EPIDEMIOLOGYANDRISKFACTORSFORPELVICORGANPROLAPSE
According to various studies, the prevalence of pelvic organ prolapse can range from 3% to 50%. Pelvic organ prolapse (PTO) - protrusion or hernia of the pelvic organs through the vaginal walland the pelvic floor. The increase in incidence is proportional to the age of women. Women aged 20 to 29 years make up 6% in the morbidity structure, at the age of 50 to 59 years - 31% and almost 50% of women with VET aged 80 years and older. All known risk factors contribute to the weakening of the connective tissue / collagen of the pelvic floor, leading to the prolapse of the pelvic organs through the vaginal walls and the pelvic floor. The strength of collagen, the main component of the body's connective tissue, and especially the fascia and pelvic floor ligaments, is determined by genetic factors. With a burdened family history, the risk of pathology increases 2.5 times. However, modifiable risk factors cannot be ignored. Obesity, as a risk factor, directly affects the symptoms of pelvic organ prolapse. Women with one child are four times more likely to have VET requiring hospitalization, and women with two children are 8.4 times more likely than nulliparous women. Labor parity is an established risk factor for primary VET but is not a risk factor for recurrence. A high risk of pelvic organ prolapse has been observed in women undergoing vaginal hysterectomy. Studies have shown that the risk of developing apical prolapse after vaginal hysterectomy due to PTO is five times higher, even if the prolapse was corrected in the primary surgery. Hormonal changes in menopause cause a decrease in the systemic concentration of estrogens, and the hypoestrogenic environment in the pelvic organs contributes to a change in the composition and strength of collagen. The effect of estrogen on tissue depends not only on the concentration of estrogen, but also on the expression of estrogen receptors.