scholarly journals Pelvic organ prolapse: A primer for urologists

2017 ◽  
Vol 11 (6S2) ◽  
pp. 125 ◽  
Author(s):  
Michel Bureau ◽  
Kevin V. Carlson

Pelvic organ prolapse (POP) results from weakness or injury of the pelvic floor supports with resulting descent of one or more vaginal compartments (anterior, apical and/or posterior). Women typically become symptomatic from the bulging vaginal wall or related organ dysfunction once this descent reaches the introitus. POP is a common condition, affecting more than half of adult women. Many women presenting to an urologist for stress urinary incontinence or overactive bladder will have associated POP; therefore, it is important for urologists who treat these conditions to be familiar with its diagnosis and management. While POP is part of the core urology training curriculum in some jurisdictions, it is not in Canada.1 This article reviews the diagnosis of POP, including pertinent symptoms to query in the history, important facets of a systematic pelvic examination, and the appropriate use of ancillary tests. Treatment options are also discussed, including conservative measures, pessaries, and various reconstructive and obliterative techniques.


2018 ◽  
Author(s):  
Lennox Hoyte ◽  
Renee Bassaly ◽  
Stuart Hart ◽  
Mona McCullough ◽  
Elisha Jackson

Pelvic organ prolapse (POP) is the descent of one of more aspects of the vagina and/or uterus. Evaluation of POP always begins with a thorough history and physical examination. Management choices include observation, conservative options, and surgical options. Surgical management is divided into two categories, which are restorative and obliterative. It is important to counsel patients that although POP may affect quality of life, it is not life-threatening. This chapter is designed to guide the healthcare provider with a review of epidemiology, anatomy, evaluation, and management of POP. The chapter contains 14 figures that illustrate examples of common examination findings, devices, and treatment options. Also, there are 5 tables that provide concise reference materials to help guide the healthcare provider. This review contains 91 references, 14 figures, and 6 tables. Key Words: constipation, mesh, pain, pelvic floor, pessary, POP-Q, risk factors, surgery, vaginal wall



2018 ◽  
Author(s):  
Lennox Hoyte ◽  
Renee Bassaly ◽  
Stuart Hart ◽  
Mona McCullough ◽  
Elisha Jackson

Pelvic organ prolapse (POP) is the descent of one of more aspects of the vagina and/or uterus. Evaluation of POP always begins with a thorough history and physical examination. Management choices include observation, conservative options, and surgical options. Surgical management is divided into two categories, which are restorative and obliterative. It is important to counsel patients that although POP may affect quality of life, it is not life-threatening. This chapter is designed to guide the healthcare provider with a review of epidemiology, anatomy, evaluation, and management of POP. The chapter contains 14 figures that illustrate examples of common examination findings, devices, and treatment options. Also, there are 5 tables that provide concise reference materials to help guide the healthcare provider. This review contains 91 references, 14 figures, and 6 tables. Key Words: constipation, mesh, pain, pelvic floor, pessary, POP-Q, risk factors, surgery, vaginal wall



2018 ◽  
Vol 6 (1) ◽  
pp. 6
Author(s):  
Parvin Bastani ◽  
Fateme Mallah ◽  
Leili Rasouli Fard

Pelvic organ prolapse (POP) is a common disease which present as symptomatic descent of the anterior or posterior vaginal wall prolapse, uterus or apical prolapse subsequent to hysterectomy, and entrocele. Since, social and cultural factors have impact on interval between symptoms incidence and seek for medical care, diagnosis method and treatment process, it was important to prepare a guideline for management of the Iranian women with POP.



2013 ◽  
Vol 75 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Aukje M. Meijerink ◽  
Reinier H. van Rijssel ◽  
Paul J.Q. van der Linden


2016 ◽  
Vol 60 (1) ◽  
Author(s):  
A. Vetuschi ◽  
A. D'Alfonso ◽  
R. Sferra ◽  
D. Zanelli ◽  
S. Pompili ◽  
...  

<p>The objective<strong> </strong>of this study was to evaluate the morphological and immunohistochemical alterations of tissue removed from the upper third of anterior vaginal wall in a sample group of the female population presenting homogenous risk factors associated with Pelvic Organ Prolapse (POP). The case study consisted of 14 patients with POP and there were 10 patients in the control group. Patient selection was carried on the basis of specific criteria and all of the patients involved in the study presented one or more of the recognized POP risk factors. Samples were taken from POP patients during vaginal plastic surgery following  colpohysterectomy, and from control patients during closure of the posterior fornix following hysterectomy. Samples were processed for histological and  immunohistochemical analyses for Collagen I and Collagen III, α-Smooth Muscle Actin (α-SMA), Platelet-Derived-Growth-Factor (PDGF), matrix metalloproteinase 3 (MMP3), Caspase3. Immunofluorescence analyses for Collagen I and III and PDGF were also carried out. In prolapsed specimens our results show a disorganization of smooth muscle cells that appeared to have been displaced by an increased collagen III deposition resulting in rearrangement of the muscularis propria architecture. These findings suggest that the increase in the expression of collagen fibers in muscularis could probably due to a phenotypic switch resulting in the dedifferentiation of smooth muscle cells into myofibroblasts. These alterations could be responsible for the compromising of the dynamic functionality of the pelvic floor.</p><p><strong> </strong></p>





GYNECOLOGY ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. 193-197
Author(s):  
Dmitrii V. Baibuz ◽  
Oleg L. Molchanov ◽  
Zhanna V. Glushchenko ◽  
Yanina A. Lebedeva ◽  
Sergei V. Utkin ◽  
...  

Pelvic organ prolapse is a common benign disease among women that is characterized by an isolated or combined descent of the anterior, posterior vaginal wall, uterus, and vaginal dome after hysterectomy. Given the fact that most of the operations are performed among middle-aged and elderly patients, the probability of detecting previously undiagnosed tumor of the abdominal cavity and pelvic region increases, which may be due to the limited volume of basic preoperative diagnosis. The purpose of our report is to draw the attention of clinicians to the problem of insufficient examination of women when planning treatment of pelvic organ prolapse on the example of our experience in managing a patient with this pathology in combination with pelvic tumor.



2012 ◽  
Vol 26 (1) ◽  
pp. 3
Author(s):  
Munir'deen A. Ijaiya ◽  
Hadijat O. Raji

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.



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