Fortifying the foundation: assessing the role of uterine ligament integrity in uterine prolapse and beyond.

Gaetano Panese, Radmila Sparic, Andrea Morciano, Andrea Tinelli, Giovanni Pecorella, Ivana Babovic

Journal: Archives of gynecology and obstetrics 2024;310(5):2333-2343

PMID: 39302411

Abstract

BACKGROUND

Pelvic floor stability is influenced by various biomechanical, anatomical, and physiological factors. Understanding these dynamics is crucial for improving the treatment of pelvic organ prolapse (POP) and related conditions.

OBJECTIVE

To analyze the key factors affecting pelvic floor integrity and explore both non-surgical and surgical interventions to enhance stability and treatment outcomes.

METHODS

This review draws from biomechanical research to assess the role of the uterosacral ligament in pelvic support, while also examining the potential of both traditional and emerging therapeutic approaches, including non-surgical interventions like vitamin C supplementation.

RESULTS

- The uterosacral ligament demonstrates superior strength and stiffness, making it essential for structural support of pelvic organs. - Non-surgical interventions, such as vitamin C supplementation, show potential in improving ligament integrity and preventing pelvic floor disorders. - Emerging surgical techniques, including tendon-based procedures and injectable fibrous hydrogel composites, offer promising improvements in outcomes for patients with pelvic organ prolapse. - Additional factors such as muscle strength and neural deficiencies contribute to the complexity of pelvic floor biomechanics, indicating the need for multifaceted treatment approaches.

CONCLUSION

This analysis provides a comprehensive framework for understanding and managing pelvic floor stability by integrating biomechanical, physiological, and anatomical insights. The findings highlight the potential for personalized treatment strategies to improve patient outcomes in pelvic floor disorders.

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Address: Department of Gynecology, Obstetrics and Reproduction Medicine, Saarland University, Kirrbergerstraße 100, Building 9, 66424, Homburg, Germany. [email protected].; Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000, Belgrade, Serbia.; Faculty of Medicine, University of Belgrade, 11000, Belgrade, Serbia.; Department of Obstetrics and Gynaecology, Pia Fondazione Cardinale G. Panico, 73039, Tricase, Italy.; Department of Obstetrics and Gynecology, and CERICSAL, (CEntro di RIcerca Clinico SALentino), Veris delli Ponti Hospital, Scorrano, Lecce, Italy.

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