Modern therapies for pelvic floor dysfunction in women due to surgical menopause

Aim. To compare the effectiveness of the kGoal vaginal trainer combined with the intimate non-hormonal phytocomplex with hyaluronic acid, Estrogial, for the non-surgical treatment of the early stages of pelvic prolapse in women with surgical menopause.

Materials and methods. We examined 65 patients who came for an outpatient consultation 6–12 months after surgery (extirpation and/or amputation of the uterus with appendages). All study subjects were diagnosed with POP-Q grade 1 pelvic organ prolapse at the time of the first visit. In addition, some patients complained of urge urinary incontinence and various symptoms typical for the genitourinary menopausal syndrome. The mean age of study patients was 48.7±6.5 years (99% confidence interval 46.62–50.78); the mean age of surgical menopause was 50.1±2.8 years (99% confidence interval 49.21–50.99); the duration of surgical menopause was 6 months to 1 year. Symptoms in patients at outpatient Visit 1 included dysuria in 29 (44.62%), stress urinary incontinence in 23 (35.39%), sexual dysfunction in 26 (40.00%), sensations of vagina dryness in 45 (69.23%), splashing sounds in the vagina during sexual intercourse or sports in 18 (27.69%), loss of vagina sensitivity in 12 (18.46%). The treatment effectiveness was assessed in 3, 6, and 9 months.

Results. After 9 months of treatment, dysuria persisted in 2 (3.33%) patients. Stress urinary incontinence persisted in 5 (8.33%) patients and sexual dysfunction in 3 (5.00%) patients. Five (8.33%) patients still reported splashing sounds in the vagina during sexual intercourse or sports. The sensation of vagina dryness and loss of vagina sensitivity after treatment were not reported in any of the patients. The significance of the association of the surgical menopause sequelae with individual clinical signs of pelvic organ prolapse was relatively high and very high (p<0.05).

Conclusion. The study on kGoal vaginal trainer combined with the local non-hormonal phytocomplex with hyaluronic acid in patients with surgical menopause showed statistically significant, good, and satisfactory clinical efficacy, reducing the clinical manifestations of pelvic organ prolapse and the severity of the symptoms of surgical menopause-related genitourinary menopausal syndrome.