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10.03.2022 | Original Article

International Urogynecological Consultation (IUC): pathophysiology of pelvic organ prolapse (POP)

verfasst von: Jan A. Deprest, Rufus Cartwright, Hans Peter Dietz, Luiz Gustavo Oliveira Brito, Marianne Koch, Kristina Allen-Brady, Jittima Manonai, Adi Y. Weintraub, John W. F. Chua, Romana Cuffolo, Felice Sorrentino, Laura Cattani, Judith Decoene, Anne-Sophie Page, Natalie Weeg, Glaucia M. Varella Pereira, Marina Gabriela M. C. Mori da Cunha de Carvalho, Katerina Mackova, Lucie Hajkova Hympanova, Pamela Moalli, Oksana Shynlova, Marianna Alperin, Maria Augusta T. Bortolini

Erschienen in: International Urogynecology Journal | Ausgabe 7/2022

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Abstract

Introduction and hypothesis

This manuscript is the International Urogynecology Consultation (IUC) on pelvic organ prolapse (POP) chapter one, committee three, on the Pathophysiology of Pelvic Organ Prolapse assessing genetics, pregnancy, labor and delivery, age and menopause and animal models.

Materials and methods

An international group of urogynecologists and basic scientists performed comprehensive literature searches using pre-specified terms in selected biomedical databases to summarize the current knowledge on the pathophysiology of the development of POP, exploring specifically factors including (1) genetics, (2) pregnancy, labor and delivery, (3) age and menopause and (4) non-genetic animal models. This manuscript represents the summary of three systematic reviews with meta-analyses and one narrative review, to which a basic scientific comment on the current understanding of pathophysiologic mechanisms was added.

Results

The original searches revealed over 15,000 manuscripts and abstracts which were screened, resulting in 202 manuscripts that were ultimately used. In the area of genetics the DNA polymorphisms rs2228480 at the ESR1 gene, rs12589592 at the FBLN5 gene, rs1036819 at the PGR gene and rs1800215 at the COL1A1 gene are significantly associated to POP. In the area of pregnancy, labor and delivery, the analysis confirmed a strong etiologic link between vaginal birth and symptoms of POP, with the first vaginal delivery (OR: 2.65; 95% CI: 1.81–3.88) and forceps delivery (OR: 2.51; 95% CI: 1.24–3.83) being the main determinants. Regarding age and menopause, only age was identified as a risk factor (OR : 1.102; 95% CI: 1.02–1.19) but current data do not identify postmenopausal status as being statistically associated with POP. In several animal models, there are measurable effects of pregnancy, delivery and iatrogenic menopause on the structure/function of vaginal support components, though not on the development of POP.

Conclusions

Genetics, vaginal birth and age all have a strong etiologic link to the development of POP, to which other factors may add or protect against the risk.

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Titel: International Urogynecological Consultation (IUC): pathophysiology of pelvic organ prolapse (POP)
verfasst von: Jan A. Deprest
Rufus Cartwright
Hans Peter Dietz
Luiz Gustavo Oliveira Brito
Marianne Koch
Kristina Allen-Brady
Jittima Manonai
Adi Y. Weintraub
John W. F. Chua
Romana Cuffolo
Felice Sorrentino
Laura Cattani
Judith Decoene
Anne-Sophie Page
Natalie Weeg
Glaucia M. Varella Pereira
Marina Gabriela M. C. Mori da Cunha de Carvalho
Katerina Mackova
Lucie Hajkova Hympanova
Pamela Moalli
Oksana Shynlova
Marianna Alperin
Maria Augusta T. Bortolini
Publikationsdatum: 10.03.2022
Verlag: Springer International Publishing
Erschienen in: International Urogynecology Journal / Ausgabe 7/2022
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-022-05081-0

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International Urogynecological Consultation (IUC): pathophysiology of pelvic organ prolapse (POP)

Abstract

Introduction and hypothesis

Materials and methods

Results

Conclusions

Neu im Fachgebiet Gynäkologie und Geburtshilfe

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Abstract

Introduction and hypothesis

Materials and methods

Results

Conclusions

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