UROGENITAL SYMPTOMS AND VAGINAL MICROBIOTA DISORDERS AS THE INITIAL SYMPTOMS OF PELVIC FLOOR FAILURE IN WOMEN OF EARLY REPRODUCTIVE AGE
DOI:
https://doi.org/10.11603/24116-4944.2024.2.15081Keywords:
women with high parity of births, pelvic floor failure, urogenital disorders, dyspareunia, fecal incontinence, vaginal microbiotaAbstract
The aim of the study – to assess the frequency and characteristics of urodynamic and dysbiotic disorders in pelvic dysfunction in women of early reproductive age with a high parity of births.
Materials and Methods.The study included 80 patients aged 18-35 years with high parity of births (more than three births) (main group) and initial forms of genital prolapse and 40 patients without pelvic floor prolapse (comparison group). The severity of urinary incontinence was assessed according to the classification of the International Incontinence Society (ICS).
Results and Discussion. The leading factors were high parity of births, heredity, fetal macrosomia, instrumental delivery and birth canal trauma, as well as a high proportion of markers of undifferentiated connective tissue dysplasia. In 92.5 % of cases, stage I vaginal prolapse and stress urinary incontinence were detected. The most common symptoms are palpable protrusion (93.75%) or a feeling of a ‘foreign body’ in the vagina (83.75%), as well as increased secretory function due to vaginal gaping (93.75%). Another important symptom wss sexual dysfunction (33.75%). Incontinence was not limited to urine, as 28.75% of women with high parity of births demonstrated symptoms of fecal incontinence. Normobiocenosis was not established in any patient of both groups.
Conclusions. Pelvic floor failure in women with high parity of births is a clinical condition that significantly affects the quality of life and increases the proportion of urogenital disorders, among which urinary incontinence, dyspareunia, fecal incontinence and vaginal microbiota disorders dominate.
References
Voitok, T.H. (2020). Klinichni aspekty nespromozhnosti tazovoho dna. [Clinical aspects of pelvic floor insufficiency]. Zbirnyk naukovykh prats spivrobitnykiv NMAPO imeni PL Shupyka – Collection of scientific works of employees of the PL Shupyk National Medical Academy of Physical Education and Sports. 38:33-8. [in Ukrainian].
Horovyi, V.I., Yatsyna, O. I. (2020). Netrymannia sechi u zhinok: navchalnyi posibnyk [Urinary incontinence in women: a textbook]. Vinnytsya: TOV “TVORY”. [in Ukrainian].
Dronova, V.L., Dronov, O.I., Tesliuk, R.S., & Burmich, K.S. (2014). Henitalnyi prolaps – aspekty etiolohiyi ta patohenezu. Suchasni osnovni metodyky khirurhichnoyi korektsiyi. [Genital prolapse – aspects of etiology and pathogenesis. Modern basic methods of surgical correction. Klinichna anatomiia ta operatyvna khirurhiya]. Clinical anatomy and operative surgery, 13(3), 82-5. [in Ukrainian] DOI: https://doi.org/10.24061/1727-0847.13.3.2014.27
Kaminskyi, V.V., Chaika, K.V., Lavreniuk, Yu.V., Dyadyk, Ye.A., Beketova, Yu.I., Baryshnykova, O.P. (2021). Porivnialna efektyvnist metodiv nekhirurhichnoyi korektsiyi pochatkovykh form henitalnoho prolapsu na osnovi dyferentsiiovanoho pidkhodu. [Comparative effectiveness of methods of non-surgical correction of initial forms of genital prolapse based on a differentiated approach]. Reproduktyvne zdorovia zhinky – Women's Reproductive Health, 3 (48), 73-80. [in Ukrainian].
Mekhedko, V.V., Moshkovskiy, A.N. (2009). Henitalnyi prolaps: etiolohiia, patohenez, klinika (ohliad literatury) [Genital prolapse: etiology, pathogenesis, clinic (literature review)]. Zhinochyi likar – Women's Doctor, 1, 26-9. [in Ukrainian].
ACOG Practice Bulletin No. 210 (2019). Summary: fecal incontinence. Obstet. Gynecol., 133(4), 837-9. DOI: 10.1097/ AOG.0000000000003188. DOI: https://doi.org/10.1097/AOG.0000000000003188
Chang, S.R., Lin, W.A., & Chang, T.C. (2021). Risk factors for stress and urge urinary incontinence during pregnancy and the first year postpartum: a prospective longitudinal study. Int Urogynecol J, 32, 2455-64. DOI: 10.1007/s00192-021-04788-w. DOI: https://doi.org/10.1007/s00192-021-04788-w
De Castro, E.B., Brito, L.G.O., Giraldo, P.C., & Teatin Juliato, C.R. (2019). Does the vaginal flora modify when a synthetic mesh is used for genital prolapse repair in postmenopausal women? A pilot, randomized controlled study. Female Pelvic Med. Reconstr. Surg, 25(4), 284-8. DOI: 10.1097/ SPV.0000000000000539. DOI: https://doi.org/10.1097/SPV.0000000000000539
Gao, J., Liu, X., Zuo, Y., & Li, X. (202). Risk factors of postpartum stress urinary incontinence in primiparas: what should we care. Medicine (Baltimore), 100(20), e25796. DOI: 10.1097/MD.0000000000025796. DOI: https://doi.org/10.1097/MD.0000000000025796
Hendrix, S.L., Clark, A., & Nygaard, I. (2002). Pelvic organ prolapse in the Women’s Health Initiative: gravity and gravidity. Am J Obstet. Gynecol., 186(6), 1160-6. DOI: https://doi.org/10.1067/mob.2002.123819
Hongliang, Y., Pengfei, L., Cuiping, J., Jieqian, H., Ling, P., & Yumin, S. (2022). Pelvic floor function and morphological abnormalities in primiparas with postpartum symptomatic stress urinary incontinence based on the type of delivery: a 1:1 matched case-control study. Int Urogynecol J., 33(2), 245-51. DOI: 10.1007/s00192-021-04816-9. DOI: https://doi.org/10.1007/s00192-021-04816-9
Kamalı, S., Özengin, N., & Topçuoğlu, M. A. (2023). The effect of e-pelvic floor muscle training on symptoms in women with stress urinary incontinence: a randomized controlled trial. Women Health, 3;63(6), 473-83. DOI: 10.1080/03630242.2023.2223729. DOI: https://doi.org/10.1080/03630242.2023.2223729
Kostyuk, A.L., Tarasyuk, E.K., Masibroda, N.G., & Storozhuk, M.S. (2016). Risk factors for urogenital disorders during pregnancy and after childbirth. Wiad Lek, 69(6), 747-9.
Kuo, Y.C., & Kuo, H.C. (2012). Potential factors that can be used to differentiate between interstitial cystitis/painful bladder syndrome and bladder oversensitivity in women. Int. J. Clin. Pract, 66(2), 146-51. DOI: https://doi.org/10.1111/j.1742-1241.2011.02767.x
Liu, W., Qian, L. (2024). Risk factors for postpartum stress urinary incontinence: a prospective study. BMC Urol., 42, 143. DOI: 10.1186/s12894-024-01430-x. DOI: https://doi.org/10.1186/s12894-024-01430-x
Lukacz, E.S. (2006). Parity, mode of delivery, and pelvic floor disorders. Obstet Gynecol, 107(6), 1253-60. DOI: https://doi.org/10.1097/01.AOG.0000218096.54169.34
Naorungrot, J., Sangnucktham, T. (2024). Incidence of Urinary Incontinence During the Postpartum Period in Rajavithi Hospital: A Prospective Cohort Study. Int Urogynecol J, 35(8), 1621-26. DOI: 10.1007/s00192-024-05833-0. DOI: https://doi.org/10.1007/s00192-024-05833-0
Nygaard, I., Barber, M.D., & Burgio, K.L. (2008). Prevalence of symptomatic pelvic floor disorders in US women. JAMA, 300(11), 1311-6. DOI: https://doi.org/10.1001/jama.300.11.1311
Patel, K., Long, J.B., Boyd, S.S., & Kjerulff, K.H. (2021). Natural history of urinary incontinence from first childbirth to 30-months postpartum. Arch Gynecol Obstet., 304(3), 713-24. DOI: 10.1007/s00404-021-06134-3. DOI: https://doi.org/10.1007/s00404-021-06134-3
Salmanov, A.G., Voitok, T.G., Maidannyk, I.V., Chorna, O.О., Marushchenko, Y.L., Lugach, O.O. (2020). Episiotomy infections in the puerperium and antimicrobial 13 resistance of responsible pathogens in Ukraine. Wiad Lek, 73(11), 2325-31. DOI: https://doi.org/10.36740/WLek202011101
Samuelsson, E.C., Victor, F.T., Tibblin, G., & Svärdsudd, K.F. (1999). Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol., 180(2), 299-305. DOI: https://doi.org/10.1016/S0002-9378(99)70203-6
Siahkal Shahla Faal (2020). Maternal, obstetrical and neonatal risk factors’ impact on female urinary incontinence: a systematic review. International urogynecology journal, 31, 2205-24. DOI: https://doi.org/10.1007/s00192-020-04442-x
Sideris, M., McCaughey, T., & Hanrahan, J.G. (2020). Risk of obstetric anal sphincter injuries (OASIS) and anal incontinence: a meta-analysis. Eur J Obstet Gynecol Reprod Biol., 252, 303–312. DOI: 10.1016/ j.ejogrb.2020.06.048. DOI: https://doi.org/10.1016/j.ejogrb.2020.06.048
Subki, A.H., Fakeeh, M.M., & Hindi, M.M. (2019). Fecal and urinary incontinence associated with pregnancy and childbirth. Mater Socio med., 31(3), 202-06. DOI: 10.5455/ msm.2019.31.202-206. DOI: https://doi.org/10.5455/msm.2019.31.202-206
Swift, S. (2005). Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol., 192(3), 795-806. DOI: https://doi.org/10.1016/j.ajog.2004.10.602
Thakar, R., & Stanton, S. (2002). Management of genital prolapse. BMJ, 324(7348), 1258-62. DOI: https://doi.org/10.1136/bmj.324.7348.1258
Vasyliuk, S., Cheredarchuk, A., Rymarchuk, M., Bondarev, R., Proshchenko, O., Mykytyuk, A. (2024). Faktory rizika fekální inkontinence a těhotenství. Ceska Gynekol., 89(2), 102-06. DOI: https://doi.org/10.48095/cccg2024102
Wang, K., Xu, X., Jia, G., & Jiang, H. (2020). Risk factors for postpartum stress urinary incontinence: a systematic review and meta-analysis. Reprod Sci., 27(12), 2129-45. DOI: 10.1007/s43032-020-00254-y. DOI: https://doi.org/10.1007/s43032-020-00254-y
Wu, J.M., Matthews, C.A., & Conover, M.M. (2014). Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet. Gynecol., 123(6), 1201-06. DOI: https://doi.org/10.1097/AOG.0000000000000286
Zhang, Y., Yang, H., Lin, L., Yang, W., Xiong, G., & Gao, G. (2022). The relationship between pelvic floor functions and vaginal microbiota in 6-8 weeks postpartum women. Front Microbiol., 13, 975406. DOI: 10.3389/fmicb.2022.975406. DOI: https://doi.org/10.3389/fmicb.2022.975406
Zhang, M., Zhou, Y., Yao, S., Zhao, Y., Batool, S. S., Huang, J., Jiang L., et al. (2024). Effect of stress urinary incontinence on vaginal microbial communities. BMC Microbiol., 24(1), 112. DOI: 10.1186/s12866-024-03237-0. DOI: https://doi.org/10.1186/s12866-024-03237-0
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 А. Р. Чередарчук, О. М. Макарчук
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in this journal agree to the following terms:
1. The authors reserve the right to authorship of the work and pass the journal right of first publication of this work is licensed under a Creative Commons Attribution License, which allows others to freely distribute the work published with reference to the authors of the original work and the first publication of this magazine.
2. Authors are entitled to enter into a separate agreement on additional non-exclusive distribution of work in the form in which it was published in the magazine (eg work place in the electronic repository institution or publish monographs in part), provided that the reference to the first publication of this magazine.
3. Policy magazine allows and encourages authors placement on the Internet (eg, in storage facilities or on personal websites) manuscript of how to submit the manuscript to the editor and during his editorial processing, since it contributes to productive scientific discussion and positive impact on the efficiency and dynamics of citing published work (see. The Effect of Open Access).
