Genital prolapse: a look at the problem
The prevalence of genital prolapse (GP) among the female population can reach 2.9% and, with regard to different clinical and anamnestic approaches, varies from 6 to 50%. 12.6-18% of patients with GP undergo surgical correction. GP is a multifactorial disease. Childbirth is only a provoking rather than basic factor. There are below 1.8 births per woman in the European countries; but the rate of GP is 4 times higher than that in non-European countries. The proportion of the white population among patients with GP reaches 87.2%. A traumogenic factor during childbirth is traced in no more than 10% of patients; and an inherited factor is seen in 26% of cases. A multifactorial genesis is confirmed by the correlation between GP and polymorphisms of the genes responsible for the synthesis of the collagens COL1A1 (rs1800012) and COL3A1 (rs1800255), the expression of regulatory genes in the pubic-coccygeal muscles MYBP, MYH3, as well as the genes responsible for the synthesis of myosin heavy chains in the smooth muscles ADAMTS1, PPP1R12A. The involvement of the LIN28B and the AGT genes that are interrelated with GP and mitral valve prolapse was found. Surgery is a leading approach in treatment. Physiotherapeutic approaches should be applied as auxiliary methods of treatment while preparing a female patient for surgery so that she can accurately perceive her own body. Sacrocolpopexy is recognized as the gold standard surgical treatment for GP. The paper discusses the results of randomized studies on the choice of this r that surgical technology and its long-term results. In some cases ZFYVE16 gene polymorphism determines the number of recurrences after sacrocolpopexy. The paper discusses approaches to choosing a surgical treatment option in Russia. The main dilemma is what to choose: an individual or standardized approach to choosing surgical technology.Smolnova T.Yu., Chuprynin V.D.
Keywords
genital prolapse
relapses
surgical technology
genes
polymorphism
multifactorialness
etiology
sacrocolpopexy
rectocele
apical genital prolapse
recurrences
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Received 08.06.2018
Accepted 22.06.2018
About the Authors
Smolnova, Tatyana Yu., Doctor of Medicine, senior researcher of surgical department, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: ±74954384068. E-mail: smoltat@list.ru.Orcid.org/0000-0003-3543-651X. Scopus Author ID: 6504317244
Chuprynin, Vladimir D., PhD, Head of the Department of General Surgery, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named
after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina Str. 4. Tel.: ±74954383575. E-mail: v_chuprynin@oparina4.ru
For citations: Smolnova T.Yu., Chuprynin V.D. Genital prolapse: a look at the problem. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (10): 33-40. (in Russian)
https://dx.doi.org/10.18565/aig.2018.10.33-40
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