The Effect of Fractional CO2 Laser Treatment on the Symptoms of Pelvic Floor Dysfunctions: pelvic Floor Distress Inventory-20 Questionnaire

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Vaginal support as determined by levator ani defect status 6 weeks after primary surgery for pelvic organ prolapse

ObjectiveTo evaluate whether major levator ani muscle defects were associated with differences in postoperative vaginal support after primary surgery for pelvic organ prolapse (POP).MethodsA retrospective chart review of a subgroup of patients in the Organ Prolapse and Levator (OPAL) study. Of the 247 women recruited into OPAL, 107 underwent surgery for prolapse and were the cohort for the present analysis. Major levator ani defects were diagnosed when more than 50% of the pubovisceral muscle was missing on MRI. Postoperative vaginal support was assessed via POPâ quantification system. Postoperative anatomic outcome was analyzed according to levator ani defect status, as determined by MRI.ResultsSupport of the anterior vaginal wall 2 cm above the hymen occurred among 62% of women with normal levator ani muscles/minor defects and 35% of those with major defects. Support of the anterior wall 1 cm above the hymen occurred among 32% women with normal muscles /minor defects and 59% of those with major defects. Levator ani defects were not associated with differences in postoperative apical/posterior vaginal support.ConclusionSix weeks after primary surgery for prolapse, women with normal levator ani muscles/minor defects had better anterior vaginal support than those with major levator defects.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135557/1/ijgo141.pd

Self‐reported natural history of recurrent prolapse among women presenting to a tertiary care center

ObjectiveTo describe the characteristics of recurrent pelvic organ prolapse (POP).MethodsA convenience sample of patients presenting with recurrent POP symptoms between October 2007 and February 2010 completed questionnaires. The survey focused on timing of recurrence(s), symptoms, and demographics.ResultsNinety‐seven women completed questionnaires. Thirty‐four (35.1%) had undergone multiple prior treatments. Overall, 23 of 76 (30.3%) women had not informed their surgeon of the recurrence. Twenty‐seven of 59 (45.8%) women reported that their symptoms were the same as before treatment, whereas 23 of 59 (39.0%) reported more severe symptoms. POP was considered to be persistent if symptoms returned within 3 months, and recurrent if symptom relief exceeded 3 months. After primary surgery, 28 of 79 (35.4%) cases were considered to be persistent, whereas 51 (64.6%) cases were recurrent. Similar percentages were seen after second and third treatments.ConclusionOverall, 35% of participants experienced early return of symptoms. Almost one‐third of participants had not informed their surgeon of the recurrence, indicating that there may not be an accurate self‐assessment of outcome in the absence of careful follow‐up.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135685/1/ijgo53.pd