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The video shows the meticulous repair of the corneoscleral tear along with management of the choroidal prolapse. The video demonstrates the steps to establish the anatomical integrity of the globe and tips to avoid suture bites through the choroid in a corneo-scleral tear repair. Identification of important landmarks helps in the establishment of anatomical integrity. Therefore, the limbal area of tear is first sutured with 10-O nylon. The extent of wound onto the sclera is checked on the other end of the tear. Second limbal suture at the opposite end of the tear is taken, followed by dividing the corneal extent of tear by rule of half and segmental suturing with 10-O nylon. Then conjunctival peritomy is done to explore the scleral extent and the uveal tissue prolapse. Blunt and atraumatic back tip of Weckel sponge is used perpendicular to the plane of the sclera to push the choroid back aiding the scleral bite. Sclera is sutured with 9-O nylon suture taking care not to include the choroidal tissue. Air injection is done to check for any wound leak. Side port is hydrated, and corneal sutures are buried. The conjunctiva is secured with fibrin glue. Anterior chamber is formed with air bubble. Povidone iodine is instilled and BCL placed.

Pelvic floor disorders are a global health problem affecting millions of women, particularly in developing countries. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence and common factors affecting pelvic floor disorders among women in Ethiopia. Databases such as PubMed, Google Scholar, SCOPUS, Hinari and DOAJ were systematically searched to identify eligible studies. The quality of included studies was assessed using Joanna Briggs Institute checklist. Data extraction was performed using Endnote and analyzed using STATA 17 version. To examine possible heterogeneity between studies, the I² test was used. A DerSimonian and Laird random effects model was used to derive pooled prevalence and odds ratio. Funnel plot and Egger's test were used to detect possible publication bias. This review was registered under PROSPERO ID 2024CRD42024572321. A total of 8 eligible studies with 9703 participants were included in this systematic review and meta-analysis. The pooled prevalence of pelvic floor disorders among women in Ethiopia was 25% (95% CI 0.20-0.30). Pelvic organ prolapse was the most common pelvic floor disorder 28% (95% CI 0.13-0.43), followed by urinary incontinence 19% (95% CI 0.09-0.29). Vaginal delivery greater than or equal to five (AOR: 4.02.95% CI 1.87-8.79), place of delivery at home (AOR: 1.02.95% CI 0.35-2.98), history of episiotomies (AOR: 2.69.95% CI 0.54-13.49) and women who married under 18 years of age (AOR: 1.32. 95% CI 0.37-4.77) showed a significant association with the prevalence of pelvic floor disorders. Pelvic organ prolapse is the most common pelvic floor disorder in Ethiopia. Vaginal deliveries, home deliveries, episiotomies and early marriage were identified as factors affecting pelvic floor disorder in Ethiopia.

Pelvic floor disorders are a global health problem affecting millions of women, particularly in developing countries. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence and common factors affecting pelvic floor disorders among women in Ethiopia. Databases such as PubMed, Google Scholar, SCOPUS, Hinari and DOAJ were systematically searched to identify eligible studies. The quality of included studies was assessed using Joanna Briggs Institute checklist. Data extraction was performed using Endnote and analyzed using STATA 17 version. To examine possible heterogeneity between studies, the I² test was used. A DerSimonian and Laird random effects model was used to derive pooled prevalence and odds ratio. Funnel plot and Egger's test were used to detect possible publication bias. This review was registered under PROSPERO ID 2024CRD42024572321. A total of 8 eligible studies with 9703 participants were included in this systematic review and meta-analysis. The pooled prevalence of pelvic floor disorders among women in Ethiopia was 25% (95% CI 0.20-0.30). Pelvic organ prolapse was the most common pelvic floor disorder 28% (95% CI 0.13-0.43), followed by urinary incontinence 19% (95% CI 0.09-0.29). Vaginal delivery greater than or equal to five (AOR: 4.02.95% CI 1.87-8.79), place of delivery at home (AOR: 1.02.95% CI 0.35-2.98), history of episiotomies (AOR: 2.69.95% CI 0.54-13.49) and women who married under 18 years of age (AOR: 1.32. 95% CI 0.37-4.77) showed a significant association with the prevalence of pelvic floor disorders. Pelvic organ prolapse is the most common pelvic floor disorder in Ethiopia. Vaginal deliveries, home deliveries, episiotomies and early marriage were identified as factors affecting pelvic floor disorder in Ethiopia.

Anterior vaginal prolapse (AVP) is the most common form of pelvic organ prolapse (POP) and has deleterious effects on women’s health. Despite recent advances in AVP diagnosis and treatment, a cell atlas of the vaginal wall in AVP has not been constructed. Here, we employ single-cell RNA-seq to construct a transcriptomic atlas of 81,026 individual cells in the vaginal wall from AVP and control samples and identify 11 cell types. We reveal aberrant gene expression in diverse cell types in AVP. Extracellular matrix (ECM) dysregulation and immune reactions involvement are identified in both non-immune and immune cell types. In addition, we find that several transcription factors associated with ECM and immune regulation are activated in AVP. Furthermore, we reveal dysregulated cell–cell communication patterns in AVP. Taken together, this work provides a valuable resource for deciphering the cellular heterogeneity and the molecular mechanisms underlying severe AVP. Anterior vaginal prolapse (AVP), the most common form of pelvic organ prolapse, has deleterious effects on women’s health. Here the authors employ single-cell RNA-seq to construct a transcriptomic atlas of vaginal wall cells from AVP patients, and find that extracellular matrix dysregulation and immune reaction are associated with AVP.

Background Pelvic floor stability is influenced by various biomechanical, anatomical, and physiological factors. Understanding these dynamics is crucial for improving the treatment of pelvic organ prolapse (POP) and related conditions. Objective To analyze the key factors affecting pelvic floor integrity and explore both non-surgical and surgical interventions to enhance stability and treatment outcomes. Methods This review draws from biomechanical research to assess the role of the uterosacral ligament in pelvic support, while also examining the potential of both traditional and emerging therapeutic approaches, including non-surgical interventions like vitamin C supplementation. Results - The uterosacral ligament demonstrates superior strength and stiffness, making it essential for structural support of pelvic organs. - Non-surgical interventions, such as vitamin C supplementation, show potential in improving ligament integrity and preventing pelvic floor disorders. - Emerging surgical techniques, including tendon-based procedures and injectable fibrous hydrogel composites, offer promising improvements in outcomes for patients with pelvic organ prolapse. - Additional factors such as muscle strength and neural deficiencies contribute to the complexity of pelvic floor biomechanics, indicating the need for multifaceted treatment approaches. Conclusion This analysis provides a comprehensive framework for understanding and managing pelvic floor stability by integrating biomechanical, physiological, and anatomical insights. The findings highlight the potential for personalized treatment strategies to improve patient outcomes in pelvic floor disorders.

ABSTRACT This study aimed to elucidate the roles of junctional adhesion molecule 2 (JAM‐2), collagen I and matrix metalloproteinase 2 (MMP‐2) in the pathogenesis of pelvic organ prolapse (POP) and explore their potential as diagnostic markers. We examined 82 POP patients and 64 controls using enzyme‐linked immunosorbent assay (ELISA) and quantitative Polymerase Chain Reaction (qPCR) to analyse protein and gene expression levels of JAM‐2, Collagen I and MMP‐2. Receiver operating characteristic (ROC) analysis evaluated their diagnostic efficacy, with correlation analyses linking molecular markers to POP severity based on POP‐Q grades. Our study found no significant differences in age, BMI and vaginal parity between POP patients and controls. Molecular analyses revealed significant alterations in the expression levels of JAM‐2, Collagen I and MMP‐2 in POP patients. Specifically, there was a marked decrease in JAM‐2 and collagen I levels, accompanied by an increase in MMP‐2 expression, indicating a disruption in the balance between tissue synthesis and degradation. ROC analysis demonstrated the significant discriminative power of these markers, with substantial area under the curve (AUC) values for diagnosing POP. Correlation analysis further showed a significant association between the expression of JAM‐2, Collagen I and MMP‐2 and the clinical severity of POP, as indicated by POP‐Q grades. Our findings revealed the significant changes in the expression of JAM‐2, Collagen I and MMP‐2 that may contribute to the POP pathogenesis. The diagnostic potential of these markers was substantiated, suggesting their utility in developing noninvasive diagnostic tools for POP.

Pelvic organ prolapse (POP) is the descent of the vaginal wall, cervix, uterus, bladder, and rectum downward into the vaginal canal. It occurs owing to the weakness of the structures supporting and keeping pelvic organs in anatomic position. Prolapse occurs due to exposure to risk factors; women in developing countries are highly predisposed to the risk factors of the prolapse. No study assesses POP in Southern Ethiopia. A case-control study design was employed in 369 participants (123 cases and 246 controls) of seven randomly selected Public Hospitals of Southern Ethiopia from February-June, 2020, using a structured questionnaire. All patients diagnosed with prolapse (stage I- IV) were included as cases; patients free of prolapse (stage 0) were taken as controls after physicians had performed a diagnosis and vaginal examination. Bivariate and multivariable logistic regression analyses were performed using SPSS. In this study, after adjusting for covariates, age of the women [greater than or equal to] 45 years (AOR = 5.33, 95% CI: 1.47, 9.05), underweight (AOR= 4.54, 95% CI: 1.4, 15.76), low income (AOR = 2.5, 95% CI:1.14, 5.59), parity [greater than or equal to]5 (AOR = 5.2, 95% CI: 2.2, 12.55), assisted vaginal delivery (AOR= 4, 95% CI: 1.55, 11.63), instrumental delivery (AOR= 3.5, 95% CI:1.45, 84), sphincter damage and vaginal tear (AOR = 3.2, 95% CI:1.44,7.1), carrying heavy loads (AOR= 2.5, 95% CI:1.2, 5.35), and prolonged labor [greater than or equal to]24 hours (AOR = 3.3, 95% CI:1.12, 97) were significant associated factors of prolapse. The odds of developing prolapse is lower among women attended school. Most(84.55%) of the women with prolapse were delayed for the treatments and only surgical interventions were done as treatments. Most of them claimed lack of social support, lack of money, and social stigma as the main reasons for the delay in seeking treatments. Older age, low educational status, underweight, low income, higher parity, assisted vaginal delivery, prolonged labor, sphincter damage, and carrying heavy loads were significant associated factors of POP. It is better to screen older age women by doing campaigns against the prolapse. Also, responsible bodies should work on raising awareness of women as well as awareness of the community about the prolapse through expanding health education. Moreover, informing women to practice pelvic muscle training daily, raising women's income to empower them, and help of family members to reduce carrying an overload of mothers are recommended.