Curative effect of hydrogen peroxide combined with silver ion disinfection on pelvic floor dysfunction

BACKGROUND Pelvic floor dysfunction(PFD)is related to muscle fiber tearing during childbirth,negatively impacting postpartum quality of life of parturient.Appropriate and effective intervention is necessary to promote PFD recovery.AIM To analyze the use of hydrogen peroxide and silver ion disinfection for vaginal electrodes in conjunction with comprehensive rehabilitation therapy for postpartum women with PFD.METHODS A total of 59 women with PFD who were admitted to the hospital from May 2019 to July 2022 were divided into two groups:Control group(n=27)received comprehensive rehabilitation therapy and observation group(n=32)received intervention with pelvic floor biostimulation feedback instrument in addition to comprehensive rehabilitation therapy.The vaginal electrodes were disinfected with hydrogen peroxide and silver ion before treatment.Intervention for both groups was started 6 weeks postpartum,and rehabilitation lasted for 3 months.Pelvic floor muscle voltage,pelvic floor muscle strength,vaginal muscle voltage,vaginal muscle tone,pelvic floor function,quality of life,and incidence of postpartum PFD were compared between the two groups.RESULTS Before comprehensive rehabilitation treatment,basic data and pelvic floor function were not significantly different between the two groups.After treatment,the observation group showed significant improvements in the maximum voltage and average voltage of pelvic floor muscles,contraction time of type I and type II fibers,pelvic floor muscle strength,vaginal muscle tone,vaginal muscle voltage,and quality of life(GQOLI-74 reports),compared with the control group.The observation group had lower scores on the pelvic floor distress inventory(PFDI-20)and a lower incidence of postpartum PFD,indicating the effectiveness of the pelvic floor biostimulation feedback instrument in promoting the recovery of maternal pelvic floor function.CONCLUSION The combination of the pelvic floor biostimulation feedback instrument and comprehensive rehabilitation nursing can improve pelvic floor muscle strength,promote the recovery of vaginal muscle tone,and improve pelvic floor function and quality of life.The use of hydrogen peroxide and silver ion disinfectant demonstrated favorable antibacterial efficacy and is worthy of clinical application.

Expression and significance of lysyl oxidase-like 1 and fibulin-5 in the cardinal ligament tissue of patients with pelvic floor dysfunction

Pelvic organ prolapse （POP） is a disabling disorder in women characterized by a loss of pelvic floor support, leading to the herniation of the uterus into or through the vagina. POP is a complex problem that likely involves multiple mechanisms with limited therapies available, and is associated with defects in connective tissue including elastic fibers. This study was designed to investigate the expression of fibulin-5 and lysyl oxidase-like 1 （LOXL1） in the cardinal ligament in samples taken from the POP group compared to the non-POP group. Specimens were obtained during abdominal hysterectomy from the cardinal ligament of 53 women with POP and 25 age- and par- ity- matched women with non-POP among post-menopausal women with benign gynecologic pathology. Protein expression was evaluated using the immunohistochemical staining method. For statistical analyses, chi-square test and Spearman＇s correlation were used with the statistical package SPSS13.0 system. Our results showed that both fibulin-5 and LOXL1 expressions were decreased in the cardinal ligament in the POP group compared to the non- POP group （P 〈 0.05）. The expression of fibulin-5 and LOXL1 were correlated closely with the stage of POP, ac- companied by stress urinary incontinence and frequency of vaginal delivery （P 〈 0.05）, but had no relationship with post-menopausal state （P 〉 0.05）. The expression of fibulin-5 was positively associated with LOXL1 in POP （P 〈 0.05）. We conclude that changes in fibulin-5 and LOXL1 expression may play a role in the development of POP.

Quantitatively evaluation on pelvic floor dysfunction by virtual touch tissue imaging quantification shear wave elastography

Objective:To investigate the value of(VTIQ)shear wave elastography in the diagnosis of pelvic floor dysfunction.Methods:20 patients with pelvic floor dysfunction and 40 healthy volunteers were enrolled in and devided into the pelvic floor dysfunction(PFD)group and the control group.20 cases in the normal non-fertile(NNF)group and the normal fertile(NF)group respectively were including in the control group.The Young's modulus of puborectalis(PR)in three groups was measured by virtual touch tissue imaging quantification(VTIQ)at different states.The Young's modulus of PR and their differences in the three groups and between groups were compared and calculated.Receiver-operating characteristic curve(ROC)analyses were performed to assess the diagnostic value of VTIQ,and the area under the curve(AUC)was compared.Results:Young's modulus of PR at resting-state,maximun rectal state and Vasalva state in NNF group and NF group were statistical significance(all P<0.05).Young's modulus of maximun rectal state was higher than that of resting-state and Vasalva state in PFD group(P<0.05).There was no significant difference in Young's modulus between the resting-state and Vasalva state in the PFD group(P>0.05).Difference of PR Young's modulus between resting status and maximun rectal state and that between resting status and Vasalva state were of statistical significance among the three groups(all P<0.05).ROC curves analyses indicated that the AUC,cut-off value,sensitivity,specificity and Youden index of the difference between the Young's modulus of resting status and maximun rectal state measured by VTIQ in control group and PFD group were 0.788,35.45kPa,91.67%,57.14%,0.488,espectively.The AUC,cut-off value,sensitivity,specificity and Youden index of the difference between the Young's modulus of resting status and Vasalva state measured by VTIQ in control group and PFD group were 0.799,14.00kPa,63.89%,85.71%,0.496,respectively.There was no significant difference in AUC between the two groups(Z=0.130,P>0.05).Conclusion:VTIQ technology is an effective method to quantitatively assess the biomechanical properties of PR.The effect of labor on the puborectalis muscle was not significant.The increase of Young's modulus of passive stretching in vasalva state was not significant in patients with pelvic floor dysfunction.The difference between resting status and maximun rectal state and difference between resting status and Vasalva state is more advantageous to the diagnosis of pelvic floor dysfunction disorder.

Chinese expert consensus on primary prevention for pelvic floor dysfunction during pregnancy

Objective Pregnancy has been identified as a risk factor for pelvic floor dysfunction(PFD).The aim of this study was to establish primary prevention measures for PFD during pregnancy and reduce the overall incidence of PFD.Methods We assembled a panel of 36 experts,including gynecologists,obstetricians,and physiotherapists.Through surveys and expert meetings,the panel reviewed and assessed the safety and effectiveness of various clinical interventions.Based on expert comments from Round 1,a revised list of 8 clinical interventions was developed and submitted for a second round of expert review.Results A consensus was reached on the importance of implementing prevention measures to protect pelvic floor function during pregnancy.Experts particularly emphasized the significance of health education,weight management,pelvic floor muscle training,respiratory training,overall exercise,physical activity,and perineal massage.Conclusion The expert consensus provides comprehensive clinical measures to safeguard pelvic floor function during pregnancy.This paper represents the initial step toward developing scientific recommendations for pregnant women regarding the primary prevention of PFD.Future research should focus on the implementation of these recommendations in clinical practice.

Pathophysiology of constipation in the older adult

This review provides information on the definition of constipation, normal continence and defecation and a description of the pathophysiologic mechanisms of constipation. In addition, changes in the anatomy and physiology of the lower gastrointestinal tract associated with aging that may contribute to constipation are described. MEDLINE (1966-2007) and CINAHL (1980-2007) were searched. The following MeSH terms were used: constipation/etiology OR constipation/ physiology OR constipation/physiopathology) AND (age factors OR aged OR older OR 80 and over OR middle age). Constipation is not well defined in the literature. While self-reported constipation increases with age, findings from a limited number of clinical studies that utilized objective measures do not support this association. Dysmotility and pelvic floor dysfunction are important mechanisms associated with constipation. Changes in GI function associated with aging appear to be relatively subtle based on a limited amount of conflicting data. Additional research is warranted on the effects of aging on GI function, as well as on the timing of these changes.

Effect of biofeedback combined with high-quality nursing in treatment of functional constipation

BACKGROUND Functional constipation(FC)is a common functional gastrointestinal disease with various clinical manifestations.It is a physical and mental disease,which seriously affects patient physical and mental health and quality of life.Biofeedback therapy is the treatment of choice for FC,especially outlet obstructive constipation caused by pelvic floor dysfunction.High-quality nursing is a new nursing model in modern clinical work and a new concept of modern nursing service.AIM To explore the effect of biofeedback combined with high-quality nursing in the treatment of FC.METHODS A total of 100 patients with FC admitted to our hospital from March 2015 to July 2019 were selected for clinical observation.These patients were randomly divided into two groups of 50:Experimental group(biofeedback combined with highquality nursing treatment group)and control group(biofeedback group).RESULTS The constipation symptom score of the experimental group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).The anal canal resting pressure and initial defecation threshold of the experimental group were significantly lower than those of the control group,and the maximum squeeze systolic pressure of the anal canal of the experimental group was significantly higher than that of the control group(P<0.05).The Self-Rating Anxiety Scale and Zung’s Self-Rating Depression Scale scores of the two groups were significantly lower than before treatment.The Self-Rating Anxiety Scale and Self-Rating Depression Scale scores of the experimental group were significantly lower than those of the control group(P<0.05).The patient satisfaction score of the experimental group was significantly higher than that of the control group(P<0.05).CONCLUSION The application of biofeedback combined with high-quality nursing in the treatment of FC has significant advantages over pure biofeedback treatment,and it is worthy of promotion in clinical work.

Chylous ascites after whole pelvis suspension:case report and literature review

We report a case of Chylous ascites after whole pelvis suspension and to discuss the possible reasons. An 85-year-old female patient with anterior vaginal prolapse 1V （AVP IV）, vaginal vault proplapse IV and posterior vaginal prolapse IV （PVP IV）, developed Chylous ascites 2 weeks after she received whole pelvis suspension, The cause of chylous ascites in the present case was not associated with malignant tumor, hepatic cirrhosis, or inflammation. Therefore, surgical trauma may be considered the cause of disorder. X-ray lymphangioadenography should be performed to draw a final conclusion.