Modern strategies of diagnosis in genital prolapse

Abstract

Introduction. Statistics shows that women's health in Republic of Moldova is alarming, given the fact that genital prolapse in the structure of gynecological diseases ranges from 11 to 38.9%, it continues to increase. The pelvic floor is a funnel-shaped musculature structure. It is important in providing support for pelvic viscera (organs). The damage to the pelvic floor contributes not only to urinary incontinence but can lead to pelvic organ prolapse; the first ranges from 11 to 38.9%, it continues to increase with prevalence of severe forms. The pelvic floor dysfunction is a big problem because this can have a negative impact on the activity and quality women’s life, because of this it should be studied. Aim of the study. Identifying morphofunctional characteristics of the pelvic floor of women with genital prolapse. Materials and methods. In this project was made a retrospective study of 103 cases of genital prolapse. Were investigated 289 women who were hospitalized in Medical Center “Galaxia”, gynecology department, Chisinau city, during 2009-2013 years and represents 35.6% of them. Results. The analysis shows that the 33,9 % of the women who were diagnosed with genital prolapse have Grade I of this disease; 66,1%-Grade II-III; 30,8% of them, this disease was associated with urinary incontinence. By number of clinical symptoms patients with Grade I of genital prolapse manifest in 68.57% of cases one symptom and two symptoms in 31,43% of cases; those with II-III Grade manifest in 14,7% of cases one symptom; in 70,5% of cases-two symtoms; 10,29%-three; 4,41%-four. As methods of investigation of functional perineum insufficiency was used in most of cases transvaginal ultrasound. Comparative analysis of the perineal echogenic parameters has demonstrated that all patients with genital prolapse identified the thinning of asymmetrically arranged muscular fascicles relative to the tendon center of the perineum, reduction of the thickness of it’s muscles and their deterioration. Conclusions. 1. Genital prolapse is a consequence of the pelvic floor integrity disorder that includes wide spectrum of disorders from an abnormally modified vaginal anatomy and clinical asymptomatic to a complete eversion associated with severe urinary disorders and sexual dysfuntion. 2. Transvaginal ultrasound establishes early structural and functional modifications of the pelvic floor.