Vitamin D Status and Vitamin D Receptor Gene Polymorphisms Are Associated with Pelvic Floor Disorders in Women

Knowledge, Attitude, and Practice Toward Pelvic Floor Dysfunction Among Postpartum and Postmenopausal Women: A Cross-sectional Study

INTRODUCTION AND HYPOTHESIS

This research sought to explore the knowledge, attitude, and practice (KAP) toward pelvic floor dysfunction (PFD) among postpartum and postmenopausal women.

METHODS

This cross-sectional study was performed among postpartum and postmenopausal women between May and August 2023. Demographic data, along with KAP scores, were collected using a self-designed questionnaire-based approach.

RESULTS

Six hundred seventy-seven valid questionnaires were collected and analyzed, with 206 (30.43%) participants aged under 30 years old. The mean scores of knowledge, attitude, and practice dimension were 7.1 ± 2.42 (range 0-9), 33.42 ± 4.75 (range 8-40), and 24.69 ± 6.68 (range 7-35). Proactive practice was independently associated with knowledge scores (OR 1.150, 95%CI 1.059-1.249, P = 0.001), attitude scores (OR 1.125, 95%CI 1.081-1.171, P < 0.001), age 30 years or older (OR 2.326, 95%CI 1.555-3.481, P < 0.001), and being in a postpartum state (OR 0.542, 95%CI 0.325-0.903, P = 0.019). The structured equation model revealed that knowledge exerted a strong positive direct effect on attitude (β = 0.634, P < 0.001), attitude had a significant direct effect on practice (β = 0.681, P < 0.001), and knowledge also markedly influenced practice (β = 0.907, P < 0.001).

CONCLUSION

Postpartum and postmenopausal women demonstrated adequate knowledge, positive attitudes, and proactive practices regarding PFD. It emphasizes the significance of tailored education, a holistic approach, and behavioral interventions to improve clinical practice in pelvic floor health.

Differences Between 25-hydroxyvitamin D Levels in Patients with Pelvic Organ Prolapse and Non-Pelvic Organ Prolapse: A Systematic Review

OBJECTIVES

Treatment options for cases of pelvic organ prolapse still lead to the use of a pessary rather than a surgical method. Additional therapy is needed to help treat or prevent pelvic organ prolapse. Vitamin D deficiency has consistently been associated with decreased muscle function, so it is assumed that it will affect the pelvic floor muscles. This paper systematically explores the differences between 25-hydroxyvitamin D levels in patients with pelvic organ prolapse and non-pelvic organ prolapse.

STUDY DESIGN

A systematic review was conducted through the PubMed, Google Scholar, Cochrane Library, and ScienceDirect databases using relevant keywords. Articles published in the last 10 years-from 2012 to 2022-that were written in English, that discuss the status or effect of vitamin D on pelvic organ prolapse, and that focus on 25 OH-vitamin D were included in the review.

RESULTS

In total, 717 articles were filtered but 8 articles met the criteria. A total of 1339 women with prolapse and without prolapse with ages ranging from 20 years to 78 years were included in the study. The studies found did not use the same standard threshold in determining deficiency status. Most studies have found that there are lower levels of vitamin D in women who have had pelvic organ prolapse. A total of 7 of 8 studies confirmed the comparison of vitamin D-25OH levels in women with pelvic organ prolapse and without pelvic organ prolapse at P < 0.05.

CONCLUSIONS

There are differences between 25-hydroxyvitamin D levels in patients with pelvic organ prolapse and non-pelvic organ prolapse.

Association of vitamin D deficiency and pelvic organ prolapse in postmenopausal women: a cross-sectional study

BACKGROUND

Vitamin D is vital for skeletal integrity as well as optimal muscle work. High incidence and prevalence of vitamin D deficiency as well as pelvic organ prolapse are found in postmenopausal women, thus raising the question of whether the entities could be related.

METHODS

We compared 50 postmenopausal women aged 50 to 75 years with pelvic organ prolapse (POP) with 48 women of same age without POP. The clinical assessment of the disorder was performed using the Pelvic Organ Prolapse Quantification system (POP-Q). An anamnestic questionnaire was filled out by the participants on their anthropometric data, life habits, reproductive history, previous and actual diseases. A blood sample was collected for determination of 25-OH-vitamin D as well as calcium and phosphorus concentrations.

RESULTS

The group with POP and the control group were comparable in body mass index, physical activity, life habits and general health, but differed significantly in parity (being higher in POP) and vitamin D blood level concentrations, being lower in POP patients. A significantly higher prevalence of vitamin D deficiency (25-OH-vitamin D < 50 nmol/l) was found in the POP group compared to controls. Taking into account the confounding variables the logistic regression model confirmed the significant role of vitamin D for POP.

CONCLUSIONS

Vitamin D deficiency might be an important systemic factor associated to pelvic organ prolapse. The determination of vitamin D levels in postmenopausal women and replenishing its deficiency might also be of importance for the pelvic floor.

Connective tissue disease in the practice of a cosmetologist and dermatologist. Features of diagnosis and management of patients

In the practice of a cosmetologist and a dermatologist, the functional features of the skin are of extremely important. At the same time, monogenic connective tissue disorders (hereditary connective tissue dysplasia) that underlie hereditary syndromes have been known for a long time, but in recent years more attention has been paid to genetic defects that, together with other internal and external factors, lead to manifestations of connective tissue dysfunction. Such disorders are called multifactorial, as a result, a general clinic of connective tissue dysplasia can develop. It is important for dermatologists and cosmetologists to diagnose the presence and risk of connective tissue pathology in time, since these disorders require special features in the clinical management of such patients. To date, there is a slight difference in the understanding of connective tissue pathology in Russia and abroad. Thus, the purpose of this review was to integrate ideas about connective tissue dysplasia in Russia and abroad, as well as to provide dermatologists and cosmetologists with an algorithm for diagnosing and managing patients with connective tissue dysfunction.