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

 ¹Peoples’ Friendship University of Russia, Moscow

²Kazan (Volga) Federal University, Kazan

 Contact details:

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

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

The long-term results of surgical treatment of pelvic organ prolapse (POP) do satisfy neither doctors nor patients: after surgery successful in short term, the risk of recurrence reaches 50%, and the rate of repeated interventions is 30%. Currently, practical medicine is in urgent need of strategies aimed at improving postoperative repair of pelvic floor soft tissues in order to prevent recurrence of genital prolapse.

The purpose — to search and analyze the evidence on the mechanisms of pelvic floor soft tissue repair disorders after POP surgical treatment as a key aspect of genital prolapse recurrence.

Materials and methods. We searched 2010–2024 publications in CochraneLibrary, PubMed, Science Direct, and ELibrary digital libraries using the keywords «pelvic organ prolapse», «recurrence», «pathogenesis», «wound healing» and analyzed the evidence.

Results. It was hypothesized that POP recurrence is associated with disorders of pelvic floor soft tissue repair. Degradation of connective-tissue elements in prolapsed tissue, as well as changes associated with age, estrogen deficiency, inflammation, and fibroblast dysfunction negatively affect postoperative pelvic floor soft tissue repair.

Conclusions. The obtained results allow conclusions about the limited understanding of POP recurrence mechanisms and about the contribution of growth factors, estrogen deficiency, fibroblast dysfunction, and immune factors in the reparative process. The necessity of qualitatively planned immunohistochemical and morphologic studies on large samples is obvious.

Key words: pelvic floor muscle dysfunction, pelvic organ prolapse, recurrence, pathogenesis, pelvic floor soft tissue repair, surgical treatment.

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