Thermodynamic Work of High-Grade Uterine Prolapse Patients Undergoing Transvaginal Mesh Repair with Total Hysterectomy
The objective benefit of transvaginal mesh with concomitant total hysterectomy (TVM-HTX) repair to high-grade uterine prolapse (UP) patients has not been fully established. This study aimed to clarify the impact of TVM-HTX on the voiding function of high-grade UP patients by comparing pre- and post-...
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2024-08-01
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| author | Hui-Hsuan Lau Cheng-Yuan Lai Ming-Chun Hsieh Hsien-Yu Peng Dylan Chou Tsung-Hsien Su Jie-Jen Lee Tzer-Bin Lin |
| author_facet | Hui-Hsuan Lau Cheng-Yuan Lai Ming-Chun Hsieh Hsien-Yu Peng Dylan Chou Tsung-Hsien Su Jie-Jen Lee Tzer-Bin Lin |
| author_sort | Hui-Hsuan Lau |
| collection | DOAJ |
| description | The objective benefit of transvaginal mesh with concomitant total hysterectomy (TVM-HTX) repair to high-grade uterine prolapse (UP) patients has not been fully established. This study aimed to clarify the impact of TVM-HTX on the voiding function of high-grade UP patients by comparing pre- and post-operatively measured pressure–flow and pressure–volume investigations. Urodynamic and thermodynamic studies were conducted on 15 high-grade UP patients (stage III/IV, POP-Q system) who underwent TVM-HTX (January 2019–December 2022) in a tertiary-care university hospital. The parameters analyzed included voiding resistance (Rvod), voiding pressure (Pvod), voiding flow (Fvod), voided volume (Vvod), voiding time (Tvod), and the trajectory-enclosed area of the pressure–volume loop (Apv). Post-operative results showed a significant reduction in Rvod (<i>p</i> < 0.001, N = 15), Pvod (<i>p</i> = 0.021, N = 15), and Apv (<i>p</i> = 0.006, N = 15), along with an increase in Fvod (<i>p</i> = 0.003, N = 15) and a decrease in Tvod (<i>p</i> < 0.001, N = 15). The operation-associated changes in Rvod (ΔRvod) correlated with alterations in Pvod and Fvod (ΔPvod and ΔFvod, r = 0.444, <i>p</i> = 0.004, r = 0.717, <i>p</i> = 0.003, respectively; both N = 15); ΔFvod correlated with the change in Tvod (ΔTvod, r = 0.629, <i>p</i> = 0.012, N = 15) but not with that in ΔVvod (r = 0.166, <i>p</i> = 0.555, N = 15). Changes in Apv (ΔApv) correlated with ΔPvod (r = 0.563, <i>p</i> = 0.029, N = 15) but not with ΔVvod (r = 0.353, <i>p</i> = 0.197, N = 15). Collectively, TVM-HTX reduced the voiding resistance, which improved the voiding efficacy and decreased the pressure gradient required for driving urine flow, thereby lessening the bladder’s workload. |
| format | Article |
| id | doaj-art-8a6497bd31614f4e8ffff17437c3adef |
| institution | OA Journals |
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| spelling | doaj-art-8a6497bd31614f4e8ffff17437c3adef2025-08-20T01:56:00ZengMDPI AGBioengineering2306-53542024-08-0111987510.3390/bioengineering11090875Thermodynamic Work of High-Grade Uterine Prolapse Patients Undergoing Transvaginal Mesh Repair with Total HysterectomyHui-Hsuan Lau0Cheng-Yuan Lai1Ming-Chun Hsieh2Hsien-Yu Peng3Dylan Chou4Tsung-Hsien Su5Jie-Jen Lee6Tzer-Bin Lin7Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 104217, TaiwanInstitute of Biomedical Sciences, Mackay Medical College, New Taipei 25245, TaiwanDepartment of Medicine, Mackay Medical College, New Taipei 25245, TaiwanDepartment of Medicine, Mackay Medical College, New Taipei 25245, TaiwanDepartment of Medicine, Mackay Medical College, New Taipei 25245, TaiwanDivision of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 104217, TaiwanDepartment of Medicine, Mackay Medical College, New Taipei 25245, TaiwanInstitute of Translational Medicine and New Drug Development, College of Medicine, China Medical University, Taichung 404328, TaiwanThe objective benefit of transvaginal mesh with concomitant total hysterectomy (TVM-HTX) repair to high-grade uterine prolapse (UP) patients has not been fully established. This study aimed to clarify the impact of TVM-HTX on the voiding function of high-grade UP patients by comparing pre- and post-operatively measured pressure–flow and pressure–volume investigations. Urodynamic and thermodynamic studies were conducted on 15 high-grade UP patients (stage III/IV, POP-Q system) who underwent TVM-HTX (January 2019–December 2022) in a tertiary-care university hospital. The parameters analyzed included voiding resistance (Rvod), voiding pressure (Pvod), voiding flow (Fvod), voided volume (Vvod), voiding time (Tvod), and the trajectory-enclosed area of the pressure–volume loop (Apv). Post-operative results showed a significant reduction in Rvod (<i>p</i> < 0.001, N = 15), Pvod (<i>p</i> = 0.021, N = 15), and Apv (<i>p</i> = 0.006, N = 15), along with an increase in Fvod (<i>p</i> = 0.003, N = 15) and a decrease in Tvod (<i>p</i> < 0.001, N = 15). The operation-associated changes in Rvod (ΔRvod) correlated with alterations in Pvod and Fvod (ΔPvod and ΔFvod, r = 0.444, <i>p</i> = 0.004, r = 0.717, <i>p</i> = 0.003, respectively; both N = 15); ΔFvod correlated with the change in Tvod (ΔTvod, r = 0.629, <i>p</i> = 0.012, N = 15) but not with that in ΔVvod (r = 0.166, <i>p</i> = 0.555, N = 15). Changes in Apv (ΔApv) correlated with ΔPvod (r = 0.563, <i>p</i> = 0.029, N = 15) but not with ΔVvod (r = 0.353, <i>p</i> = 0.197, N = 15). Collectively, TVM-HTX reduced the voiding resistance, which improved the voiding efficacy and decreased the pressure gradient required for driving urine flow, thereby lessening the bladder’s workload.https://www.mdpi.com/2306-5354/11/9/875thermodynamicsworkloadresistancepelvic organ prolapsepelvic floor repair |
| spellingShingle | Hui-Hsuan Lau Cheng-Yuan Lai Ming-Chun Hsieh Hsien-Yu Peng Dylan Chou Tsung-Hsien Su Jie-Jen Lee Tzer-Bin Lin Thermodynamic Work of High-Grade Uterine Prolapse Patients Undergoing Transvaginal Mesh Repair with Total Hysterectomy Bioengineering thermodynamics workload resistance pelvic organ prolapse pelvic floor repair |
| title | Thermodynamic Work of High-Grade Uterine Prolapse Patients Undergoing Transvaginal Mesh Repair with Total Hysterectomy |
| title_full | Thermodynamic Work of High-Grade Uterine Prolapse Patients Undergoing Transvaginal Mesh Repair with Total Hysterectomy |
| title_fullStr | Thermodynamic Work of High-Grade Uterine Prolapse Patients Undergoing Transvaginal Mesh Repair with Total Hysterectomy |
| title_full_unstemmed | Thermodynamic Work of High-Grade Uterine Prolapse Patients Undergoing Transvaginal Mesh Repair with Total Hysterectomy |
| title_short | Thermodynamic Work of High-Grade Uterine Prolapse Patients Undergoing Transvaginal Mesh Repair with Total Hysterectomy |
| title_sort | thermodynamic work of high grade uterine prolapse patients undergoing transvaginal mesh repair with total hysterectomy |
| topic | thermodynamics workload resistance pelvic organ prolapse pelvic floor repair |
| url | https://www.mdpi.com/2306-5354/11/9/875 |
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