Pelvic Organ Prolapse

Kushtagi, Pralhad (2011) Pelvic Organ Prolapse. In: In Essentials of Gynaecology. Jaypee Brothers Medical Publishers (P) Ltd, New Delhi-110002, pp. 213-227. ISBN 978-81-8448-910-1

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Prolapse is commonly classified on the basis of anatomical structure that is protruded or prolapsed; namely uterine prolapse, cystocele (for bladder descent), urethrocele (for descent of urethra), enterocele (for small bowel), rectocele (for protrusion of rectum), etc. All pelvic prolapse conditions and urethral hypermobility result from pelvic floor relaxation. Damage to the upper suspensory fibres of the paracolpium (level I) causes different type of prolapse from that caused by damage to the midlevel supports of the vagina (level II). Defects in the support provided by loss of the upper suspensory fibers of the paracolpium and parametrium (level I) is responsible for the development of vaginal vault and uterine prolapse. Since pelvic support defects are frequently associated with specific alteration in bowel or bladder, or sexual function, both the evaluation and management of poor support and abnormal visceral function are important in developing treatment a treatment plan and assessing therapeutic outcome. The modalities of treatment include follow-up, surgical repair, or use of vaginal pessary. Prolapse has been treated by surgery, nature of which depends on degree and type of prolapsed, patient’s general health status and the need for preservation of menstrual, reproductive or coital function. The goal of surgery should be to relieve the patient of her symptoms by repairing each aspect of abnormal pelvic support in a durable and long-lasting manner. Pelvic organ prolapse is not due to single etiology. Normal support of the pelvic organs depends on a combination of fascial and muscular support. The specific type of prolapse that exists in an individual corresponds with specific defects in the anatomic structures responsible for normal support. Hence, surgical management needs to be individualized.

Item Type: Book Section
Uncontrolled Keywords: Pelvic organ prolapse; fascial supports; muscular supports; pessary; surgical repair; expectant management
Subjects: Medicine > KMC Mangalore > Obstetrics & Gynaecology
Depositing User: KMCMLR User
Date Deposited: 18 May 2012 06:44
Last Modified: 18 May 2012 06:44

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