Prospective Evaluation of Outcomes of Mechanical Devices in Women with Symptomatic Pelvic Organ Prolapse in Ogbomoso, South-Western Nigeria

Background: Symptomatic pelvic organ prolapse (POP) impacts the sufferers’ quality of life negatively. There is a preference for a mechanical device in certain conditions though the definitive management of POP is surgical. Objectives: We conducted the study to evaluate the outcome of management of POP using mechanical devices. Methods: It was a prospective study. It took place in the gynecology unit of the Bowen University Teaching Hospital Ogbomoso between May 2014 and April 2019. We followed up with eligible patients who opted for pessary use for a median duration of 18 months (Range 12 - 84 months). We excluded those who refuse to participate in the study. Results: Of the 127 patients with symptomatic POP, seventy-five (59.1%) opted for the use of mechanical devices, and 70 successfully retained them four weeks after insertion. We lost Six (9.2%) patients to follow up. Of the 64 women included in the analysis, 16 (25%) discontinued use at some point after four weeks, whereas 36 (56.3%) used the pessary successfully throughout the follow-up period. Overall, 12.1% of the women experienced minor complications (6.9% pain or discomfort, 3.2% excoriation or bleeding, and 2.0% dis-impaction or constipation). After cessation of pessary use, 12 (25%) of the 48 women chose surgery, and 10 (20.8%) chose no further treatment. Conclusion: This study concluded that pessary use for pelvic organ prolapse is safe in low resource settings. Therefore, it is justifiable to offer pessaries in the initial management of uterovaginal prolapse to all patients who opt for conservative management and those awaiting surgery.

DDA强度折减法及其在东苗家滑坡中的应用

为了分析滑坡的稳定性以及预测滑坡的失稳模式,该文在DDA(discontinuous deformation analysis)方法以及强度折减法研究的基础上,提出了DDA强度折减法。通过对西北某黄土高边坡的算例分析验证所提出的方法。验证结果表明:DDA强度折减法计算所得稳定系数为1.20,与极限平衡法计算结果一致,且其潜在的滑动面也相近。在此基础上,该文将DDA强度折减法应用于小浪底水利枢纽近坝区的东苗家滑坡稳定性及破坏模式分析中。分析结果表明:东苗家滑坡体的稳定系数为1.07;其可能的破坏模式为中部推移式滑动和后缘牵引式滑动的复合破坏模式,前缘滑塌体对其整体稳定性起支撑作用。