Pelvic organ prolapse in grand multiparae: a translational and bi-continental study

Outline of the research: In Ghana there is a proportion of the female population who are at risk for pelvic floor disorders, mainly because they are grand multiparae. Therefore there is a need for adequate care in this population. We aim to undertake translational and clinical research that may eventually benefit this population:1. Clinically, we aim to document the perception of current and future pessary users in this subgroup, being a conservative treatment option available nationwide. Though multiparae are at increased risk, they are also at risk to have prolapse earlier in life, and more at risk to fail therapy, including pessaries. This makes this subgroup an interesting population.2. Also we aim to characterize a subgroup in the population who present with POP during pregnancy, and investigate the efficacy of conservative measures in this group.3. We aim to perform translational research, and will characterize the pelvic floor muscles of grand multipara sheep. The sheep model has been proposed by the Leuven group, and they have already studied the effects of first delivery, second or third delivery, and menopause.4. Also we will evaluate technical modifications that should make the standard of care of uterine prolapse (laparoscopic level I repair) faster and therefore more accessible, i.e. by replacing a sutured repair by one using tissue glues. This will include the study of the host response to glue, the study of the pull out strength and a clinical cost-minimization study. Hysteropexy is an operation that will please more African women, as it conserves their ability to conceive.Prof. Jan Deprest and Dr. Noble Ayitey Ayayee

Keywords:Pelvic organ prolapse, multiparae, laparoscopic sacrocolpoxy, Tissue glue

Disciplines:Gynaecology and obstetrics not elsewhere classified

Project type:PhD project