Introduction: Pelvic organ prolapse (POP) is an important health problem but it is still receiving little attention, patients often seek medical help only when the disease is very disturbing/severe.
Case description: This case report describes a series of three cases of POP in young women who had similar profiles in terms of several characteristics, including age, occupation, ethnicity, BMI, parity, age of the youngest child (years), number of vaginal deliveries, operative vaginal deliveries, episiotomy, birth weight of the largest child, family history of prolapse, diagnosis, and procedures performed. In this case series, conservative operative treatment (Purandare hysteropexy) was carried out, then an examination of the sacrouterine ligament tissue was performed from the operation. The results of the examination showed a decrease in the expression of type I collagen, an increase in type III collagen, an increase in the levels of matrix metalloproteinases-2 (MMP-2), and MMP-9 which based on previous studies are found in patients with POP.
Conclusion: Conservative treatment with Purandare hysteropexy was done in all cases, further research is needed to establish whether this condition is the cause of the occurrence of POP in young people and the genetic correlation associated with the disorder.
Walters MD, Karram MM. Urogynecology and Reconstructive Pelvic Surgery. 4th ed. 2015.
Kim S, Harvey MA, Johnston S. A review of the epidemiology and pathophysiology of pelvic floor dysfunction: Do racial differences matter? J Obstet Gynaecol Can 2005;27(3):251–259. DOI: 10.1016/s1701-2163(16)30518-7.
Single Surgical Procedures in Obstetrics and Gynaecology – 15. Uterus – Displacements. A Color Atlas of Cervicopexy (Purandare's) Nagrath A, Malhotra N, Seth S. Jaypee Brothers Medical Publishers Ltd. 2012.
Spence-Jones C, Kamm MA, Henry MM, et al. Bowel dysfunction: A pathogenic factor in uterovaginal prolapse and urinary stress incontinence. Br J Obstet Gynaecol 1994;101(2):147–152. DOI: 10.1111/j.1471-0528.1994.tb13081.x.
Patel DA, Xu X, Thomason AD, et al. Childbirth and pelvic floor dysfunction: An epidemiologic approach to the assessment of prevention opportunities at delivery. Am J Obstet Gynecol 2006;195(1):23–28. DOI: 10.1016/j.ajog.2006.01.042.
Marta KF, DKK. Terdapat Hubungan Diameter Tranversal Dan Intertuberum Panggul Perempuan Suku Bali Dengan Prolaps Organ Panggul (Tesis). 2013;37:1–2.
Megadhana WW. Ekspresi Reseptor Estrogen Alfa dan Kolagen III yang tinggi serta ekspresi elastin yang rendah pada ligamentum sakrouterina sebagai faktor risiko terjadinya Prolaps uterus stadium III-IV (Disertasi) 2014;107–108. DOI: 10.1016/j.ajog.2004.11.042.
Megaputra IG, Manuaba IBAP, Pranamartha AAAGMK, et al. The role of estrogen receptor α, COL3A1, and fibulin-5 genes polymorphisms as risk faktors for pelvic organ prolapse in Balinese women. Gineco. Eu J 2018;14(54):135–140. DOI: 10.18643/gieu.2018.135.
Kerkhof M, Hendriks L, Brölmann HAM. Changes in connective tissue in patients with pelvic organ prolapse. A review of the current literature. Int Urogynecol J Pelvic Floor Dysfunct 2009;20(4):461–474. DOI: 10.1007/s00192-008-0737-1.
Handa VL, Blomquist JL, Knoepp LR, et al. Pelvic floor disorders 5–10 years after vaginal or cesarean childbirth. Obstet Gynecol 2011;118(4):777–784. DOI: 10.1097/AOG.0b013e3182267f2f.