The ageing of the population, having access to good quality of care, will result in an increase in the prevalence of pelvic floor diseases. Those persons, often in good general health, may experience difficulties in accepting functional pathologies, associated with loss in quality of life. One out of 2 women will have a pelvic floor problem and 1 out of 9 will have a surgical perineal procedure before the age of 80 years. The unitary character of the pelvic floor, a complex functional anatomic region, is often forgotten, essentially because the patients complain about one main pathology like urinary incontinence, genital prolapse, constipation and sexual disorders or chronic pain and will consult one specific specialist. Our role as health care professionals is to be aware of those associated pathologies and to obtain an optimal quality of care. The actual evolution towards specific clinical pathways with the integration of office provided care outside the hospital, needs to become the new standard of care. We try to give an overview of the different preventive, diagnostic and therapeutic options, available in a general practitioner's office. Taking care of the pelvic floor needs to be done in a global and pluridisciplinar setting. Referring towards specialised centres as well as the integration of the general practitioner, especially for the more complex cases, is essential.
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Eur J Obstet Gynecol Reprod Biol
January 2025
Objective: To evaluate the feasibility and safety of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for performing adnexectomy and high uterosacral ligament suspension (HUSLS) after vaginal hysterectomy (VH) under epidural anesthesia.
Method: This was a retrospective case series of 42 women who underwent VH for stage II or greater apical prolapse according to pelvic organ prolapse quantification (POP-Q); however, adnexectomy could not performed and replace the vNOTES technique. The procedure continued with vNOTES adnexectomy and bilateral HUSLS under epidural anesthesia.
Clin Biomech (Bristol)
January 2025
Department of Mechanical Engineering, University of Michigan, 2350 Hayward St, Ann Arbor, MI 48109, United States; Department of Biomedical Engineering, University of Michigan, 200 Bonisteel Blvd, Ann Arbor, MI 48109, United States. Electronic address:
Background: The lower birth canal is the final constriction through which a fetal head must pass for delivery. Unfortunately, injuries to the lower birth canal tissues occur in up to 19 % of first-time vaginal deliveries due to the 300 % stretch required.
Methods: This is a secondary analysis of data from 56 healthy nullipara recorded by a lower birth canal dilator during the first stage of labor.
ACS Nano
January 2025
Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases, Department of Gynecology & Obstetrics, Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China.
Regeneration of the injured endometrium, particularly the functional layer, is crucial for the prevention of uterine infertility. At present, clinical treatment using sodium hyaluronate hydrogel injection is limited by its relatively low fluidity, short-term retention, and insufficient bioactive ingredients, so it is necessary to develop an advanced healing-promoting hydrogel. The modulation of the microenvironment by presents a bioactive component that can facilitate the regeneration of the functional layer.
View Article and Find Full Text PDFUrogynecology (Phila)
January 2025
Division of Female Pelvic Medicine and Reconstructive Surgery, Northwestern Medicine, Chicago, IL.
Importance: Literature surrounding conservative management of voiding dysfunction (VD) due to pelvic organ prolapse (POP) is limited.
Objective: The objective of this study was to evaluate the effect of pessaries on VD in women with symptomatic POP.
Study Design: This was a retrospective case series of adult women who underwent a pessary fitting for POP and VD between January 2010 to December 2022 at 2 tertiary care centers.
Gland Surg
December 2024
Department of Breast Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Background: Luminal B breast cancer is routinely treated with chemotherapy and endocrine therapy. However, its sensitivity to treatment remains heterogeneous; therefore, identifying patients who may most benefit remains crucial. Immune-related genes are reportedly related to the prognosis of breast cancer.
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