Navegando por Palavras-chave "Pelvic Organ Prolapse"
Agora exibindo 1 - 6 de 6
Resultados por página
Opções de Ordenação
- ItemAcesso aberto (Open Access)Associação dos polimorfismos de DNA dos genes dos colágenos 1 e 3 e o prolapso de órgãos pélvicos em mulheres brasileiras(Universidade Federal de São Paulo (UNIFESP), 2019-12-10) Batista, Nilce Coimbra [UNIFESP]; Castro, Rodrigo De Aquino [UNIFESP]; Bortolini, Maria Augusta Tezelli [UNIFESP]; Dias, Marcia Maria [UNIFESP]; http://lattes.cnpq.br/1150368284144393; http://lattes.cnpq.br/2533347189752809; http://lattes.cnpq.br/6590913930590292; http://lattes.cnpq.br/0498522647671838; Universidade Federal de São Paulo (UNIFESP)Introduction: Pelvic organ prolapse (POP) has a multifactorial etiology that includes environmental and genetic factors. Several studies have investigated the association between COL1A1 and COL3A1 and POP polymorphisms. However, the results presented show differences between the populations analyzed. Objective: To compare the presence and frequency of COL1A1 and COL3A1 polymorphisms in patients with advanced POP (stages III and IV) and in women without POP in the Brazilian population. Methods: A case-control study that included 826 patients was divided into case (n = 348) and control (n = 286) groups. Peripheral blood DNA was extracted and the real-time polymerase chain reaction (RT-PCR) technique was used to determine genotyping of the samples. The programs SPSS (Chicago, USA) and GraphPad Prism 5.0 (California, USA) were used for statistical analysis, considering p <0.05 as statistically significant. Results: The case group had a mean age (68.03 years) higher than the control group (60.39 years) with p <0.0001. Regarding obstetric history, we observed a higher number of pregnancies, number of vaginal deliveries (normal and forceps) and higher newborn weight in women in the case group compared to the control group, p<0.05. On the other hand, women in the control group had a higher number of cesarean deliveries, p<0.0001. Regarding the COL1A1 and COL3A1 genotypes, no differences were observed in univariate and multivariate analyzes (p> 0.05). In the analysis of clinical factors, it was observed that women who had systemic arterial hypertension (SAH) [OR = 2.16; p=<0.0001], Diabetes Mellitus (DM) [OR = 2.48; p=<0.0001], varicose veins [OR = 1.60; p=0.016], heart disease [OR = 2.92; p=0.016] and family history (AFPOP) [OR = 1.82; p=0.010] had an increased risk for POP. Logistic regression model 1 reinforced vaginal delivery [OR = 10,582; p=0.000], the presence of heart disease [OR = 3.082; p=0.005), DM [OR = 2.509; p=0.016], AFPOP [OR = 2.493; p=0.007], HAS [OR = 2.118; p=0.013] and the number of pregnancies [OR = 1.225; p=0.001] as risk factors for POP. Regression model 2, on the other hand, showed that vaginal delivery [OR = 11,236; p=0.000], AFPOP [OR = 2.072; p=0.002], the number of pregnancies [OR = 1.283; p=0.000] and age [OR=1,096; p=0,000 as risk factors for POP. Meanwhile, Caesarean delivery was considered a protective factor for POP [OR = 0.431; p=0.000]. Conclusion: The distribution of COL1A1 polymorphism (rs1800012) and COL3A1 (rs1800255) wasn’t considered a risk factor for this disease. However, vaginal delivery, AFPOP, number of pregnancies, DM, and age were considered risk factors, and cesarean delivery was a protective factor for the development of POP.
- ItemAcesso aberto (Open Access)Estudo de polimorfismo de DNA do gene codificador da LOXL-1 e prolapso de órgãos pélvicos em mulheres brasileiras(Universidade Federal de São Paulo (UNIFESP), 2019-12-18) Silva, Carolina Landim Da Costa E [UNIFESP]; Castro, Rodrigo De Aquino [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction and hypothesis: We verified the presence of single nucleotide polymorphisms (SNP) rs2165241 of the lysyl oxidase-like 1 (LOXL-1) gene and the association with pelvic organ prolapse (POP) in Brazilian women and determined risk factors for POP development. Methods: We assessed 630 postmenopausal women divided into POP (stages III and IV) and control (stages 0 and I) groups by examination and peripheral blood sample collection. DNA sequence of interest was analyzed by real-time reverse-transcriptase polymerase chain reaction (RT-PCR). We used logistic regression models for the analysis, with p < 0.05 for significance. Results: There were no association between the polymorphism analyzed and POP. Multiple logistic regression analysis identified age [odds ratio (OR) = 1.09, confidence interval (CI) 95%= 1.07; 1.12], number of vaginal births (OR = 2.17, CI 95%= 1.67; 2.82), and family history (OR = 2.27, CI 95%= 1.41; 3.66) as independent risk factors for POP. Cesarean section was shown to be a protective factor (OR = 0.73, CI 95%= 0.56; 0.95). Conclusion: Our research suggests that there is a lack of association between DNA polymorphism rs2165241 of LOXL-1 with advanced POP in this population.
- ItemAcesso aberto (Open Access)Prolapso de órgãos pélvicos e seu impacto na qualidade de vida das mulheres não indígenas e indígenas não aldeadas da região metropolitana de Manaus, Amazonas, Brasil(Universidade Federal de São Paulo (UNIFESP), 2020-12-18) Maciel, Maria Auxiliadora De Sousa [UNIFESP]; Girao, Manoel Joao Batista Castello [UNIFESP]; Universidade Federal de São PauloIntroduction: Pelvic organ prolapse is defined by the International Continence Society as the descent of any vaginal segment or pelvic organ from its usual anatomical position. We do not have access to epidemiological data on the impact of pelvic organ prolapse symptoms and their relationship to the quality of life of indigenous and non-indigenous women in the metropolitan region of Manaus, where the largest number of indigenous women exists in the Amazon region. Objective: To analyze and compare the symptoms of pelvic organ prolapse and its impact on the (QoL) of non-indigenous and non-indigenous indigenous women in the metropolitan region of the city of Manaus, Amazonas, Brazil. Methods: Cross-sectional, descriptive, analytical, quali / quantitative study, developed at the Getúlio Vargas University Hospital, in the city of Manaus / Amazonas. The prolapsed quality of life questionnaire (P-QOL) and another with socio-demographic data were used. The Shapiro-Wilk test was used to determine the normality of the data distribution and helped in the choice of the statistical test. To test the difference in proportions, the chi-square test was used. Student t test was used to analyze continuous variables to compare means between two independent groups. The level of significance was p <0.05. Results: The most prevalent domains were urinary and intestinal, with differences in urine symptoms in non-indigenous women (61.3%) with p=0.022 and in daily activities p=0.035, with no statistical differences in intestinal symptoms. Quality of life affected by urine symptoms in non-indigenous women, p=0.005 and moderate severe symptoms p=0.042. Age groups of 16 and 77 years old, non-indigenous with older age p> 0.001, body weight (p=0.003), prevalence of brown color, lower level of education in high school and elementary school (p=0.015), in symptoms of quality of life prolapse statistical differences in urinary, intestinal, personal relationships, emotions and sleep. In the study, 41.5% had more than 3 pregnancies, normal births (p=0.008) and abortions (p=0.009) in greater numbers among indigenous women. In the general perception of health, there were no differences between groups (p=0.108). Indigenous women had a higher number of pregnancies, vaginal deliveries and abortions, with fewer symptoms for prolapse. Conclusion: Statistical differences were found, related to prolapse, in relation to age, ethnicity, number of pregnancies, vaginal births, level of education, urinary and intestinal symptoms, personal relationships, emotions and sleep, which affect the quality of life. The obstetric history pointed to a greater number of vaginal births and abortions in indigenous women, but it was not a risk factor for symptoms associated with prolapse and did not affect the quality of life. Non-indigenous women had lower vaginal parity, fewer abortions, older age and urinary and instinct symptoms, in which the impact of prolapse symptoms occurred, in addition to affecting quality of life.
- ItemSomente MetadadadosSacrocolpopexia Laparoscópica Comparada A Outras Cirurgias Para Correção De Prolapso De Órgãos Pelvicos: Revisão Sistemática E Metanálise.(Universidade Federal de São Paulo (UNIFESP), 2018-08-30) Elias, Joyce Campodonio Falcao [UNIFESP]; Sartori, Marair Gracio Ferreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: Genital Prolapse Is An Important Cause Of Morbidity Among Women And Strongly Affects Their Quality Of Life. Purpose: To Perform A Systematic Review Followed By A Meta-Analysis Of Randomized Clinical Trials Comparing The Laparoscopic Approach For Correction Of Genital Prolapse, To Other Surgical Techniques. Search Strategy: A Bibliographic Search Was Performed In Library Databases. Outcomes Related To Efficacy And Safety Were Evaluated. Selection Criteria: Studies Were Included If They Were Full Articles, Randomized Controlled Trials, Comparing A Laparoscopic Approach With Other Surgical Techniques For The Correction Of Female Pelvic Organ Prolapse And Evaluated Efficacy And Safety Outcomes Of The Techniques. Data Collection And Analysis: A Standardized Form Was Used To Collect The Data From Each Study. Study Combination Was Performed Using The Review Manager Software (Revman5.0) Of The Cochrane Collaboration. Main Results: We Found 879 Articles. Withdrawing The Duplicates And According To The Elig
- ItemAcesso aberto (Open Access)Sexual function after anterior vaginal wall prolapse surgery(Faculdade de Medicina / USP, 2012-08-01) Feldner Junior, Paulo Cezar [UNIFESP]; Delroy, Carlos Antonio [UNIFESP]; Martins, Sérgio Brasileiro [UNIFESP]; Castro, Rodrigo de Aquino [UNIFESP]; Sartori, Marair Gracio Ferreira [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: The aim of this study was to compare female sexual function after surgical treatment of anterior vaginal prolapse with either small intestine submucosa grafting or traditional colporrhaphy. METHODS: Subjects were randomly assigned, preoperatively, to the small intestine submucosa graft (n = 29) or traditional colporrhaphy (n = 27) treatment group. Postoperative outcomes were analyzed at 12 months. The Female Sexual Function Index questionnaire was used to assess sexual function. Data were compared with independent samples or a paired Student's t-test. RESULTS: In the small intestine submucosa group, the total mean Female Sexual Function Index score increased from 15.5±7.2 to 24.4±7.5 (p<0.001). In the traditional colporrhaphy group, the total mean Female Sexual Function Index score increased from 15.3±6.8 to 24.2±7.0 (p<0.001). Improvements were noted in the domains of desire, arousal, lubrication, orgasm, satisfaction, and pain. There were no differences between the two groups at the 12-month follow-up. CONCLUSIONS: Small intestine submucosa repair and traditional colporrhaphy both improved sexual function postoperatively. However, no differences were observed between the two techniques.
- ItemAcesso aberto (Open Access)Vitamina D: a influência na matriz extracelular do tecido conjuntivo de sustentação dos órgãos pélvicos(Universidade Federal de São Paulo (UNIFESP), 2019-11-01) Kemp, Marta Maria [UNIFESP]; Girao, Manoel Joao Batista Castello [UNIFESP]; Nader, Helena Bonciani [UNIFESP]; http://lattes.cnpq.br/7175631659428994; http://lattes.cnpq.br/0973903299568770; Universidade Federal de São Paulo (UNIFESP)Hypothesis/aims of study: Vitamin D deficiency is largely spoken of as being associated with several different diseases. Most of the associations are inferred by the levels of 25(OH)D in the plasma, which has no direct correlation to the activity of its active metabolites, i.e. 1,25(OH)D, since it follows the patterns of a steroid hormone, with negative and positive feedbacks and other molecular interactions, instead of behaving as a vitamin. Pelvic organ prolapse has also been linked to lower serum levels of vitamin D, although the exact mechanism for this increase in risk is not totally understood. One of the potential mechanisms for this increased risk is the influence vitamin D has on the architecture of the extracellular matrix (ECM) main component of the structures of the pelvic support apparatus and responsible for its mechanical properties. The aim of this study was to examine the arrangement of collagen fibers, the most prevalent fibrous protein present in the ECM at the endopelvic fascia, and other structural components of the ECM and cytoskeleton of the endopelvic fascia, to capture any different morphological pattern between subjects with a normal diet and those under a vitamin D supplementation. Collagen quantification was also performed. Study design, materials and methods: This hypothesis was investigated using female healthy adult Wistar rats (8 weeks old, approximately 200-220g). The treatment group received cholecalciferol diluted in arachid oil by gavage (in the dose 37.5mcg/Kg/day, equivalent to 1,500Ui/Kg/day), and the control group received only the oil, for 18 consecutive days. Twenty-four hours after the last gavage procedure, euthanasia was performed and a surgical procedure was undertaken extracting, as a bloc, the lower third of the uterus with the uterosacral ligament, the upper half of the vagina with the connective tissue surrounding and the bladder with proximal urethra. Samples were immersed in Tissue-Tek and cut in 30 and 50 micrometer thick slices and placed on the sheets for microscopic evaluation with SHG (second harmonic generation) technique, which requires no tissue preparation. For the purpose of interpretation, the rats were also separated into groups according to the estrous phase: high estrogenic influence (proestrus and estrus) and low estrogenic influence (metaestrus and diestrus) identified by cytology and histology under conventional light microscopy. Collagen by Picrosirius and antibodies for other extracellular structural components were also performed. Tissues were analyzed using Confocal Microscope (TCS SP8 CARS from Leica) and F and Epi-SHG detectors were used to detect SHG signals from collagen fibers. Images are represented as maximum intensity projections, corresponding to the Z-series of confocal stacks and were collected by tile scan and processed with Leica LAS AF software and, posteriorly, manipulated with ImageJ software. Results: We found that collagen fibers have a consistently undulated pattern and more random disposition in the xvi treated group whereas in the control group it assumes a more taut and oriented appearance, when under high estrogenic influence. The collagen signal from SHG was statistically more intense in the treated group compared to the control group also under a high estrogenic environment. The extracellular components alpha-actin, heparan sulfate and glicoconjugates containing sialic acid and N-acetylgkucosamine residues also showed clear different images when comparing control and treated groups. Conclusion: These findings suggest that there is a difference in the morphological presentation of the extracellular matrix of subjects under high dose intake of vitamin D compared to subjects under normal intake of the vitamin, pointing to a probable change in the mechanical properties of the tissue and that there might be an interaction of the metabolic pathways of the two steroid hormones cholecalciferol and estrogen at least regarding the amount of collagen deposited in the tissue. Not only the collagen, other components of the ECM presented differently in the treated and control groups. Oral high dose intake of vitamin D changes the framework and composition of the extracellular matrix at the level of the endopelvic fascia, which can impact the properties and resilience of the tissue. In summary, new research are needed in the biomechanical field to approach a clinical significance but we have shown a tangible relation between vitamin D exposure and collagen fiber architecture.