Radzinsky VE, Orazov MR, Mikhaleva LM, Krestinin MV, Lologaeva MS. Pathogenesis of vaginal prolapse with the formation of rectocele: a review. Gynecology. 2021;23(6):601–604. DOI: 10.26442/20795696.2021.6.201287
Патогенез опущения влагалища с формированием ректоцеле
Radzinsky VE, Orazov MR, Mikhaleva LM, Krestinin MV, Lologaeva MS. Pathogenesis of vaginal prolapse with the formation of rectocele: a review. Gynecology. 2021;23(6):601–604. DOI: 10.26442/20795696.2021.6.201287
Проведен систематический анализ данных, имеющихся в современной литературе, относительно патогенеза формирования опущения влагалища с формированием ректоцеле. Несостоятельность тазового дна, а именно заднего компартмента с формированием ректоцеле на фоне опущения задней стенки влагалища, продолжает оставаться одним из наиболее распространенных гинекологических заболеваний. В статье представлен анализ современных данных литературы о патогенезе пролапса тазовых органов (ПТО) с формированием ректоцеле. Исследования последних лет заметно расширили представления об этиологии и патогенезе ПТО в его заднем компартменте. Однако вопросы этиологии и патогенеза генитального пролапса у пациенток репродуктивного возраста, роли отдельных факторов риска и их сочетаний, патогенетические механизмы развития все еще далеки от окончательного решения. К сожалению, ни одна из существующих теорий полностью не объясняет все причины формирования ПТО в его заднем компартменте.
To carry out a systematic analysis of the data available in the modern literature on the pathogenesis of the formation of vaginal prolapse with the formation of rectocele rectum. The failure of the pelvic floor, namely its posterior compartment with the formation of a rectocele against the background of the lowering of the posterior vaginal wall, continues to be one of the most common gynecological diseases. This article presents an analysis of current literature data on the pathogenesis of pelvic organ prolapse with the formation of rectocele. Analyzing the above-mentioned data, it can be noted that the research data of recent years have significantly expanded the understanding of the etiology and pathogenesis of pelvic organ prolapse in its posterior compartment. However, the issues of etiology and pathogenesis of genital prolapse in patients of reproductive age, the role of individual risk factors and their combinations, pathogenetic mechanisms of development are still far from being resolved. Unfortunately, none of the above theories fully explains all the reasons for the formation of pelvic organ prolapse in its posterior compartment.
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2. Gong R, Xia Z. Collagen changes in pelvic support tissues in women with pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol. 2019;234:185-9. DOI:10.1016/j.ejogrb.2019.01.012
3. Dietz HP, Clarke B. Prevalence of rectocele in young nulliparous women. Aust N Z J Obstet Gynaecol. 2005;45(5):391-4. DOI:10.1111/j.1479-828X.2005.00454.x
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7. Vogler SA. Rectal Prolapse. Dis Colon Rectum. 2017;60(11):1132-5. DOI:10.1097/DCR.0000000000000955
8. Milani R, Manodoro S, Cola A, et al. Transvaginal native-tissue repair of enterocele. Int Urogynecol J. 2018;29(11):1705-7. DOI:10.1007/s00192-018-3686-3
9. Hendrix SL, Clark A, Nygaard I, et al. Pelvic organ prolapse in the Women’s Health Initiative: gravity and gravidity. Am J Obstet Gynecol. 2002;186(6):1160-6. DOI:10.1067/mob.2002.123819
10. Meijerink AM, van Rijssel RH, van der Linden PJ. Tissue composition of the vaginal wall in women with pelvic organ prolapse. Gynecol Obstet Invest. 2013;75(1):21-7. DOI:10.1159/000341709
11. Blomquist JL, Carroll M, Muñoz A, Handa VL. Pelvic floor muscle strength and the incidence of pelvic floor disorders after vaginal and cesarean delivery. Am J Obstet Gynecol. 2020;222(1):62.e1-62.e8. DOI:10.1016/j.ajog.2019.08.003
12. Sferra R, Pompili S, D’Alfonso A, et al. Neurovascular alterations of muscularis propria in the human anterior vaginal wall in pelvic organ prolapse. J Anat. 2019;235(2):281-8. DOI:10.1111/joa.13014
13. Mowat A, Maher D, Baessler K, et al. Surgery for women with posterior compartment prolapse. Cochrane Database Syst Rev. 2018;3(3):CD012975. DOI:10.1002/14651858.CD012975
14. Schwarzman P, Paz Levy D, Walfisch A, et al. Pelvic floor disorders following different delivery modes-a population-based cohort analysis. Int Urogynecol J. 2020;31(3):505-11. DOI:10.1007/s00192-019-04151-0
15. Cundiff GW, Fenner D. Evaluation and treatment of women with rectocele: focus on associated defecatory and sexual dysfunction. Obstet Gynecol. 2004;104(6):1403-21. DOI:10.1097/01.AOG.0000147598.50638.15
16. Mao M, Li Y, Zhang Y, et al. Tissue Composition and Biomechanical Property Changes in the Vaginal Wall of Ovariectomized Young Rats. Biomed Res Int. 2019;2019:8921284. DOI:10.1155/2019/8921284
17. Richardson AC. The anatomic defects in rectocele and enterocele. J Pelvic Surg. 2005;1(4):214-21.
18. Weintraub AY, Glinter H, Marcus-Braun N. Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse. Int Braz J Urol. 2020;46(1):5-14. DOI:10.1590/S1677-5538.IBJU.2018.0581
19. Luo J, Larson KA, Fenner DE, et al. Posterior vaginal prolapse shape and position changes at maximal Valsalva seen in 3-D MRI-based models. Int Urogynecol J. 2012;23(9):1301-6. DOI:10.1007/s00192-012-1760-9
________________________________________________
1. Zuchelo LTS, Bezerra IMP, Da Silva ATM, et al. Questionnaires to evaluate pelvic floor dysfunction in the postpartum period: a systematic review. Int J Womens Health. 2018;10:409-24. DOI:10.2147/IJWH.S164266
2. Gong R, Xia Z. Collagen changes in pelvic support tissues in women with pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol. 2019;234:185-9. DOI:10.1016/j.ejogrb.2019.01.012
3. Dietz HP, Clarke B. Prevalence of rectocele in young nulliparous women. Aust N Z J Obstet Gynaecol. 2005;45(5):391-4. DOI:10.1111/j.1479-828X.2005.00454.x
4. Toktar LR. Female pelvic prolapse: from a pathogenesis to efficiency of prophylaxis and treatment. Akusherstvo i ginekologiia: novosti, mneniia, obuchenie. 2017;3(17):98-107 (in Russian).
5. Petros P. The female pelvic floor: function, dysfunction and management according to the integral theory. Translation from English language. Ed. by D. Sci. (Med.) DD Shkarupa. 2nd edition. Moscow: MEDpress-inform, 2017 (in Russian).
6. Perineologiia. Esteticheskaia ginekologiia. Pod red. VE Radzinskogo. Moscow: StatusPraesens, 2020 (in Russian).
7. Vogler SA. Rectal Prolapse. Dis Colon Rectum. 2017;60(11):1132-5. DOI:10.1097/DCR.0000000000000955
8. Milani R, Manodoro S, Cola A, et al. Transvaginal native-tissue repair of enterocele. Int Urogynecol J. 2018;29(11):1705-7. DOI:10.1007/s00192-018-3686-3
9. Hendrix SL, Clark A, Nygaard I, et al. Pelvic organ prolapse in the Women’s Health Initiative: gravity and gravidity. Am J Obstet Gynecol. 2002;186(6):1160-6. DOI:10.1067/mob.2002.123819
10. Meijerink AM, van Rijssel RH, van der Linden PJ. Tissue composition of the vaginal wall in women with pelvic organ prolapse. Gynecol Obstet Invest. 2013;75(1):21-7. DOI:10.1159/000341709
11. Blomquist JL, Carroll M, Muñoz A, Handa VL. Pelvic floor muscle strength and the incidence of pelvic floor disorders after vaginal and cesarean delivery. Am J Obstet Gynecol. 2020;222(1):62.e1-62.e8. DOI:10.1016/j.ajog.2019.08.003
12. Sferra R, Pompili S, D’Alfonso A, et al. Neurovascular alterations of muscularis propria in the human anterior vaginal wall in pelvic organ prolapse. J Anat. 2019;235(2):281-8. DOI:10.1111/joa.13014
13. Mowat A, Maher D, Baessler K, et al. Surgery for women with posterior compartment prolapse. Cochrane Database Syst Rev. 2018;3(3):CD012975. DOI:10.1002/14651858.CD012975
14. Schwarzman P, Paz Levy D, Walfisch A, et al. Pelvic floor disorders following different delivery modes-a population-based cohort analysis. Int Urogynecol J. 2020;31(3):505-11. DOI:10.1007/s00192-019-04151-0
15. Cundiff GW, Fenner D. Evaluation and treatment of women with rectocele: focus on associated defecatory and sexual dysfunction. Obstet Gynecol. 2004;104(6):1403-21. DOI:10.1097/01.AOG.0000147598.50638.15
16. Mao M, Li Y, Zhang Y, et al. Tissue Composition and Biomechanical Property Changes in the Vaginal Wall of Ovariectomized Young Rats. Biomed Res Int. 2019;2019:8921284. DOI:10.1155/2019/8921284
17. Richardson AC. The anatomic defects in rectocele and enterocele. J Pelvic Surg. 2005;1(4):214-21.
18. Weintraub AY, Glinter H, Marcus-Braun N. Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse. Int Braz J Urol. 2020;46(1):5-14. DOI:10.1590/S1677-5538.IBJU.2018.0581
19. Luo J, Larson KA, Fenner DE, et al. Posterior vaginal prolapse shape and position changes at maximal Valsalva seen in 3-D MRI-based models. Int Urogynecol J. 2012;23(9):1301-6. DOI:10.1007/s00192-012-1760-9
1 ФГАОУ ВО «Российский университет дружбы народов», Москва, Россия;
2 Клиника репродуктивного здоровья Prior Clinic, Москва, Россия;
3 ФГБНУ «Научно-исследовательский институт морфологии человека им. акад. А.П. Авцына», Москва, Россия
*omekan@mail.ru
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Viktor E. Radzinsky1, Mekan R. Orazov*1,2, Liudmila M. Mikhaleva3, Mikhail V. Krestinin1, Milana S. Lologaeva1
1 People’s Friendship University of Russia, Moscow, Russia;
2 Clinic of Reproductive Health “Prior Clinic”, Moscow, Russia;
3 Avtsyn Research Institute of Human Morphology, Moscow, Russia
*omekan@mail.ru