Editorial
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2025; 16(2): 99823
Published online Feb 15, 2025. doi: 10.4239/wjd.v16.i2.99823
Pelvic floor dysfunction in patients with gestational diabetes mellitus
Mustafa Arslan, Ramazan Kozan
Mustafa Arslan, Department of Anestesiology and Reanimation, Gazi University Faculty of Medicine, Ankara 06560, Yenimahalle, Türkiye
Ramazan Kozan, Department of General Surgery, Gazi University Faculty of Medicine, Ankara 06500, Yenimahalle, Türkiye
Co-first authors: Mustafa Arslan and Ramazan Kozan.
Author contributions: Arslan M and Kozan R contributed equally to this paper as co-first authors; Arslan M designed the overall concept and outline of the manuscript; Kozan R contributed to the discussion and design of the manuscript; Arslan M and Kozan R contributed to the writing, and editing the manuscript and review of literature; all authors have read and approved the final manuscript.
Conflict-of-interest statement: Mustafa Arslan and Ramazan Kozan have nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mustafa Arslan, MD, Professor, Department of Anestesiology and Reanimation, Gazi University Faculty of Medicine, Emniyet Mh. Mevlana Blv. No. 47, Ankara 06560, Yenimahalle, Türkiye. mustarslan@gmail.com
Received: August 1, 2024
Revised: October 10, 2024
Accepted: November 20, 2024
Published online: February 15, 2025
Processing time: 152 Days and 2.3 Hours
Abstract

In this editorial, we comment on an article by Wang et al. Recent literature shows an increase in research on pelvic organ prolapse (POP). Although the true incidence of POP remains uncertain, its impact on quality of life is substantial. Anatomical studies report high incidence rates, surpassing those observed in symptom-based surveys. Weakness of the endopelvic fascia is a primary anatomical risk factor for POP. Additionally, gestational diabetes mellitus (GDM) has emerged as a growing concern, as poor glycemic control increases complications for both mother and fetus. GDM and POP are interconnected, with factors like maternal obesity, macrosomia, and hormonal changes exacerbating pelvic floor dysfunction. Modifiable risk factors, such as obesity and chronic hyperglycemia, along with multiparity, instrumental deliveries, and obstetric trauma, further increase susceptibility. For patients with GDM, gynecological exams, Pelvic Organ Prolapse Quantification staging, and pelvic floor ultrasonography are valuable diagnostics, with proctological exams and magnetic resonance defecography aiding in multi-compartment prolapse diagnoses. Imaging, though uncomfortable during pregnancy, is safe in the early postpartum period. This editorial emphasizes the need for further research on the pathophysiology of GDM-related POP and offers recommendations for improving diagnosis and clinical management of patients with GDM.

Keywords: Defecography; Chronic hyperglycemia; Gestational diabetes mellitus; Multiparity; Pelvic floor ultrasonography; Pelvic organ prolapse; Obesity

Core Tip: Recent years have seen a surge in pelvic organ prolapse (POP) research, highlighting significant links between gestational diabetes mellitus (GDM) and increased POP risk due to factors such as obesity and macrosomia. Diagnostic tools, including Pelvic Organ Prolapse Quantification staging and pelvic floor ultrasonography, are crucial in assessing POP, especially in patients with GDM. Understanding these relationships and utilizing appropriate diagnostic methods can aid in the early identification and effective management of POP, particularly during the postpartum period.