Влияние пролапса тазовых органов и различных вариантов его коррекции на женскую сексуальную функцию
Влияние пролапса тазовых органов и различных вариантов его коррекции на женскую сексуальную функцию
Подзолкова Н.М., Осадчев В.Б., Глазкова О.Л., Бабков К.В., Денисова Ю.В. Влияние пролапса тазовых органов и различных вариантов его коррекции на женскую сексуальную функцию. Гинекология. 2023;25(1):31–38. DOI: 10.26442/20795696.2023.1.201899
Podzolkova NМ, Osadchev VB, Glazkova ОL, Babkov KV, Denisova YuV. The effect of pelvic organ prolapse and various options for its correction on female sexual function: A review. Gynecology. 2023;25(1):31–38.
DOI: 10.26442/20795696.2023.1.201899
Влияние пролапса тазовых органов и различных вариантов его коррекции на женскую сексуальную функцию
Подзолкова Н.М., Осадчев В.Б., Глазкова О.Л., Бабков К.В., Денисова Ю.В. Влияние пролапса тазовых органов и различных вариантов его коррекции на женскую сексуальную функцию. Гинекология. 2023;25(1):31–38. DOI: 10.26442/20795696.2023.1.201899
Podzolkova NМ, Osadchev VB, Glazkova ОL, Babkov KV, Denisova YuV. The effect of pelvic organ prolapse and various options for its correction on female sexual function: A review. Gynecology. 2023;25(1):31–38.
DOI: 10.26442/20795696.2023.1.201899
Отмечено, что сексуальная активность пациенток до и после лечения пролапса тазовых органов (ПТО) во многом определяет их качество жизни и удовлетворенность от проведенного вмешательства. В предлагаемом обзоре проведен анализ современных данных о характере изменения параметров сексуальной функции при различных методах коррекции несостоятельности тазового дна. Особое внимание уделено сравнительной оценке влияния существующих хирургических техник при абдоминальном и влагалищном доступах на риск развития диспареунии de novo. На основании результатов клинических исследований и систематических обзоров установлены наиболее оптимальные пути коррекции ПТО, предложены инструменты оценки их эффективности в рутинной клинической практике, отмечена важность междисциплинарного подхода к лечению ПТО с привлечением медицинских психологов ввиду значимой роли эмоционального и поведенческого факторов в развитии сексуальной дисфункции.
The sexual activity of patients before and after the treatment of pelvic organ prolapse (POP) largely determines their quality of life and satisfaction with the intervention. This review analyzes current data on the nature of changes in sexual function in various pelvic organ prolapse correction methods. Particular attention is paid to a comparative assessment of the effect of available surgical techniques with abdominal and vaginal access on the risk of de novo dyspareunia. Based on the results of clinical studies and systematic reviews, the most optimal ways of correcting POP have been established; tools for assessing their effectiveness in routine clinical practice have been proposed; the importance of an interdisciplinary approach to the treatment of POP with the involvement of medical psychologists has been noted due to the significant role of emotional and behavioral factors in sexual dysfunction.
Keywords: pelvic organ prolapse, pelvic floor failure, sexual function, dyspareunia
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________________________________________________
1. Fatton B. Sexual outcome after pelvic organ prolapse surgery. Prog Urol. 2009;19:1037-59.
2. Glazkova OL. Prikladnyie aspekty funktsional'noi morfologii tazovogo dna i promezhnosti. Klinicheskaia ginekologiia: uchebnoie posobiie. Pod red. NM Podzolkovoi. Moscow: Meditsinskoie informatsionnoie agenstvo, 2009, p. 532-709 (in Russian).
3. Weber AM, Abrams P, Brubaker L, et al. The standardization of terminology for researchers in female pelvic floor dysfunction. Int Urogynecol J. 2001;12:178-86.
4. Ellerkmann RM, Cundiff GW, Melick CF, et al. Correlation of symptoms with location and severity of pelvic organ prolapse. Am J Obstet Gynecol. 2001;185(6):1332-7.
5. Jha S, Gray T. A systematic review and meta-analysis of the impact of native tissue repair for pelvic organ prolapse on sexual function. Int Urogynecol J. 2015;26:321-7.
6. Achtari C, Dwyer PL. Sexual function and pelvic floor disorders. Best Pract Res Clin Obstet Gynaecol. 2005;19:993-1008.
7. Perry S, McGrother CW, Turner K. An investigation of the relationship between anxiety and depression and urge incontinence in women: development of a psychological model. Br J Health Psychol. 2006;11:463-82.
8. Tettamanti G, Altman D, Iliadou AN, et al. Depression, neuroticism, and urinary incontinence in premenopausal women: a nationwide twin study. Twin Res Hum Genet. 2013;16:977-84.
9. Kafri R, Kodesh A, Shames J, et al. Depressive symptoms and treatment of women with urgency urinary incontinence. Int Urogynecol J. 2013;24:1953-9.
10. Lowenstein L, Gamble T, Sanses TV, et al. Sexual function is related to body image perception in women with pelvic organ prolapse. J Sex Med. 2009;6:2286-91.
11. Yaakobi T, Handelzalts JE, Peled Y, et al. Direct and indirect effects of personality traits on psychological distress in women with pelvic floor disorders. Female Pelvic Med Reconstr Surg. 2017;23:412-6.
12. Rogers RG, Kammerer-Doak D, Darrow A, et al. Sexual function after surgery for stress urinary incontinence and/or pelvic organ prolapse: A multicenter prospective study. AJOG. 2004;191:206-10.
13. Ryzhkov SV, Ostapenko AV, Shabunina EYu, et al. Evaluation of sexual function in women after surgical treatment of genital prolapse and/or urinary incontinence. Modern problems of science and education. 2011;6. Available at: https://science-education.ru/ru/article/view?id=5039. Аccessed: 17.01.2022 (in Russian).
14. Rockwood TH, Melissa L, Adegoke O, et al. The PISQ-IR: considerations in scale scoring and development. Int Urogynecol J. 2013;24(7):1105-22.
15. Iglesia CB, Smithling KR. Pelvic organ prolapse. Am Fam Physician. 2017;96:179–85.
16. Ge J, Wei XJ, Zhang HZ, Fang GY. Pelvic floor muscle training in the treatment of pelvic organ prolapse: A meta-analysis of randomized controlled trials. Actas Urol Esp (Engl Ed). 2021;45(1):73-82.
17. Wang T, Wen Z, Li M. The effect of pelvic floor muscle training for women with pelvic organ prolapse: a meta-analysis. Int Urogynecol J. 2022;33(7):1789-801.
18. Rossiyskoie obshchestvo akusherov-ginekologov, Obshcherossiiskaia obshchestvennaia organizatsiia “Rossiyskoie obshchestvo urologov”. Klinicheskiie rekomendatsii “Vypadeniie zhenskikh polovykh organov”. Moscow, 2021, p. 49 (in Russian).
19. Herbison GP, Dean N. Weighted vaginal cones for urinary incontinence. Cochrane Database Syst Rev. 2013;7:CD002114.
20. Plevnik S. New method for testing and strengthening of pelvic floor (Abstract). In: Proceeding of the 15th Annual Meeting of the International Continence Society, London, 1985, p. 267-8.
21. Lee JB, Choi SY. Effects of Electric Stimulation and Biofeedback for Pelvic Floor Muscle Exercise in Women with Vaginal Rejuvenation Women. J Korean Acad Nurs. 2015;45(5):713-22.
22. Delneri C. Pelvic floor rehabilitation. A comparison of two methods of treatment: Vaginal cones versus functional electrical stimulation. Europa Medicophysica. 2000;36(1):45-8.
23. Hay-Smith J, Bø K, Berghmans LCM, et al. Pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev. 2008;2:89-90.
24. Glazkova OL, Makeev DYu, Khuzhokova IN, Kukovenko EM. Conservative management of pelvic floor weakness after spontaneous delivery. Voprosy ginekolii, akusherstva I perinatologii. 2019;18(4):104-8 (in Russian).
25. Glazkova OL, Makeev DYu, Shmeleva SV, et al. Electromyostimulation in the treatment of early forms of postpartum pelvic floor dysfunction. Voprosy ginekolii, akusherstva I perinatologii. 2021;20(3):63-8 (in Russian).
26. Radnia N, Hajhashemi М, Eftekhar Е, et al. Patient satisfaction and symptoms improvement in women using a vаginal pessary for the treatment of pelvic organ prolapse. J Med Life. 2019:12:271-5.
27. Betschart C, Cervigni M, Ortiz OC, et al. Management of apical compartment prolapse (uterine and vault prolapse): A FIGO Working Group report. Neurourol Urodyn. 2017;36(2):507-13.
28. FDA. Urogynecologic Surgical Mesh: Update on the Safety and Effectiveness of Transvaginal Placement for Pelvic Organ Prolapse. 2011. Available at: https://www.fda.gov/downloads/medicaldevices/safety/alertsand-notices/ucm262760.pdf. Аccessed: 01.07.2022.
29. Rantell A. Vaginal pessaries for pelvic organ prolapse and their impact on sexual function. Sex Med Rev. 2019;7:597-603.
30. Cheung RY, Lee JH, Lee LL, et al. Vaginal Pessary in Women With Symptomatic Pelvic Organ Prolapse: A Randomized Controlled Trial. Obstet Gynecol. 2016;128(1):73-80.
31. Dicke GB, Glukhov EYu, Neff EI, et al. Surgical correction and conservative care for pelvic organ prolapse. Pharmateka. 2021;28(6):25-32 (in Russian).
32. Kenton K, Pham T, Mueller E, Brubaker L. Patient preparedness: an important predictor of surgical outcome. Am J Obstet Gynecol. 2007;197:654.e1–6.
33. Thompson JC, Rogers RG. Surgical management for pelvic organ prolapse and its impact on sexual function. Sex Med Rev. 2016;4:213-20.
34. Srivastava R, Thakar R, Sultan A. Female sexual dysfunction in obstetrics and gynecology. Obstet Gynecol Surv. 2008;63:527-37.
35. Hultgren R, Sjogren B, Soderberg M, et al. Sexual function in women suffering from aortoiliac occlusive disease. Eur J Vasc Endovasc Surg. 1999;17:306-12.
36. Zobbe V, Gimbel H, Andersen BM, et al. Sexuality after total vs. Subtotal hysterectomy. Acta Obstet Gynecol Scand. 2004;83:191-6.
37. Costantini E, Porena M, Lazzeri M, et al. Changes in female sexual function after pelvic organ prolapse repair: role of hysterectomy. Int Urogynecol J. 2013;24:1481-7.
38. McPherson K, Herbert A, Judge A, et al. Psychosexual health 5 years after hysterectomy: population-based comparison with endometrial ablation for dysfunctional uterine bleeding. Health Expect. 2005;8:234-43.
39. Ulrich D, Dwyer P, Rosamilia A, et al. The effect of vaginal pelvic organ prolapse surgery on sexual function. Neurourol Urodyn. 2015;34:316-21.
40. Weber AM, Walters MD, Piedmonte MR. Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol. 2000;182:1610-5.
41. Kahn MA, Stanton SL. Posterior colporrhaphy: its effects on bowel and sexual function. Br J Obstet Gynaecol. 1997;104:82-6.
42. Schiavi MC, D'Oria O, Faiano P, et al. Vaginal native tissue repair for posterior compartment prolapse: long-term analysis of sexual function and quality of life in 151 patients. Female Pelvic Med Reconstr Surg. 2017;24:419-23.
43. Maher C, Feiner B, Baessler K, et al. Transvaginal mesh or grafts compared with native tissue repair for vaginal prolapse. Cochrane Database Syst Rev. 2016;2:CD012079.
44. FDA. FDA Safety Communication: UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse. Available at: http://www.fda.gov/medicaldevices/safety/alertsandnotices/ucm262435.htm. Аccessed: 13.01.2022.
45. Chapple CR, Cruz F, Deffieux X, et al. Consensus statement of the European Urology Association and the European Urogynaecological Association on the use of implanted materials for treating pelvic organ prolapse and stress urinary incontinence. Eur Urol. 2017;72:424-31.
46. Marschke J, Hengst L, Schwertner-Tiepelmann N, et al. Transvaginal single-incision mesh reconstruction for recurrent or advanced anterior vaginal wall prolapse. Arch Gynecol Obstet. 2015;291:1081-7.
47. Deffieux X, Letouzey V, Savary D, et al. Prevention of complications related to the use of prosthetic meshes in prolapse surgery: guidelines for clinical practice. Eur J Obstet Gynecol Reprod Biol. 2012;165:170-80.
48. Altman D, Mikkola TS, Beket KM, et al. Pelvic organ prolapse repair using the uphold™ vaginal support system: a 1-year multicenter study. Int Urogynecol J. 2016;27:1337-45.
49. Rogowski A, Bienkowski P, Tarwacki D, et al. Retrospective comparison between the Prolift and Elevate anterior vaginal mesh procedures: 18-month clinical outcome. Int Urogynecol J. 2015;26:1815-20.
50. Long CY, Wang CL, Wu MP, et al. Comparison of clinical outcomes using “elevate anterior” versus “Perigee” system devices for the treatment of pelvic organ prolapse. Biomed Res Int. 2015;479610.
51. Milani AL, Withagen MI, The HS, et al. Sexual function following trocar-guided mesh or vaginal native tissue repair in recurrent prolapse: a randomized controlled trial. J Sex Med. 2011;8:2944-53.
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1 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия;
2 ГБУЗ «Государственная клиническая больница им. Д.Д. Плетнева» Департамента здравоохранения г. Москвы, Москва, Россия
*yuliya.sheveleva.97@mail.ru
________________________________________________
Natalia М. Podzolkova1, Vasilii B. Osadchev1,2, Olga L. Glazkova1, Kirill V. Babkov1, Yulia V. Denisova*1
1 Russian Medical Academy of Continuous Professional Education, Moscow, Russia;
2 Pletnev City Clinical Hospital, Moscow, Russia
*yuliya.sheveleva.97@mail.ru