoperative preparation groups, there is less severity of the inflammatory reaction, absence of infiltration and fibrosis of the stroma. In addition to the above changes, when examining the vaginal mucosa in the DQRF group, significant vascularization and homogeneous ordered structure of collagen fibers were recorded.

Conclusion. The use of DQRF and PRP therapy methods in women of reproductive age with POP as preoperative preparation demonstrated an improvement in sexual function in the postoperative period. According to a morphological study of the vaginal mucosa, the use of preoperative preparation using DQRF and PRP therapy has a positive effect on regeneration processes and reduces signs of chronic inactive inflammation. The DQRF stimulates tissue regeneration, regulates neoangiogenesis, neocollagenogenesis, as well as decreases chronic inactive inflammation, while PRP therapy acts exclusively in the form of a decrease in the morphological signs of chronic inflammation. DQRF can be considered as one of the methods of preoperative preparation for surgical treatment of genital prolapse to improve the quality of life of women and their sexual health in the postoperative period.

关键词

pelvic organ prolapse, preoperative preparation, PRP therapy, dynamic quadripolar radiofrequency, histological examination, female sexual function

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作者简介

Alisa Yuminova

Ural Research Institute for the Protection of Maternity and Infancy

编辑信件的主要联系方式.
Email: lisa_yuminova@mail.ru
ORCID iD: 0000-0002-6496-5675

Obstetrician-Gynecologist, Full-Time Graduate Student in the Department of Preservation of Reproductive Function

俄罗斯联邦, Yekaterinburg

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