Pelvic floor muscle function in a general population of women with and without pelvic organ prolapse

This study aims to examine the relationship between pelvic floor muscle function (PFMF) and pelvic organ prolapse (POP) in a general female population. Cross-sectional study on women aged 45-85 years. Validated questionnaires were used to assess pelvic floor muscle function. POP and PFMF were evaluated with vaginal examination. For statistical analysis chi-squared test for trend and analysis of variance were used. Response rate to the questionnaire was 62.7% (1,869/2,979). No significant differences were found in muscle strength and endurance during voluntary muscle contraction between the POP stages. Women with POP stages I and II were significantly less able to achieve effective involuntary muscle contraction during coughing (38.3% and 37.7%) than women without POP (75.2%). Involuntary contraction of the PFM during coughing (that resulted in stabilization of the perineum) was significantly weaker in the women with POP stage I and II than in the women without POP

Prevalence of major levator abnormalities in symptomatic patients with an underactive pelvic floor contraction

Introduction and hypothesis: Major levator ani abnormalities (LAA) may lead to abnormal pelvic floor muscle contraction (pfmC) and secondarily to stress urinary incontinence (SUI), prolapse, or fecal incontinence (FI). Methods: A retrospective observational study included 352 symptomatic patients to determine prevalence of LAA in underactive pfmC and the relationship with sympt

Progesterone Inhibits Epithelial-to-Mesenchymal Transition in Endometrial Cancer

Background: Every year approximately 74,000 women die of endometrial cancer, mainly due to recurrent or metastatic disease. The presence of tumor infiltrating lymphocytes (TILs) as well as progesterone receptor (PR) positivity has been correlated with improved prognosis. This study describes two mechanisms by which progesterone inhibits metastatic spread of endometrial cancer: by stimulating T-cell infiltration and by inhibiting epithelial-to-mesenchymal cell transition (EMT). Methodology and Principal Findings: Paraffin sections from patients with (n = 9) or without (n = 9) progressive endometrial cancer (recurrent or metastatic disease) were assessed for the presence of CD4+ (helper), CD8+ (cytotoxic) and Foxp3+ (regulatory) T-lymphocytes and PR expression. Progressive disease was observed to be associated with significant loss of TILs and loss of PR expression. Frozen tumor samples, used for genome-wide expression analysis, showed significant regulation of pathways Conclusion: Intact progesterone signaling in non-progressive endometrial cancer seems to be an important factor stimulating immunosurveilance and inhibiting transition from an epithelial to a more mesenchymal, more invasive phenotype

Outcome Measures in Adult Vulvar Lichen Sclerosus:A Systematic Review

Objectives:Core outcome domains (CODs) for treatment of adult vulvar lichen sclerosus (VLS) have recently been established through a Delphi study. A number of measuring tools are available for evaluating VLS. The aim of this study is to identify available standardized measurement tools for the major CODs for VLS that have recently been defined, namely, physical findings and quality of life (QoL) specific to VLS. Materials and Methods: A systematic search through September 8, 2023, for measuring tools applicable to VLS regarding physical findings and QoL including sexual function or sexual well-being and self-image was performed. Results: Thirty-five studies were included in the systematic review describing 26 tools covering the following 6 outcome domains: QoL-general health, QoL-lichen sclerosus specific, symptoms, clinical signs, emotional impact, and sexual functioning. Conclusions: In current research, there is no uniformity in use of measurement tools for evaluating VLS. The established CODs to evaluate treatment of VLS are applicable for evaluating disease course as well. A comprehensive study to reach consensus regarding measurement of physical findings, QoL-lichen sclerosus specific, sexuality, and self-image taking the predetermined CODs and other factors such as age into account is needed.</p