Acta Scientific Women's Health (ASWH)(ISSN: 2582-3205)

Research Article Volume 5 Issue 4

Effects of Preoperative Preparation on the Vaginal Mucosa in Women with Genital Prolapse Associated with Genitourinary Menopausal Syndrome

AA Mikhelson1, MV Lazukina1*, AN Varaksin2, OA Melkozerova1, GN Chistyakova1 and EV Lugovykh1

1Ural Science Research Institute of Maternity and Child Care of the Ministry of Health of the Russian Federation, Ekaterinburg, Russia
2Institute of Industrial Ecology, Ural Branch of the Russian Academy of Sciences, Ekaterinburg, Russia

*Corresponding Author: MV Lazukina, Ural Science Research Institute of Maternity and Child Care of the Ministry of Health of the Russian Federation, Ekaterinburg, Russia.

Received: January 09, 2023; Published: March 31, 2023


Objective: To analyze the effect of preoperative preparation on vaginal architectonics and vaginal microbiota composition in women with stage III, IV genital prolapse POP-Q in combination with genitourinary menopausal syndrome.

Methods: A prospective randomized trial was conducted on the basis of the gynecological department of the Federal State Budgetary Institution of Research Institute of OMM of the Ministry of Health of Russia in the period 2018-2020. The study included 100 women aged 52 to 79 years with prolapse of the anterior vaginal wall of stage III, IV according to POP - Q. The first group are women who were given local hormone therapy (estriol and progesterone) in combination with lactobacteria at the preoperative stage (n = 35); the second group - local monotherapy with estriol (n = 35), the third group (control) - without previous preparation for surgery (n = 30). Material for morphological and immunohistochemical examination - biopsy of anterior vaginal wall mucosa was obtained during surgery. To determine the state of the receptor apparatus of the vaginal mucosa (ERα, ERβ), an immunohistochemical study was carried out. Real-time diagnosis based on polymeresis chain reaction was used to determine vaginal microbiocenosis.

Results: It has been found that the use of vaginal forms of estrogen and progesterone in combination with lactobacteria reduces the intensity of the inflammatory process in the vaginal mucosa, reduces the severity of dystrophic changes, and also statistically significantly increases the level of ERα expression and ERβ in all layers of the vaginal epithelium. Comparative characterization of Candida spp. after treatment, the observation groups showed a significantly lower number of yeast-like fungi in the first group with a statistically significant increase in lactobacillary flora.

Conclusion: This study revealed a significant positive effect of preoperative vaginal preparation using complex therapy with estriol, progesterone in combination with Lactobacillus on architectonics, local vaginal immunity and vaginal microbiota in women with severe postmenopausal genital prolapse.

Recommendations: As a local preoperative preparation of the vaginal mucosa, it is recommended to give preference to a complex approach - the use of local forms of estriol and progesterone in combination with lactobacteria.

 Keywords: Genital Prolapse; Genitourinary Menopausal Syndrome


  1. Aitbayeva B., et al. “Mini-Review: Modern Concept of Pelvic Organ Prolapse”. Open Access Macedonian Journal of Medical Sciences 10 (2022): 201-207.
  2. Benini Vittoria., et al. “New Innovations for the Treatment of Vulvovaginal Atrophy: An Up-to-Date Review”. Medicina (Kaunas, Lithuania)6 (2022): 770.
  3. Kayembe Antoine Tshimbundu., et al. “Genital prolapse: epidemiology, clinic and therapeutic at Saint Joseph Hospital of Kinshasa”. The Pan African Medical Journal 37 (2020): 196.
  4. Weintraub Adi Y., et al. “Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse”. International Brazilian Journal of Urology: Official Journal of the Brazilian Society of Urology 46,1 (2020): 5-14.
  5. De Landsheere, Laurent., et al. “Histology of the vaginal wall in women with pelvic organ prolapse: a literature review”. International Urogynecology Journal 24,12 (2013): 2011-2020.
  6. Wihersaari Olga., et al. “Complications of Pelvic Organ Prolapse Surgery in the 2015 Finnish Pelvic Organ Prolapse Surgery Survey Study”. Obstetrics and Gynecology6 (2020): 1135-1144.
  7. Fritel X., et al. “Serious complications and recurrences after pelvic organ prolapse surgery for 2309 women in the VIGI-MESH registry”. BJOG : An International Journal of Obstetrics and Gynaecology4 (2022): 656-663.
  8. Chollet Janet A., et al. “Efficacy and safety of vaginal estriol and progesterone in postmenopausal women with atrophic vaginitis”. Menopause (New York, N.Y.)5 (2009): 978-983.
  9. Ratten Larissa K., et al. “The Effect of Exogenous Sex Steroids on the Vaginal Microbiota: A Systematic Review”. Frontiers in Cellular and Infection Microbiology 11 (2021): 732423.
  10. Diem Susan J., et al. “Effects of vaginal estradiol tablets and moisturizer on menopause-specific quality of life and mood in healthy postmenopausal women with vaginal symptoms: a randomized clinical trial”. Menopause (New York, N.Y.)10 (2018): 1086-1093.
  11. Kiefer Zoë E., et al. “Vaginal microbiota differences associated with pelvic organ prolapse risk during late gestation in commercial sows†”. Biology of Reproduction6 (2021): 1545-1561.
  12. Costa Ana Paula Ferreira., et al. “Hormonal Approach for Postmenopausal Vulvovaginal Atrophy”. Frontiers in Reproductive Health 3 (2021): 783247.
  13. Benini Vittoria., et al. “New Innovations for the Treatment of Vulvovaginal Atrophy: An Up-to-Date Review”. Medicina (Kaunas, Lithuania)6 (2022): 770.
  14. Kiefer Zoë E., et al. “Vaginal microbiome and serum metabolite differences in late gestation commercial sows at risk for pelvic organ prolapse”. Scientific Reports1 (2021): 6189.
  15. Hummelen Ruben., et al. “Vaginal microbiome and epithelial gene array in post-menopausal women with moderate to severe dryness”. PloS One11 (2011): e26602.
  16. Naboka Y., et al. “Bacterial colonization of female reproductive tract in genital prolapse (preliminary results)”. Meditsinskiy sovet = Medical Council 19 (2014): 53-55.
  17. Borovleva OA., et al. “Bioelectric potential measurement of oral cavity of dental patients”. Medical Herald of the South of Russia 3 (2016): 31-35.
  18. “Genitourinary menopausal syndrome – interdisciplinary problem”. Gynecology5 (2018): 9-14.
  19. Eliseev DE., et al. “Preoperative preparation of patients with prolapse of pelvic organs and genital fistulas”. RMJ 1 (2018): 41-44.
  20. Erekson EA., et al. “The Vulvovaginal Symptoms Questionnaire”. Menopause 9 (2015): 973-979.
  21. Teresiński Leszek., et al. “Assessment of morphological changes and steroid receptors in the uteri of postmenopausal women”. Histology and Histopathology 34,6 (2019): 631-644.


Citation: MV Lazukina., et al. “Effects of Preoperative Preparation on the Vaginal Mucosa in Women with Genital Prolapse Associated with Genitourinary Menopausal Syndrome". Acta Scientific Women's Health 5.4 (2023): 83-97.


Copyright: © 2023 MV Lazukina., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate35%
Acceptance to publication20-30 days

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is May 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US