“I Felt Something Coming Down Below”: A Case of POP

Mumtaz Adiba Bt Juanda ◽  
Suzanna Daud

Pelvic floor disorders, which includes pelvic organ prolapse (POP), have shown an increasing prevalence among women worldwide. (Wu 2014) It is perceived as embarrassment and affect the women’s quality of life. A 68-year-old housewife, Para 3, complained of a 50-cent coin size lump coming down from her vagina since 2019, which could be reduced back manually inside the vagina. The symptom exacerbated by straining and carrying heavy objects. Ignoring the symptom, causing the lump to increase in size and protruded out from her vagina for the past 2 months. She had 3 SVD with maximum birth weight of 3.75kg and a prolonged second stage of labour in her second pregnancy. She was not aware and never practiced pelvic floor exercise nor taken any HRT. There were no urinary symptoms nor constipation. Her BMI is 25.2kg/m2. Abdominal examination was unremarkable. On speculum examination, vagina was atrophic and third degree uterine prolapse was evident. She was arranged to have Vaginal hysterectomy, anterior colporrhaphy and sacrospinous fixation done. The positive risk factors in this case are multiparity, menopausal status, a history of prolonged labor and frequent heavy lifting. The delay in presentation is due to lack of awareness. It was also found in a study that feeling of embarrassment and social stigma could be the reason. (Abhyankar 2019) Pelvic Floor exercise and avoidance of heavy lifting may be beneficial at onset of symptom. For conclusion, POP awareness is crucial to empower women to prevent POP and seek treatment as soon as they are symptomatic.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S24

2021 ◽  
Vol 14 (5) ◽  
pp. e238669
Liam Joseph Beamer ◽  
Sarah Neary ◽  
Thomas McCormack ◽  
David Ankers

We describe the first reported case of transient distal ureteric obstruction attributed to post-surgical oedema in a patient with a solitary kidney. This occurred following combined pelvic floor repair and sacrospinous fixation for recurrent pelvic organ prolapse and manifested clinically as anuria, radiological hydroureter and acute kidney injury in the postoperative period. The transient nature of this obstruction, which was managed by a temporary percutaneous nephrostomy, indicates that it was caused by ureteric compression secondary to soft tissue oedema following surgery. We highlight the importance of this potential complication in females with a history of nephrectomy, unilateral renal tract anomalies or severely diminished renal reserve.

2009 ◽  
Vol 20 (1) ◽  
pp. 49-66 ◽  

The topic of pelvic floor assessment is increasingly attracting attention from gynaecologists, colorectal surgeons, urologists and physiotherapists. This is not surprising, many women who have given birth naturally are affected by pelvic floor trauma, and so are their partners. Health professionals deal with the eventual consequences of such trauma, especially pelvic organ prolapse and faecal incontinence.

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
M S Moussa ◽  
Y I Abdelkhaleq ◽  
S M Botros ◽  
A A Montasser

Abstract Purpose to assess the role of the role of MR defecography in assessment of pelvic floor failure . Methods and Material Thirty-six patients (twenty-seven female and nine male) with female and male patients, complaining of stress urinary incontinence, constipation, fecal incontinence or pelvic organ prolapse. Results MRI revealed 18 cystocele (50%), compared to physical examination 2 cases(5.6%),MRI revealed 28 rectocele ( 77.8%) compared to physical examination that showed 13 (36.1%) , MRI revealed 10 uterine descent (40.7%), compared to physical examination 6 (22.2%) I, MRI revealed 7 enterocele (19.4%) compared to physical examination that was negative. MRI revealed level I/II facial defect in and level III facial defect in, 19 cases of Intussusception (52.8%), urethral hypermobility in 14 (38.9%), sphincteric defect 7 (19.4%), levator angle weakness in 30 cases (83.3%), iliococcygeaus muscle tear in 5 cases (13.9%), puborectalis tear in 3 cases (8.3%),anorectal decent in 26 cases (72.2%), genital hiatus width in 23 (63.9%) Conclusion Dynamic MR imaging is a necessary tool in the diagnosis of multicompartment pelvic organ prolapse and it provides good concordance with clinical examination

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