Pelvic organ prolapse management

2020 ◽  
Vol 26 (2) ◽  
pp. 79-85
Author(s):  
K Fleischer ◽  
G Thiagamoorthy
Keyword(s):  
Pelvic Organ Prolapse ◽  
Effective Treatment ◽  
Treatment Options ◽  
Treatment Success ◽  
Pelvic Organ ◽  
Current Evidence ◽  
Pelvic Organs ◽  
Current State ◽  
Mesh Surgery ◽  
The Uk

Pelvic organ prolapse describes the loss of support and subsequent descent of pelvic organs into the vagina. It is common, affecting up to 50% of parous women, and can be accompanied by a number of burdening symptoms. Prolapse has been thrown into the spotlight secondary to mesh-related complications. There are a number of effective treatment options to consider when managing pelvic organ prolapse and most do not require mesh. Patients’ choice, comorbidities and likelihood of treatment success should be considered when making decisions about their care. Vaginal mesh surgery is currently on hold in the UK and even prior to this there has been a reduction both in the number of all prolapse surgeries and the number of women seeking surgery to manage their symptoms. This article reviews the current evidence for the management of pelvic organ prolapse, providing an update on the current state of mesh in prolapse surgery and summarises the key evidence points derived from the literature.

scholarly journals Treatment of pelvic organ prolapse

2012 ◽  
Vol 26 (1) ◽  
pp. 3
Author(s):  
Munir'deen A. Ijaiya ◽  
Hadijat O. Raji
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
De Novo ◽  
Treatment Options ◽  
Reproductive Function ◽  
Pelvic Organ ◽  
Pelvic Organs ◽  
Choice Of Treatment ◽  
Principles Of Treatment

Prolapse of the pelvic organs is a common condition encountered in gynecological practice that adversely affects the quality of life of affected women. It affects millions of women worldwide. The principles of treatment of pelvic organ prolapse include restoring anatomy and vaginal function, correcting associated urinary and or fecal incontinence, and preventing de novo prolapse and incontinence. There are various treatment options for pelvic organ prolapse. These vary from conservative treatments/ mechanical interventions to surgery. The choice of treatment depends on severity of symptoms, patient’s age, parity, and whether there is the need to conserve the uterus for reproductive function. In conclusion, thorough evaluation of symptoms and degree of prolapse is essential in order to provide the best possible treatment and ultimately improve quality of life.

Nonsurgical Management Options for Pelvic Organ Prolapse: Review of the Current Evidence

2018 ◽  
Author(s):  
Nathan Kow
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Uterine Prolapse ◽  
Pelvic Floor Muscle ◽  
Treatment Options ◽  
Pelvic Organ ◽  
Current Evidence ◽  
Management Options ◽  
Nonsurgical Management ◽  
First Line Therapy

Pelvic organ prolapse (POP) is a common disorder that impacts a woman’s quality of life and has been projected to increase in the near future. Although many different treatments are currently available, healthcare practioners should be familiar with the common nonsurgical options that are considered the first-line therapy. Advances in nonsurgical interventions have traditionally included pessaries and pelvic floor muscle therapy.  These optiosn have not changed much over time, however there have been recent trials providing more evidence with regards to their efficacy.  The objective of this article is to review the current evidence for nonsurgical treatment options for POP.  This review contains 2 tables and 19 references Key Words: pelvic floor muscle training, pelvic floor physical therapy, pelvic organ prolapse, pessary, kegel excercises, uterine prolapse, cystocele, rectocele

scholarly journals Long-term outcomes of transvaginal mesh surgery for pelvic organ prolapse: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaojuan Wang ◽  
Yisong Chen ◽  
Changdong Hu ◽  
Keqin Hua
Keyword(s):  
Pelvic Organ Prolapse ◽  
Patient Characteristics ◽  
Pelvic Organ ◽  
Transvaginal Mesh ◽  
Recurrence Rates ◽  
Kaplan Meier ◽  
Mesh Surgery ◽  
Patient Global Impression

Abstract Background The objective of this study was to evaluate the overall outcomes and complications of transvaginal mesh (TVM) placement for the management of pelvic organ prolapse (POP) with different meshes with a greater than 10-years of follow-up. Methods We performed a retrospective review of patients with POP who underwent prolapse repair surgery with placement of transvaginal mesh (Prolift kit or self-cut Gynemesh) between January 2005 and December 2010. Baseline of patient characteristics were collected from the patients’ medical records. During follow-up, the anatomical outcomes were evaluated using the POP Quantification system, and the Patient Global Impression of Improvement (PGI-I) was used to assess the response of a condition to therapy. Overall postoperative satisfaction was assessed by the following question: “What is your overall postoperative satisfaction, on a scale from 0 to 10?”. Relapse-free survival was analyzed using Kaplan–Meier curves. Results In total, 134 patients were included. With a median 12-year (range 10–15) follow-up, 52 patients (38.8%) underwent TVM surgery with Prolift, and Gynemesh was used 82 (61.2%). 91% patients felt that POP symptom improved based on the PGI-I scores, and most satisfied after operation. The recurrence rates of anterior, apical and posterior compartment prolapse were 5.2%, 5.2%, and 2.2%, respectively. No significant differences in POP recurrence, mesh-associated complications and urinary incontinence were noted between TVM surgery with Prolift versus Gynemesh. Conclusions Treatment of POP by TVM surgery exhibited long-term effectiveness with acceptable morbidity. The outcomes of the mesh kit were the same as those for self-cutmesh.

Long-term observation on postoperative recurrence and complications of transvaginal mesh surgery for pelvic organ prolapse

2021 ◽  
Author(s):  
Junfang Yang ◽  
Kun Zhang ◽  
Jinsong Han ◽  
Yiting Wang ◽  
Ying Yao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pelvic Organ Prolapse ◽  
Protective Factor ◽  
Pelvic Organ ◽  
Vaginal Mesh ◽  
Transvaginal Mesh ◽  
Mesh Exposure ◽  
Mesh Surgery ◽  
Post Menopause

Objective: This study aims to evaluate the risk factors for subjective recurrence and complications of patients who underwent transvaginal synthetic mesh surgery. Design：This retrospective cohort study included patients who received transvaginal mesh (TVM) surgery between January 2005 and June 2019. Methods: The information of patients was collected, including basic characteristics, subjective recurrence, and mesh-related complications. The clinical characteristics of patients with and without subjective recurrence were compared. The sexual activities of patients before and after the operation were recorded. SPSS 20.0 was used for the statistical analysis. Results: A total of 257 patients were included. Among them, 62 (24.1%) patients were lost to follow-up. The median follow-up time was 80 months (12 months, 170 months). Finally, 195 patients were followed up, 11 (5.6%) patients had a subjective recurrence of pelvic organ prolapse, and 26 (13.3%) patients had mesh-related complications (11 patients with de novo pain and 15 patients with mesh exposure). We found significant differences in age (68.9±5.1 vs. 63.4±5.8 years old), years of post-menopause (17.5±6.3 vs. 13.3±6.9 years), previous hysterectomy (27.3% vs. 6.0%), and concomitant hysterectomy (45.5% vs. 81.0%) between patients with and without subjective recurrence (P<0.05). The mesh exposure proportion of patients with total vaginal mesh (47.6%) was significantly higher than that with anterior vaginal mesh (2.9%) (P<0.05). Furthermore, 6.7% of sexually active patients reported do novo dyspareunia. Limitation: The investigators could only record the subjective recurrence of patients, thus there is a lack of objective recurrence data. Conclusion: Age, years of post-menopause and previous hysterectomy are risk factors for subjective recurrence of transvaginal mesh surgery; however，concomitant hysterectomy is a protective factor. Mesh exposure is the most common complication, especially for total vaginal mesh repair surgery.

Pelvic organ prolapse

2020 ◽  
pp. 57-82
Author(s):  
Helen Jefferis ◽  
Natalia Price
Keyword(s):  
Pelvic Organ Prolapse ◽  
Patient Management ◽  
Pelvic Organ ◽  
Anatomical Position ◽  
Pelvic Organs ◽  
Different Types

Pelvic organ prolapse (POP) is where the pelvic organs (uterus/vaginal apex/bladder/bowel) herniate into or beyond the vagina from their normal anatomical position. This chapter provides both the classification and grading of pelvic organ prolapse, alongside assessment and examination of the patient. Management is split into conservative, pessaries, and surgery. Different types of surgery and their techniques are described, with indications and variants for various prolapses.

Sign in / Sign up

Export Citation Format

Share Document