Female genital prolapse
|Female Genital prolapse / Pelvic organ prolapse|
|Classification and external resources|
Female genital prolapse (or vaginal prolapse or pelvic organ prolapse) is characterized by a portion of the vaginal canal protruding (prolapsing) from the opening of the vagina. The condition usually occurs when the pelvic floor collapses as a result of childbirth or heavy lifting which can tear soft tissues, i.e. herniating fascia membranes so that the vaginal wall collapses, resulting in cystocele, rectocele or both.
- Cystocele (bladder into vagina)
- Enterocele (small intestine into vagina)
- Rectocele (rectum into vagina)
- Urethrocele (urethra into vagina)
- Uterine prolapse (uterus into vagina)
- Vaginal vault prolapse (roof of vagina) - after Hysterectomy
They are graded either via the Baden-Walker System or Shaw's System or the Pelvic Organ Prolapse Quantification (POP-Q) System.
- Anterior wall
*Upper 2/3 cystocele *Lower 1/3 urethrocele
- Posterior wall
*Upper 1/3 enterocele *Middle 1/3 rectocele *Lower 1/3 deficient perenium
- Uterine prolapse
*Grade 0 Normal position *Grade 1 decent into vagina not reaching introitus *Grade 2 decent up to the introitus *Grade 3 decent outside the introitus *Grade 4 Procenditia
|Grade||posterior urethral descent, lowest part other sites|
|0||normal position for each respective site|
|1||descent halfway to the hymen|
|2||descent to the hymen|
|3||descent halfway past the hymen|
|4||maximum possible descent for each site|
|0||No prolapse anterior and posterior points are all -3 cm, and C or D is between -TVL and -(TVL-2) cm.|
|1||The criteria for stage 0 are not met, and the most distal prolapse is more than 1 cm above the level of the hymen (less than -1 cm).|
|2||The most distal prolapse if between 1 cm above and 1 cm below the hymen (at least one point is -1, 0, or +1).|
|3||The most distal prolapse is more than 1 cm below the hymen but no further than 2 cm less than TVL.|
|4||Represents complete procidentia or vault eversion; the most distal prolapse protrudes to at least (TVL-2) cm.|
Vaginal prolapses are treated according to the severity of symptoms. They can be treated:
- With conservative measures (changes in diet and fitness, Kegel exercises, etc.)
- With surgery (for example Colpocleisis). Surgery is used to treat symptoms such as bowel or urinary problems, pain, or a prolapse sensation. A Cochrane Collaboration review found that limited data are available on optimal surgical approaches, including the use of transvaginal surgical mesh, in the form of a patch or sling, similar to its implementation for abdominal hernia.
Genital prolapse occurs in about 316 million women worldwide as of 2010 (9.3% of all females).
- "ACOG Practice Bulletin No. 85: Pelvic organ prolapse". Obstet Gynecol 110 (3): 717–29. September 2007. doi:10.1097/01.AOG.0000263925.97887.72. PMID 17766624.
- Maher C, Feiner B, Baessler K, Adams EJ, Hagen S, Glazener CM (2010). "Surgical management of pelvic organ prolapse in women". Cochrane Database Syst Rev (4): CD004014. doi:10.1002/14651858.CD004014.pub4. PMID 20393938.
- Vos, T (2012 Dec 15). "Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.". Lancet 380 (9859): 2163–96. doi:10.1016/S0140-6736(12)61729-2. PMID 23245607.
- Selected abstracts from recent medical literature on vaginal and uterine prolapse
- Vaginal Mesh FDA Alert
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