Perineal descent and pelvic organ prolapse in women

Abstract

ABSTRACTRose, Karen Isabelle. Perineal descent and pelvic organ prolapse in women (Doctor of Medicine thesis), The University of Manchester, April 2013. INTRODUCTIONThe relationship between pelvic organ prolapse (POP) and symptoms of prolapse remain poorly understood. This study tests the hypothesis that the degree of perineal descent is associated with vaginal support and symptoms of prolapse, and examines their relationships in order to improve our understanding of the anatomical and functional response of surgical POP interventions.Mesh implants are increasingly employed in surgical treatment of POP yet there remains insufficient research into the effectiveness and changes in appearance of the various meshes. This study assesses ultrasound scan appearances of vaginal mesh implants to determine their effect on prolapse surgery outcomes. METHODOLOGYEighty-three women undergoing various surgical treatments for POP were prospectively studied preoperatively, six to eight weeks postoperatively and at six-month follow-up for prolapse and perineal descent. Prolapse symptoms were recorded using the Pelvic Organ Prolapse Symptom Scale (POP-SS), vaginal support was assessed using the Pelvic Organ Prolapse Quantification examination (POP-Q) and perineal descent was measured in the lithotomy position using a perineometer. The level of the perineum was recorded at rest, on maximum Valsalva and whilst using a valsalvometer. Fifty five women received either biological or synthetic mesh implants which were assessed for their appearance and size using B-K 8802 transperineal and B-K 8848 linear array transvaginal probes.RESULTSA statistically significant correlation was noted between the preoperative POP-Q and perineal descent measurements (p

Date of Award	1 Aug 2013
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Mourad Seif (Supervisor)