Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Estrogen receptors and progesterone receptors were detected and quantified in female pelvic floor muscles, urogenital ligaments and in uterus (myometrium) by use of monoclonal antibody assay techniques. Qualitative assessment with immunohistochemical methods further localized the estrogen receptors and progesterone receptors to the nuclei of connective tissue cells and striated muscle cells in the levator ani muscle, and to the cell nuclei of smooth muscle cells in the round ligament. These findings fulfil a prerequisite for viewing the pelvic floor and the round ligament as target organs for estrogens. The results also contribute to the understanding of the etiological role the reduction in estrogen levels has on the increased incidence of prolapse and urinary incontinence after the menopause. For treatment of urogenital mucosal atrophy a new vaginal silicone ring releasing 5-10 micrograms estradiol/24 h for a minimum of 90 days has been developed. The efficacy, safety and acceptability of the ring were studied in 222 postmenopausal women with symptoms and signs of atrophic vaginal mucosa. The maturation of the vaginal epithelium, as measured by cytological parameters, was significantly improved during treatment. There were significant decreases in vaginal pH, and these changes correlated well with the cytological evaluation. No proliferation of the endometrium was encountered. The therapy had a significant effect on symptoms and on signs of atrophic vaginitis, with cure/improvement registered in > or = 90%. The patient acceptability was high. It is concluded that a vaginal silicone ring giving a continuous release of an ultra-low dose of estradiol is an effective and safe treatment for urogenital estrogen deficiency. No addition of progestogen is needed.
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PMID:Estrogens and the urogenital tract. Studies on steroid hormone receptors and a clinical study on a new estradiol-releasing vaginal ring. 839 9

Decreased estrogen levels result in significantly lower urogenital tract changes and adversely influences quality of life. Consequences include atrophic vaginitis, atrophic urethritis, urinary incontinence, and pelvic organ prolapse. Evaluation of lower genital tract estrogen status is an integral part of evaluating the postmenopausal woman with urogenital symptoms.
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PMID:The role of vaginal estrogen in the treatment of urogenital dysfunction in postmenopausal women. 934 43

The purpose of this study was to survey nursing home women residents for pathologies in the vulvovaginal area. A total of 96 nursing and skilled nursing elderly woman, from four long-term care (LTC) wards entered the study. The average age was 82 (range 66-98). A total of 88% were wheel chair bound, 86% were urinary incontinent and 80% were communication handicapped. A total of 29% of the examined women had vulvovaginal pathologies. Atrophic vaginitis was detected in 14 cases. Candida vaginitis was found in four cases. Six women had uterine prolapse, three had lichen sclerosus and two had cervical polyps. Such a high rate of findings is probably influenced by age related changes, immobilization and incontinence. This study, a first of its kind emphasizes the importance of routine vulvovaginal examination in elderly LTC women.
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PMID:Vulvovaginal examinations in elderly nursing home women residents. 1098 57

Urinary incontinence (UI) is the complaint of any involuntary loss of urine and is a common condition that is likely to be under-reported. In the UK, the prevalence is estimated to be 17-40%, and rates are higher in the elderly. UI is more common in women than men. Its frequency increases with age, parity, high BMI, and associated comorbidities. The common types are stress UI, overactive bladder (OAB) or urge UI, and mixed UI a combination of the two. In stress UI there is involuntary loss of urine that occurs in association with an increase in intra-abdominal pressure. OAB is caused by overactivity of the detrusor muscle. This may be idiopathic or secondary to lesions affecting the motor or sensory pathways to the muscle. The history should include the circumstances in which the incontinence occurs, the duration and how it affects the patient's quality of life. The initial assessment should include enquiring for symptoms of urinary tract infection and carrying out a urine dipstick test. Abdominal examination should exclude a large pelvic-abdominal mass and a palpable bladder post micturition. Vulval-vaginal examination should assess for atrophic vaginitis and prolapse, masses and pelvic floor muscle contraction. Involving a skilled continence nurse or dedicated pelvic physiotherapist will improve care and can reduce referrals to secondary care. When conservative measures for OAB are unsuccessful, the next step is pharmacological treatment. Referral to secondary care should be offered when the response to two drugs has not been satisfactory. For stress UI, referral is indicated after failure of pelvic floor muscle training.
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PMID:Improving the management of urinary incontinence. 2479 7

This study investigated the prevalence and risk factors of urinary incontinence (UI) among perimenopausal women in Wuhan. A cross-sectional survey was performed on 1067 women aged 40-65 years sampled in Wuhan urban area from April to October 2014. Information about demographic characteristics, menstruation, parity and UI symptoms was collected using a questionnaire. The data were evaluated by Chi-square test and multiple Logistic regression analysis. The prevalence rate of UI was 37.2%, with stress UI (32.2%) being more prevalent than urgency UI (21.6%) and mixed UI (16.6%). 31.2% women with UI stated that UI had negative impact on their life. Risk factors for UI included menstrual disorder, menopause, overweight, perineal laceration, atrophic vaginitis, constipation and pelvic organ prolapse. Appropriate investigation apropos the factors associated with UI should be performed to diminish its impact on women's life.
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PMID:Prevalence and risk factors of urinary incontinence among perimenopausal women in Wuhan. 2775 11

Genitourinary syndrome of menopause (GSM), encompassing the disorders of atrophic vaginitis, urinary incontinence, and pelvic prolapse, affects the majority of postmenopausal women, as well as patients who are undergoing breast cancer treatement, post-ovarectomy, post-radiation, and breast-feeding. There is a need for better treatment options for these common conditions that adversely affect physical function and quality of life and that are often underserved by existing options. Lasers have been used to treat genitourinary tissue for over 40 years, and over the past decade, several lasers and radiofrequency devices have been developed and clinically tested for the treatment of GSM, with an accumulating body of evidence demonstrating their safety and efficacy. Fractional lasers, including carbon dioxide, erbium: YAG and hybrid technologies, as well as monopolar radiofrequency devices, work by resurfacing and/or stimulating via heat the vaginal lining resulting in a re-epithelialization, neovascularization, and remodeling of the vaginal tissue from an atrophic postmenopausal state to a thickened, glycogen-rich and well-vascularized state similar to premenopausal vaginal lining. These changes are correlated clinically with improved function on a variety of validated vaginal health scales and urinary incontinence tests. Currently cleared for general application to genitourinary tissue, clinical trials are underway for FDA clearance or approval for specific GSM indications.
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PMID:Device-based treatment for vaginal wellness. 3047 26

The prevalence of, and related factors to, stress urinary incontinence (SUI) among perimenopausal Chinese women and its impact on daily life among those women with sexual desire problem in Hubei province were investigated. In this study, 1519 perimenopausal women aged 40 to 65 years were selected from three urban communities in the Wuhan area, and two impoverished, mountainous communities in Hubei province, and followed from April to October 2014. Detailed information about demographic characteristics, menstruation, pregnancy, sexual life and chronic diseases was collected. A cross-sectional survey was carried out following information collection by Chi-square test and multiple logistic regression analysis. Univariate and multivariate logistic regression analysis demonstrated that the potential factors associated with developing SUI were old age (OR=3.4, 95% CI: 1.92-6.04), vaginal delivery (OR=0.623, 95% CI: 0.45-0.87), low income (OR=0.063, 95% CI: 0.40-0.92), atrophic vaginitis (OR=1.4, 95% CI: 1.03-1.80), pelvic organ prolapse (OR=2.81, 95% CI: 1.36-5.80), chronic pelvic pain (OR=2.17, 95% CI: 1.90-4.03), constipation (OR=1.44, 95% CI: 1.07-1.93) and incontinence of feces (OR=3.32, 95% CI: 2.03-5.43). Moreover, the ratio of SUI (33.2%) was higher than the ratio of urgency urinary incontinence (24.1%) or the ratio of mixed urinary incontinence (17.4%), and SUI had a greater impact on daily life among women with decreased sexual desire. In conclusion, SUI is a common disorder affecting over one third of the women surveyed, and has a severe impact on the daily life of perimenopausal women with declined sexual desire. Age, mode of delivery, and monthly income are major risk factors involved in the development of SUI.
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PMID:Prevalence and Risk Factors of Stress Urinary Incontinence Among Perimenopausal Women and Its Influence on Daily Life in Women with Sexual Desire Problem. 3134 99