International Urogynecological Consultation (IUC): pathophysiology of pelvic organ prolapse (POP).

Delivery, Obstetric / adverse effects Female Humans Parturition Pelvic Organ Prolapse / genetics Pregnancy Referral and Consultation Vagina

Age Delivery Genetics Hormones Labor Menopause Pathogenesis Pelvic organ prolapse Pregnancy Risk factor

Journal

International urogynecology journal

ISSN: 1433-3023

Titre abrégé: Int Urogynecol J

Pays: England

ID NLM: 101567041

Informations de publication

Date de publication:
07 2022

Historique:

received: 29 11 2021

accepted: 27 12 2021

pubmed: 11 3 2022

medline: 14 7 2022

entrez: 10 3 2022

Statut: ppublish

Résumé

This manuscript is the International Urogynecology Consultation (IUC) on pelvic organ prolapse (POP) chapter one, committee three, on the Pathophysiology of Pelvic Organ Prolapse assessing genetics, pregnancy, labor and delivery, age and menopause and animal models. An international group of urogynecologists and basic scientists performed comprehensive literature searches using pre-specified terms in selected biomedical databases to summarize the current knowledge on the pathophysiology of the development of POP, exploring specifically factors including (1) genetics, (2) pregnancy, labor and delivery, (3) age and menopause and (4) non-genetic animal models. This manuscript represents the summary of three systematic reviews with meta-analyses and one narrative review, to which a basic scientific comment on the current understanding of pathophysiologic mechanisms was added. The original searches revealed over 15,000 manuscripts and abstracts which were screened, resulting in 202 manuscripts that were ultimately used. In the area of genetics the DNA polymorphisms rs2228480 at the ESR1 gene, rs12589592 at the FBLN5 gene, rs1036819 at the PGR gene and rs1800215 at the COL1A1 gene are significantly associated to POP. In the area of pregnancy, labor and delivery, the analysis confirmed a strong etiologic link between vaginal birth and symptoms of POP, with the first vaginal delivery (OR: 2.65; 95% CI: 1.81-3.88) and forceps delivery (OR: 2.51; 95% CI: 1.24-3.83) being the main determinants. Regarding age and menopause, only age was identified as a risk factor (OR : 1.102; 95% CI: 1.02-1.19) but current data do not identify postmenopausal status as being statistically associated with POP. In several animal models, there are measurable effects of pregnancy, delivery and iatrogenic menopause on the structure/function of vaginal support components, though not on the development of POP. Genetics, vaginal birth and age all have a strong etiologic link to the development of POP, to which other factors may add or protect against the risk.

Identifiants

DOI: 10.1007/s00192-022-05081-0 PMID: 35267063

pubmed: 35267063

doi: 10.1007/s00192-022-05081-0

pii: 10.1007/s00192-022-05081-0

doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

Pagination

1699-1710

Commentaires et corrections

Type : CommentIn

Informations de copyright

Références

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