M.R. ORAZOV¹, V.E. RADZINSKIY¹, F.F. MINNULLINA²

 ¹Peoples’ Friendship University of Russia, Moscow

²Kazan Federal University, Kazan

 Contact details:

Minnullina F.F. — PhD (Medicine), Associate Professor, Head of the Department of Obstetrics and Gynecology, Institute of Fundamental Medicine and Biology

Address: 18 Kremlevskaya St., Kazan, Russian Federation, 420008, tel.: +7-987-233-04-78, e-mail: minnullina_f@mail.ru

Pelvic organ prolapse (POP) is a serious problem for health care systems in developed countries. According to epidemiologic studies, the prevalence of this condition ranges from 2.9 to 41%, but there are no precise data on the POP incidence. Surgical reconstruction is the only treatment for POP that can effectively control prolapse symptoms, but it carries surgical risks, as well as a high risk of recurrence (58%) and reoperation (up to 30%).

It is not possible to reduce the incidence of primary prolapse under the global population aging; therefore, clinicians should reduce the recurrence risk. To do so, it is necessary to understand the etiology of POP recurrence, which will provide an optimal approach to the pre- and postoperative management of patients and the choice of surgical correction method.

We analyzed publications in the scientific databases CochraneLibrary, PubMed, ELibrary, and Science Direct for 2010–2024 by keywords «pelvic organ prolapse», «recurrence», «etiology», «risk factors», and «vaginal wound healing».

Analysis of published data suggests that the high recurrence rate of POP is based on impaired healing of surgical wounds, possibly related to altered functionality of fibroblasts, connective tissue, intracellular matrix (ICM), growth factors, and estrogen deficiency. Better determination of POP recurrence etiological factors will improve pre- and postoperative management of patients and allow choosing the optimal method of surgical reconstruction of the pelvic floor.

The purpose — to analyze the modern literature and to summarize the data on etiology of POP recurrence accumulated so far.

Conclusions. Data on the risk factors for POP recurrence are contradictory, and there is no reliable evidence base available. In this regard, it is not possible to select the optimal tactics of pre- and postoperative management of patients, to choose the most appropriate method and volume of surgical treatment, and to determine achievable goals of intervention.

There is an urgent need to develop effective strategies for healing of surgical wounds, which will improve the results of surgical intervention in POP.

Key words: pelvic organ prolapse, recurrence, etiology, risk factors, surgical treatment.

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