International Urogynecological Consultation (IUC): pathophysiology of pelvic organ prolapse (POP)
Issued Date
2022-07-01
Resource Type
ISSN
09373462
eISSN
14333023
Scopus ID
2-s2.0-85125997851
Pubmed ID
35267063
Journal Title
International Urogynecology Journal
Volume
33
Issue
7
Start Page
1699
End Page
1710
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Urogynecology Journal Vol.33 No.7 (2022) , 1699-1710
Suggested Citation
Deprest J.A., Cartwright R., Dietz H.P., Brito L.G.O., Koch M., Allen-Brady K., Manonai J., Weintraub A.Y., Chua J.W.F., Cuffolo R., Sorrentino F., Cattani L., Decoene J., Page A.S., Weeg N., Varella Pereira G.M., Mori da Cunha de Carvalho M.G.M.C., Mackova K., Hympanova L.H., Moalli P., Shynlova O., Alperin M., Bortolini M.A.T. International Urogynecological Consultation (IUC): pathophysiology of pelvic organ prolapse (POP). International Urogynecology Journal Vol.33 No.7 (2022) , 1699-1710. 1710. doi:10.1007/s00192-022-05081-0 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/87288
Title
International Urogynecological Consultation (IUC): pathophysiology of pelvic organ prolapse (POP)
Author(s)
Deprest J.A.
Cartwright R.
Dietz H.P.
Brito L.G.O.
Koch M.
Allen-Brady K.
Manonai J.
Weintraub A.Y.
Chua J.W.F.
Cuffolo R.
Sorrentino F.
Cattani L.
Decoene J.
Page A.S.
Weeg N.
Varella Pereira G.M.
Mori da Cunha de Carvalho M.G.M.C.
Mackova K.
Hympanova L.H.
Moalli P.
Shynlova O.
Alperin M.
Bortolini M.A.T.
Cartwright R.
Dietz H.P.
Brito L.G.O.
Koch M.
Allen-Brady K.
Manonai J.
Weintraub A.Y.
Chua J.W.F.
Cuffolo R.
Sorrentino F.
Cattani L.
Decoene J.
Page A.S.
Weeg N.
Varella Pereira G.M.
Mori da Cunha de Carvalho M.G.M.C.
Mackova K.
Hympanova L.H.
Moalli P.
Shynlova O.
Alperin M.
Bortolini M.A.T.
Author's Affiliation
KU Leuven– University Hospital Leuven
Soroka University Medical Center
Universidade Estadual de Campinas
University of Utah School of Medicine
Nepean Hospital
Università degli Studi di Foggia
University of Toronto
Faculty of Medicine Ramathibodi Hospital, Mahidol University
UPMC Magee-Womens Hospital
Imperial College London
Universidade Federal de São Paulo
UC San Diego School of Medicine
Medizinische Universität Wien
Fudan University
John Radcliffe Hospital
Soroka University Medical Center
Universidade Estadual de Campinas
University of Utah School of Medicine
Nepean Hospital
Università degli Studi di Foggia
University of Toronto
Faculty of Medicine Ramathibodi Hospital, Mahidol University
UPMC Magee-Womens Hospital
Imperial College London
Universidade Federal de São Paulo
UC San Diego School of Medicine
Medizinische Universität Wien
Fudan University
John Radcliffe Hospital
Other Contributor(s)
Abstract
Introduction and hypothesis: 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. Materials and methods: 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. Results: 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. Conclusions: 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.