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Prevention and Treatment for Pelvic and Relative Diseases

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 25 June 2024 | Viewed by 5300

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Special Issue Editor

Prof. Dr. Ewa Barcz

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Guest Editor

Chair of Gynecology and Obstetrics, Medical Faculty Collegium Medicum Cardinal Stefan Wyszynski University, Multidisciplinary Hospital Warsaw-Miedzylesie, 04-749 Warsaw, Poland
Interests: endometriosis; urogynecology; gynaecological surgery; laparoscopic surgery; pelvic reconstructive surgery; urogynecology and female urology; urinary incontinence; urodynamics; pelvic organ prolapse; uterine prolapse; vaginal surgery; pelvic floor; stress urinary incontinence; overactive urinary bladder; urge urinary incontinence; incontinence; suburethral slings; hysterectomy; fecal incontinence; fistulas

Special Issue Information

Dear Colleagues,

Current medicine focuses on developing diagnostic tools and treatment for life threatening conditions such as neoplasms or infectious disease, which is one of the greatest challenges faced by society today. Nevertheless, we cannot forget about other population diseases that affect wellbeing, self-esteem and quality of life, such as pelvic and pelvic floor diseases. Uro-gynecological problems such as pelvic organ prolapse, urgency, stress urinary incontinence, fecal incontinence and surgery complications affect a significant population of women, as it is estimated that over 30% of adult females suffer from one of these conditions. Deep infiltrating endometriosis, adenomyosis, myomas causing pelvic pain syndrome and abnormal bleedings complete the picture of the problems that influence the everyday life of affected women. Therefore, it is of high importance to carry out research concerning the prevention, risk factors and diagnostic tools associated with these diseases, as well as appropriate treatment for patients.

I am sure that your participation in this Special Issue will significantly contribute to the advancement of medical knowledge in the pelvic diseases field.

Prof. Dr. Ewa Barcz
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

pelvic organ prolapse
urinary incontinence
fecal incontinence
endometriosis
pelvic pain syndrome
overactive bladder syndrome
vaginal surgery

Published Papers (5 papers)

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Research

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11 pages, 4427 KiB

Open AccessArticle

Acellular Dermal Matrices as an New Alternative for Treatment in Reproductive Organ Static Disorders: A Pilot Study

by Marcin Sadłocha, Kaja Skowronek, Wojciech Łabuś, Jakub Staniczek, Maisa Mansar-Dyrbuś and Rafał Stojko

J. Clin. Med. 2024, 13(6), 1550; https://doi.org/10.3390/jcm13061550 - 8 Mar 2024

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Abstract

Background: The study aimed to evaluate the clinical effects of utilizing acellular dermal matrix (ADM) for treating pelvic organ prolapse. The motivation behind exploring a new treatment method stems from the limited efficacy of current surgical options, which are often associated with side effects. Methods: Ten patients with reproductive organ prolapse underwent surgery at the Chair and Department of Gynecology, Obstetrics, and Gynecological Oncology in Katowice. ADM was used as a support material, with eight patients receiving double TOT and two undergoing a six-point fixation mesh procedure. Pelvic organ prolapse was evaluated pre-operatively and one month post-surgery using the Pelvic Organ Prolapse Quantification (POP-Q) System. General medical history and complaints were assessed using the short form (PFDIQ-SF20). The study included ten patients aged 39 to 71 (mean: 63.6 years), all with a history of at least one vaginal delivery (mean of two). None had undergone a cesarean section. Four patients exhibited POP-Q 3, and five had POP-Q 2. Results: The mean PFDIQ-SF20 score before surgery was 70.6 points. No major complications occurred during or after surgery. One patient experienced a vaginal fungal infection and an allergic reaction to sutures. Post-operation, ailments reduced by an average of 60.76 points, with five patients reporting no complaints. Conclusions: ADM emerges as a material of interest for gynecological surgery, with initial reports highlighting its effectiveness and optimistic safety profile. Further research is warranted to explore its potential as a promising option in pelvic organ prolapse treatment. Full article

(This article belongs to the Special Issue Prevention and Treatment for Pelvic and Relative Diseases)

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13 pages, 2332 KiB

Open AccessArticle

The Influence of Successful Treatment of Stress Urinary Incontinence and Pelvic Organ Prolapse on Depression, Anxiety, and Insomnia—A Prospective Intervention Impact Assessment Study

by Urszula Kalata, Michał Jarkiewicz, Andrzej Pomian, Aneta Janina Zwierzchowska, Edyta Horosz, Wojciech Majkusiak, Beata Rutkowska and Ewa Monika Barcz

J. Clin. Med. 2024, 13(6), 1528; https://doi.org/10.3390/jcm13061528 - 7 Mar 2024

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Abstract

Introduction: The association between pelvic floor disorders (PFDs) and psychiatric conditions is an area of emerging interest. The causal direction of this relationship, however, remains ambiguous; it is unclear whether PFDs directly contribute to the deterioration of mental health or if pre-existing psychiatric conditions such as depression exacerbate the symptoms of PFDs. This study aimed to evaluate the effects of successful surgical treatment for stress urinary incontinence (SUI) and pelvic organ prolapse (POP) on symptoms of depression, anxiety, and insomnia. Materials and Methods: This investigation focused on patients who underwent successful surgical interventions for SUI and POP. Both subjective and objective symptoms of PFDs, along with psychiatric status, were assessed before and after the surgical procedures. Results: This study found that successful surgical treatment of SUI and POP led to a significant reduction in anxiety scores. Additionally, in patients with SUI, successful treatment was objectively associated with a decrease in the severity of insomnia. Alleviation of symptoms associated with the lower urinary tract, prolapse, and colorectal–anal region following POP surgery was correlated with improvements in depression and anxiety but not insomnia. Subjectively assessed improvements in SUI subjective symptoms were linked to reductions in the severity of depression, anxiety, and insomnia in patients who underwent anti-incontinence surgery. Conclusions: These findings suggest a potential cause-and-effect relationship between PFDs and certain psychiatric disorders, highlighting the importance of successful treatment of PFDs in mitigating symptoms of depression, anxiety, and insomnia. Full article

(This article belongs to the Special Issue Prevention and Treatment for Pelvic and Relative Diseases)

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19 pages, 3194 KiB

Open AccessArticle

Determination of Serum Arginase-1 Concentrations and Serum Arginase Activity for the Non-Invasive Diagnosis of Endometriosis

by Maciej Pliszkiewicz, Malgorzata Czystowska-Kuzmicz, Karolina Soroczynska, Bogumił Paweł Siekierski and Krzysztof Safranow

J. Clin. Med. 2024, 13(5), 1489; https://doi.org/10.3390/jcm13051489 - 5 Mar 2024

Viewed by 698

Abstract

Backgroud: Endometriosis remains a diagnostic challenge, both clinically and economically, affecting 6% to 15% of women of child-bearing potential. We have attempted to determine whether testing serum concentrations and activity of arginase isoenzymes could be useful for the non-invasive diagnosis of endometriosis. Methods: This study involved 180 women (105 endometriosis subjects—study group B; 22 subjects with other benign gynaecological conditions—control group 1—K1, both undergoing surgery; and 53 healthy subjects without features of endometriosis—control group 2—K2). Results: Preoperative and postoperative arginase-1 (Arg-1) concentrations were significantly higher in patients, as compared with the control groups K1 (p < 0.0001 and p = 0.0005, respectively) and K2 (both p < 0.0001). Similarly, arginase activity was significantly higher in patients than in the control group K1 before surgery and higher than in both control groups after surgery. No significant differences in either Arg-1 concentrations or arginase activity were noted between the operated control group K1 and the non-operated control group K2. A significant postoperative decrease in Arg-1 concentration was observed within both patient (p < 0.0001) and control group K1 (p = 0.0043). Diagnostic performance was assessed using the receiver operating characteristic (ROC) method. The threshold for differentiation between endometriosis patients and healthy non-operated controls was 42.3 ng/mL, with a sensitivity of 90% and specificity of 81%. For differentiation of patients and operated controls with benign gynaecological conditions, the threshold was 78.4 ng/mL, with a sensitivity of 61% and specificity of 95%. Conclusions: We, therefore, conclude that Arg-1 serum concentrations and arginase activity could be considered potential biomarkers for endometriosis but require further studies on larger cohorts of patients. Full article

(This article belongs to the Special Issue Prevention and Treatment for Pelvic and Relative Diseases)

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12 pages, 2574 KiB

Open AccessArticle

Influence of Stress Urinary Incontinence and Pelvic Organ Prolapse on Depression, Anxiety, and Insomnia—A Comparative Observational Study

by Urszula Kalata, Andrzej Pomian, Michał Jarkiewicz, Vitalii Kondratskyi, Krzysztof Lippki and Ewa Barcz

J. Clin. Med. 2024, 13(1), 185; https://doi.org/10.3390/jcm13010185 - 28 Dec 2023

Cited by 2 | Viewed by 1709

Abstract

Background: Among pelvic floor disorders (PFDs), overactive bladder is a well-recognized condition affecting mental health. The aim of this study was to assess whether there is a correlation between stress urinary incontinence (SUI), pelvic organ prolapse (POP), and mental health in comparison to control subjects and whether objective or subjective aspects of diseases are responsible for the aforementioned symptoms. Methods: 192 patients with SUI, 271 with symptomatic prolapse (>2 in the POPQ scale), and 199 controls without pelvic floor disorders were included in this study. Patients completed questionnaires assessing levels of depression, anxiety, and insomnia. The 1-h pad test and IIQ-7 questionnaires were collected in SUI. The pelvic organ prolapse quantification scale and the POPDI6, UDI6, and CRADI-8 questionnaires were used in POP patients. Results: Higher scores in psychiatric scales were observed in SUI (p < 0.05) and POP (p < 0.05) compared to control. There were no correlations between the objective severity of PFDs and psychological symptoms, while subjective complaints correlated with psychological health. In conclusion, we showed that subjective perceptions of SUI and POP are factors that augment psychiatric symptoms, while objective severity is not correlated with mental status. Conclusions: Our findings suggest that patients with PFDs necessitate multidisciplinary attention, including psychiatric care. Full article

(This article belongs to the Special Issue Prevention and Treatment for Pelvic and Relative Diseases)

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Review

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24 pages, 3440 KiB

Open AccessReview

Sonography as a Diagnostic Tool in Midurethral Sling Complications: A Narrative Review

by Aneta Zwierzchowska, Paweł Tomasik, Edyta Horosz and Ewa Barcz

J. Clin. Med. 2024, 13(8), 2336; https://doi.org/10.3390/jcm13082336 - 18 Apr 2024

Viewed by 515

Abstract

Despite the established safety and efficacy of midurethral slings (MUS), which are the current gold standard treatment for stress urinary incontinence (SUI), the potential for postoperative complications remains a significant concern for both healthcare professionals and patients. Meanwhile, sonography has emerged as a significant diagnostic tool in urogynecology, and one of the applications of this imaging modality may be the evaluation of complications arising from MUS procedures. This review, based on a comprehensive literature search, focuses on the use of pelvic floor ultrasound (US) in the context of MUS complications. It includes analyses of randomized controlled trials, prospective, and retrospective studies, covering preoperative and postoperative investigations, to assess complications such as persistent and recurrent SUI, urinary retention and obstructive voiding, de novo urgency/overactive bladder, vaginal exposure, sling erosion, pain, and hematoma. The review critically examines the existing literature, with a particular focus on recent publications. Despite the variability in findings, it appears that for each of the discussed complications, the application of pelvic floor US can significantly support the diagnostic and therapeutic process. The paper also identifies potential future directions for the development of US applications in diagnosing MUS complications. Full article

(This article belongs to the Special Issue Prevention and Treatment for Pelvic and Relative Diseases)

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