Podium Session

Poster, Podium & Video Sessions

PD02-01: Types of pelvic floor defects in women with pelvic organ prolapse

Friday, May 12
7:00 AM - 7:10 AM
Location: BCEC: Room 162

Presentation Authors: George Kasyan*, Nataliya Tupikina, Dmitry Pushkar, Moscow, Russian Federation

Introduction: This study presents a new potentially useful three-dimensional (3D) non-invasive tool to determine the basic 3D models of the pelvic floor, static and dynamic, in patients with pelvic organ prolapse (POP) which help to identify the main types of pelvic floor defects and to create an individual approach to their reconstruction.

Methods: We scanned 42 patients who were suffering from POP (no less than Grade 2 by Pelvic Organ Prolapse Quantification (POP-Q)) at rest and during Valsalva maneuver by using an Artec® 3D optic portable scanner. Pelvic floor 3D models were generated. We calculated the volume of the prolapsed vaginal wall using Dynamic prolapse increment (DPI). It was defined as an increase in the prolapse volume from the rest to its maximal Valsalva probe (DPI = (Vval - Vrest) / Vrest %).

Results: The average value of the DPI in women with POP was 648% (95% CI 194-1102%). It indicated the presence of an advanced mobility of the pelvic floor and the need to use mesh surgical correction of POP in some cases. According to generated pelvic floor 3D models, six basic types of pelvic defects were allocated. The central defects of an anterior vaginal wall along with mixed one (cystocele combined with uterine prolapse or rectocele) were the most common defects of the pelvic floor (in 24 and 26%, respectively). The lateral defect occurred in 7%, the asymmetric one - in 10%, urethra cystocele - in 19%, the isolated uterine defect - 10% and enterocele - 5% (Figure 1).

Conclusions: The detection of types of pelvic floor defects in women with POP by 3D modeling may allow creating of synthetic implants for an individual pelvic floor reconstruction, taking into account patients' reserves of pelvic floor mobility. It will contribute reducing the risk of possible functional complications of surgical correction of POP. The further investigations of the pelvic floor dynamic features in women are necessary.

Source Of Funding: none

George R. Kasyan

Moscow State University of Medicine and Dentistry

Professor of Urology, Head of Functional Urology and Urodynamics Unit

Department of Urology of Moscow State University of Medicine and Dentistry (MSMSU) Moscow, Russian Federation

Scientific Secretary of the Russian Society of Urogynecology and Robotic Surgery


Mosfilmovskaya str. 15 – 69,
119330 Moscow, Russia
Tel/Fax + 7 499 760 75 89
Mobile +7 915 464 33 18
g.kasyan@gmail.com



Education 2014 Defended second step Ph. D. Thesis – Functionals of urinary incontinence in females

2008 Defended first step Ph.D. thesis – Surgical approaches in the treatment of female stress urinary incontinence

2005 – 2008 Postgraduate training in Female and Functional Urology
Moscow State University of Medicine and Dentistry, Moscow

1998 – 2001 Resident in Urology
Belorussian Medical Academy, Minsk

1996 – 1998 Fellow in General Medicine,
Yerevan State University of Medicine, Yerevan, Armenia

1990 – 1996 General Medicine
Yerevan State University of Medicine, Yerevan, Armenia

Professional Experience

2014 - present Professor, Department of Urology, MSMSU

2011-2014 Associate Professor, Department of Urology, MSMSU

2009- 2011 Assistant Professor, Department of Urology, MSMSU

``` 2001 – 2009 General urologist, Outpatient city clinic of Krasnodar


Member of Russian Society of Urology
Member of European Association Urology
Associate member of the EAU Section of Female and Functional Urology
Member of Russian Society of Urogynecology and Robotic Surgery
Honorary Member of Armenian Society of Urology
Honorary Member of Georgean Society of Urology

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PD02-01: Types of pelvic floor defects in women with pelvic organ prolapse



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