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Female Pelvic Medicine and Reconstructive Surgery
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Female Pelvic Medicine and Reconstructive Surgery

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

Deadline for manuscript submissions: closed (15 November 2022) | Viewed by 8028

Special Issue Editors

Dr. Liliana Mereu

E-Mail Website
Guest Editor
Obstetrics and Gynecological Department, Santa Chiara Hospital, Trento, Italy
Interests: laparoscopy; robotics; minimally invasive surgery
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Paolo Scollo

E-Mail Website
Guest Editor
1. Onco-Gynecology Unit, Department of Obstetrics and Gynecology, Cannizzaro Hospital-Catania, 95126 Catania, Italy
2. Kore University of Enna, 94100 Enna, Italy
Interests: gynecologic Oncology; V-NOTES surgery; uterine transplantation; pelvic reconstructive surgery

Special Issue Information

Dear Colleagues,

Pelvic organ prolapse is a prevalent disorder with a high lifetime incidence of surgical repair, its surgical treatment having greatly evolved over the past years with pelvic floor reconstructive surgeons now faced with a vast array of treatment options for their patients. Pelvic reconstructive surgery for POP can be subdivided into numerous different classifications and types of procedures, first being an anatomic classification by compartment (anterior, posterior and/or apical). The type of approach may be transvaginal or abdominal, with the latter feasibly performed by open, laparoscopic or robot-assisted laparoscopic techniques. If an apical prolapse is present, a decision as to whether or not to perform a hysterectomy must be determined. Finally, the reconstruction may be performed with or without mesh for added support, both through transvaginal and abdominal routes. In the present Special Issue, we present an overview of each technique, focusing our interest on the most popular and controversial current trends in pelvic reconstructive surgery as well as presenting the most recent approaches and techniques.

Dr. Liliana Mereu
Prof. Dr. Paolo Scollo
Guest Editors

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
  • apical suspension
  • mesh repair
  • fascial repair
  • biosynthetic and coated transvaginal mesh
  • autologous tissue
  • laser therapy
  • reconstructive surgery
  • urinary incontinence
  • pelvic floor

Related Special Issue

Published Papers (4 papers)

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Research

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9 pages, 256 KiB  
Article
Minimal Invasive Abdominal Sacral Colpopexy and Abdominal Lateral Suspension: A Prospective, Open-Label, Multicenter, Non-Inferiority Trial
by Eleonora Russo, Maria Magdalena Montt Guevara, Koray Gorkem Sacinti, Giulia Misasi, Maria Falcone, Riccardo Morganti, Liliana Mereu, Francesca Dalprà, Saverio Tateo and Tommaso Simoncini
J. Clin. Med. 2023, 12(8), 2926; https://doi.org/10.3390/jcm12082926 - 18 Apr 2023
Cited by 1 | Viewed by 1638
Abstract
Background: Abdominal minimally invasive surgery has become increasingly prominent for the treatment of prolapse. Abdominal sacral colpopexy (ASC) is the gold standard for the treatment of advanced apical prolapse; however, alternative surgical approaches such as the abdominal lateral suspension (ALS) have been developed [...] Read more.
Background: Abdominal minimally invasive surgery has become increasingly prominent for the treatment of prolapse. Abdominal sacral colpopexy (ASC) is the gold standard for the treatment of advanced apical prolapse; however, alternative surgical approaches such as the abdominal lateral suspension (ALS) have been developed to improve patient outcomes. This study aims to determine whether ALS improves outcomes compared to ASC in multicompartmental prolapse patients. Methods: A prospective, open-label, multicenter, non-inferiority trial was conducted in 360 patients who underwent ASC or ALS for the treatment of apical prolapse. The primary outcome was anatomical and symptomatic cure of the apical compartment at 1-year follow-up; secondary outcomes included prolapse recurrence, re-operation rate, and post-operative complications. A 300-patient cohort was subdivided into 200-patients who underwent ALS and 100-patients who underwent ASC. The confidence interval method was used to calculate the p-value of non-inferiority. Results: At the 12-months follow-up, the objective cure rate of the apical defect was 92% for ALS and 94% for ASC (recurrence rates were 8% and 6%, respectively, and the p-value for non-inferiority was <0.01). The mMesh complication rates were 1% and 2% for ALS and ASC, respectively. Conclusions: This study demonstrated that the ALS technique is not inferior to the gold standard ASC for the surgical treatment of apical prolapse. Full article
(This article belongs to the Special Issue Female Pelvic Medicine and Reconstructive Surgery)

Review

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9 pages, 899 KiB  
Review
Application of Acellular Dermal Matrix in Gynaecology—A Current Review
by Kaja Skowronek, Wojciech Łabuś, Rafał Stojko, Diana Kitala, Marcin Sadłocha and Agnieszka Drosdzol-Cop
J. Clin. Med. 2022, 11(14), 4030; https://doi.org/10.3390/jcm11144030 - 12 Jul 2022
Cited by 5 | Viewed by 1542
Abstract
The aim of our study is to draw attention to the multitude of applications of acellular dermal matrix (ADM) in the surgical treatment of urogynaecological disorders, such as reduction in the reproductive organs, and in reconstructive gynaecology. Despite the existence of numerous operational [...] Read more.
The aim of our study is to draw attention to the multitude of applications of acellular dermal matrix (ADM) in the surgical treatment of urogynaecological disorders, such as reduction in the reproductive organs, and in reconstructive gynaecology. Despite the existence of numerous operational methods and materials, the effectiveness of transvaginal operation is still insufficient. Native tissue operations are often not durable enough, while operations with synthetic materials have numerous side effects, such as infections, hematomas, vaginal erosion, or dyspareunia. Hence, the search continues for a different material with a better efficacy and safety profile than those previously mentioned. It seems that ADM can meet these requirements and be a useful material for urogynaecological surgery. Key words related to the usage of ADM in gynaecological reconstructive surgery were used to search relevant databases (NCBI MedLine, Clinical Key, Clinicaltrials.gov). This manuscript is based on 43 literature sources, 28 (65.11%) of which were released after 2016. Older sources are cited for the purpose of presenting basic science, or other important issues related to the manuscript. ADM seems to be an ideal material for urogynaecological and reconstructive surgery. It has high durability, and thus high effectiveness. Moreover, it does not have the side effects typical for synthetic materials. There are no reports of material rejection, erosion or dyspareunia directly related to the presence of the mesh. Due to the difficulties in obtaining ADM and the need to perform additional tests, this material is not common in routine clinical practice. Therefore, the number of cases and the size of the research groups are insufficient to clearly define the potential of mesh from biological tissue. However, the results are so promising that it is worth considering a wider introduction to the use of this material. Our hope is that increasing clinicians’ awareness of this topic will lead to more studies comparing methods using native tissues or synthetic materials and those using ADM. Full article
(This article belongs to the Special Issue Female Pelvic Medicine and Reconstructive Surgery)
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Other

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31 pages, 3365 KiB  
Systematic Review
Quality of Life Following Pelvic Organ Prolapse Treatments in Women: A Systematic Review and Meta-Analysis
by Zinat Ghanbari, Marjan Ghaemi, Arman Shafiee, Parivash Jelodarian, Reihaneh Sadat Hosseini, Shahla Pouyamoghaddam and Ali Montazeri
J. Clin. Med. 2022, 11(23), 7166; https://doi.org/10.3390/jcm11237166 - 01 Dec 2022
Cited by 5 | Viewed by 2344
Abstract
Introduction: Quality of life (QoL) improvement is one of the main outcomes in the management of pelvic organ prolapse as a chronic illness in women. This systematic review aimed to investigate the impact of surgical or pessary treatment for pelvic organ prolapse (POP) [...] Read more.
Introduction: Quality of life (QoL) improvement is one of the main outcomes in the management of pelvic organ prolapse as a chronic illness in women. This systematic review aimed to investigate the impact of surgical or pessary treatment for pelvic organ prolapse (POP) on quality of life. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was applied. Electronic databases, including PubMed, Scopus, and Web of Science, were searched for original articles that evaluated the QoL before and after surgical interventions or pessary in pelvic organ prolapse from 1 January 2012 until 30 June 2022 with a combination of proper keywords. Included studies were categorized based on interventions, and they were tabulated to summarize the results. Results: Overall, 587 citations were retrieved. Of these, 76 articles were found eligible for final review. Overall, three categories of intervention were identified: vaginal surgeries (47 studies), abdominal surgeries (18 studies), and pessary intervention (11 studies). Almost all interventions were associated with improved quality of life. The results of the meta-analysis showed a significant association between the employment of surgical approach techniques (including vaginal and abdominal surgeries) and the quality of life (Pelvic Floor Distress Inventory (PFDI) (MD: −48.08, 95% CI: −62.34 to −33.77, p-value < 0.01), Pelvic Floor Impact Questionnaire (PFIQ) (MD: −33.41, 95% CI: −43.48 to −23.34, p < 0.01)) and sexual activity of patients with pelvic organ prolapse (Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ) (MD: 4.84, 95% CI: 1.75 to 7.92, p < 0.01)). Furthermore, narrative synthesis for studies investigating the effect of the pessary approach showed a positive association between the use of this instrument and improvement in the quality of life and sexual activity. Conclusions: The results of our study revealed a significant improvement in the women’s quality of life following abdominal and vaginal reconstructive surgery. The use of pessary was also associated with increased patient quality of life. Full article
(This article belongs to the Special Issue Female Pelvic Medicine and Reconstructive Surgery)
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12 pages, 1022 KiB  
Systematic Review
Analysis of the Structural Characteristics and Psychometric Properties of the Pelvic Floor Bother Questionnaire (PFBQ): A Systematic Review
by Guadalupe Molina-Torres, Leticia Amiano-López, Marta María Córdoba-Peláez, Alfonso Javier Ibáñez-Vera and Esther Diaz-Mohedo
J. Clin. Med. 2022, 11(23), 7075; https://doi.org/10.3390/jcm11237075 - 29 Nov 2022
Cited by 2 | Viewed by 1151
Abstract
Background: The Pelvic Floor Bother Questionnaire is a validated and reliable questionnaire that studies the presence and degree of pelvic floor discomfort, providing a global vision of pelvic floor dysfunction. This questionnaire assesses urinary stress incontinence, urinary urgency, urinary frequency, urge urinary incontinence, [...] Read more.
Background: The Pelvic Floor Bother Questionnaire is a validated and reliable questionnaire that studies the presence and degree of pelvic floor discomfort, providing a global vision of pelvic floor dysfunction. This questionnaire assesses urinary stress incontinence, urinary urgency, urinary frequency, urge urinary incontinence, pelvic organ prolapses, dysuria, dyspareunia, defecatory dysfunction, fecal incontinence, and the disability it causes to the respondent. Aim: The aim of the present study was to analyze the structural characteristics and psychometric properties of the different versions of the pelvic floor bother questionnaire, as well as the methodological quality, the quality of evidence, and the criteria used for good measurement properties. Methods: A systematic review was carried out in different databases, such as PubMed, SCOPUS, Web of Science, Dialnet, ScienceDirect, and CINAHL, on studies adapting and validating the pelvic floor bother questionnaire in other languages. The data were analyzed taking into account the guidelines of the preferred reporting item statement for systematic reviews and meta-analyses (PRISMA) and following the COSMIN guidelines, considering articles published up to 28 February 2022, and registered in the PROSPERO database. Results: Initially, a total of 443 studies were found, from which a total of four studies were analyzed with regard to structural characteristics and psychometric properties, such as reliability, internal consistency, construct validity, and criterion validity. Conclusions: The different versions of the questionnaires show basic structural characteristics and psychometric properties for the evaluation of patients with pelvic floor dysfunctions. Most of the analyzed versions present criteria for good measurement properties qualified as sufficient, inadequate–adequate methodological quality, and low–moderate quality of evidence. Full article
(This article belongs to the Special Issue Female Pelvic Medicine and Reconstructive Surgery)
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