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Pelvic Organ Prolapse


Presentation

  • All patients presented with a midline anterior enterocele with atrophic ulcerated vaginal skin. One patient presented with small bowel evisceration and required an emergency surgical repair.[ncbi.nlm.nih.gov]
  • Here we are presenting a report of successful repair. This elderly lady presented to us with chief complaints of 3rd degree prolapse.[ncbi.nlm.nih.gov]
  • This case emphasizes that differential diagnosis of recurrent vaginal discharge that presents remote from obliterative procedure for pelvic organ prolapse should consider not only pyometra, but also other causes.[ncbi.nlm.nih.gov]
  • VVM often presents as a mass protruding from the vagina, mimicking pelvic organ prolapse (POP). It can coexist with POP, thereby usually exaggerating the severity of POP.[ncbi.nlm.nih.gov]
  • We present a case of recurrent prolapse in the setting of bladder exstrophy and discuss factors that may warrant consideration during the evaluation of such patients.[ncbi.nlm.nih.gov]
Pain
  • The most common symptoms of a vaginal vault prolapse are: a feeling of pressure in the abdomen and vagina painful intercourse back pain vaginal bleeding urinary incontinence The pelvic floor is a layer of muscles that stretches like a hammock from the[womenshealthmatters.ca]
  • pain and constipation Painful intercourse As women age, pelvic organ prolapse becomes more common.[baptisthealth.net]
  • Vulvar symptoms (burning, pain, itching, dyspareunia, and discharge) were measured by asking respondents to rate the severity of each symptom from 0 (none) to 10 (most severe).[ncbi.nlm.nih.gov]
  • Symptoms of Vaginal or Pelvic Organ Prolapse Not all women with POP have symptoms, but some describe a "bulge," vaginal pressure, bladder and bowel problems, pain with intercourse, back pain, and/or pelvic pain.[columbiaurology.org]
  • Most respondents felt that pessary use would improve emotional status (56.2%), pain (52.0%) and quality of life (75%).[ncbi.nlm.nih.gov]
Recurrent Urinary Tract Infection
  • urinary tract infections (due to incomplete emptying resulting in a chronic residual volume) Nocturia (due to accumulating residuals during the day) Clinical diagnosis Figure 1.[racgp.org.au]
Gangrene
  • On admission, an edematous and gangrenous totally prolapsed cervix was seen protruding outside the introitus and cesarean section was then performed. A healthy female infant with a birth weight of 2,920 g was delivered.[ncbi.nlm.nih.gov]
Third Trimester Pregnancy
  • The concomitant phenomenon of a third trimester pregnancy with a significant degree of pelvic organ prolapse is extremely rare.[ncbi.nlm.nih.gov]
Fecal Incontinence
  • Among women with prolapse, 30 (16%) also had stress urinary incontinence, 39 (20%) had urgency urinary incontinence, and 42 (22%) had fecal incontinence.[ncbi.nlm.nih.gov]
  • Initial evaluation includes a history and systematic pelvic examination including assessment for urinary incontinence, bladder outlet obstruction, and fecal incontinence. Treatment options include observation, vaginal pessaries, and surgery.[ncbi.nlm.nih.gov]
  • Pelvic floor disorders (urinary incontinence, fecal incontinence, and pelvic organ prolapse) affect one in five women in the United States. 1 Pelvic organ prolapse is less common than urinary or fecal incontinence but affects almost 3% of U.S. women.[womenshealth.gov]
  • The symptoms of pelvic organ prolapse include the following: The feeling of pressure, fullness or aching in the vagina The feeling that something is coming out of the vagina or the anus Urinary incontinence Fecal incontinence Constipation Frequent urinary[rush.edu]
  • Treatment options A Summa urogynecologist can recommend a variety of therapies to relieve the symptoms of prolapse, urinary or fecal incontinence or other pelvic floor symptoms.[summahealth.org]
Fracture
  • Pelvic Floor Injury Injury to any part of the pelvic floor can occur during vaginal delivery, surgery, pelvic radiation, or fractures to the back and pelvis caused by falls or motor vehicle accidents.[voicesforpfd.org]
  • Loss of pelvic support can occur when any part of the pelvic floor is injured during vaginal delivery, surgery, pelvic radiation or back and pelvic fractures during falls or motor vehicle accidents.[silvercross.org]
Neglect
  • Two women, at ages of 85 and 93, referred for involuntary urine loss were found to have neglected pessaries resulting in large vesicovaginal fistulas. After the removal of the pessary, fistula repair and LeFort colpocleisis were done with success.[ncbi.nlm.nih.gov]
Urinary Incontinence
  • […] organ prolapse and urgency urinary incontinence, and (4) pelvic organ prolapse, urinary incontinence, and fecal incontinence.[ncbi.nlm.nih.gov]
  • A history of cervical insufficiency was associated with an increased risk of either pelvic organ prolapse or stress urinary incontinence (aOR 1.93, 95%CI: 1.84-2.02).[ncbi.nlm.nih.gov]
  • Treatment success, risk for urinary incontinence after surgery and complication risk were the most important factors. Taken the future risk of endometrial cancer into account, 18% of the women preferred hysterectomy because of this risk.[ncbi.nlm.nih.gov]
  • Case Description: A 31-year-old woman presented with postpartum POP, diastasis recti, urinary incontinence, and constipation.[ncbi.nlm.nih.gov]
  • So far, the oral estrogen in HRT has not been reliably shown to provide relief to those suffering from pelvic organ prolapse and urinary incontinence.[uchospitals.edu]
Pelvic Pain
  • pain can attend an Interstitial Cystitis and Pelvic Pain Support Group meeting at South Miami Hospital, 2-4 p.m., August 30 and November 1, in the Victor E.[baptisthealth.net]
  • Some of the less obvious include pelvic pain, backache, problems going to the bathroom, or painful intercourse. Sometimes there are no symptoms with pelvic organ prolapse.[chihealth.com]
  • Complications include urinary or fecal retention or incontinence, abdominal/pelvic pain , and avoidance of sexual activity because of embarrassment or discomfort.[amboss.com]
  • Nonsurgical or surgical treatment usually provides significant relief, but it may not completely solve all symptoms associated with POP such as pelvic pain or pressure.[fda.gov]
  • Symptoms of Vaginal or Pelvic Organ Prolapse Not all women with POP have symptoms, but some describe a "bulge," vaginal pressure, bladder and bowel problems, pain with intercourse, back pain, and/or pelvic pain.[columbiaurology.org]
Urinary Urgency
  • Back pain Bulge in the vagina Constipation Dyspareunia Dysuria Fecal incontinence Pelvic heaviness Postcoital bleeding Urinary frequency Urinary incontinence Urinary urgency Vaginal discharge The International Continence Society identifies several types[americannursetoday.com]
  • Other possible adverse effects of prolapse surgery include injuries to adjacent organs, urinary problems (retention of urine, stress incontinence, urinary infection, urinary urgency), pain during sex (dyspareunia), and the formation of blood clots.[ourbodiesourselves.org]
  • Symptoms may also be independent of the prolapse, for example, symptoms of overactive bladder (urinary urgency) or urinary stress incontinence when a cystocele is present.[doi.org]

Workup

  • If pain is not relieved, proceed with workup or referral to address the cause of pain. Similar pessary trials can be applied for constipation and urinary complaints that the patient attributes to prolapse .[journals.lww.com]

Treatment

  • 165.5) were were responsible for delaying treatment forobstetric fistula.[ncbi.nlm.nih.gov]
  • The first theme, "health-system factors", suggests that accessibility and affordability of the treatment, and the supportive role of female community health volunteers facilitate women to seek treatment in the camp.[ncbi.nlm.nih.gov]
  • RESULTS: Almost half of the participants (43%) reported UI symptoms, with only 25% of these participants reporting treatment. A much smaller percentage (5%) reported POP symptoms, but 44% reported receiving treatment.[ncbi.nlm.nih.gov]
  • Incontinence treatment — Our team offers various treatments for urinary incontinence and fecal incontinence , which may be brought on by pelvic organ prolapse.[loyolamedicine.org]

Prognosis

  • Lastly, the short form of the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) was used to evaluate prognosis of surgical patients and twenty patients finished the follow-up.[ncbi.nlm.nih.gov]
  • Prognosis and outcome For observation of minimally symptomatic pelvic organ prolapse, roughly 70-80% will have minimal change in their exam findings and symptoms over time.[cancertherapyadvisor.com]
  • Thus, estrogen may maintain the integrity and function of fibroblasts and connective tissues during mechanical stretching to prevent POP and improve POP prognosis [ 29 ].[omicsonline.org]

Etiology

  • This review encapsulates contemporary concepts of etiology, prevalence, and management of POP and pregnancy in the adult female BE patient.[ncbi.nlm.nih.gov]
  • Laparoscopy is a unique method for etiologic diagnosis and neurosurgical treatment of such nerve lesions through decompression or implantation of an electrode for neuromodulation.[ncbi.nlm.nih.gov]
  • Etiology POP is due to an insufficiency of the pelvic floor muscles and the ligamentous supportive structure of the uterus and vagina , which may be caused by: References: [1] [2] Clinical features Patients with POP may present with concurrent complications[amboss.com]
  • Etiology of pelvic organ prolapse. Clin Obstet Gynecol . 2005;48(3):639–647. 4. Berglas B, Rubin IC. Study of the supportive structures of the uterus by levator myography. Surg Gynecol Obstet . 1953;97(6):677–692. 5.[aafp.org]
  • Two Etiological Reasons of Constipation: Anterior Rectocele and Internal Mucosal Intussusception. Indian J. Surg. 77 , 868–871 (2015). 27. Kim, L., Kim, J.-A. & Kim, S.[nature.com]

Epidemiology

  • Author information 1 Vanderbilt Epidemiology Center, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America. 2 Division of Epidemiology, Department of Medicine, Vanderbilt University[ncbi.nlm.nih.gov]
  • : [1] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • Pelvic organ prolapse in women: Epidemiology, risk factors, clinical manifestations, and management. . Accessed July 10, 2017. Jelovsek JE. Pelvic organ prolapse in women: Choosing a primary surgical procedure. . Accessed July 10, 2017. Biofeedback.[mayoclinic.org]
  • Besides PISQ-IR, women also completed the following questionnaires: Incontinence Severity Index (ISI); Female Sexual Function Index (FSFI); Pelvic Floor Distress Inventory (PFDI-20); and question #35 from the Epidemiology of Prolapse and Incontinence[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • In this article we discuss different animal models and their utility for investigating the natural progression of pelvic organ prolapse pathophysiology and novel treatment approaches.[ncbi.nlm.nih.gov]
  • Our data provide an understanding of molecular mechanisms involved in POP-related pathophysiological processes and might represent an important tool to develop novel therapeutic agents for the treatment of this condition.[ncbi.nlm.nih.gov]
  • Neither aetiology nor pathophysiology of FPOP is fully understood.[racgp.org.au]
  • Visit for more related articles at Journal of Molecular and Genetic Medicine Abstract Pelvic organ prolapse (POP) is a multifactorial disease with a complex and largely unknown etiology and pathophysiology.[omicsonline.org]

Prevention

  • Pelvic organ prolapse risk factors Old age Having had multiple vaginal births Previous hysterectomy (removal of the uterus) or other pelvic floor surgery Preventing pelvic organ prolapse While research on pelvic prolapse prevention is in its early stages[rush.edu]
  • Fiber helps prevent constipation and straining during bowel movements. Preventing constipation may reduce the risk of some pelvic floor disorders. Do not smoke. Smoking can lead to chronic cough, which puts stress on the pelvic floor muscles.[womenshealth.gov]
  • There is a dearth of trials addressing lifestyle changes as a treatment for prolapse, and trials aimed at prevention of prolapse.[cochrane.org]
  • What can be done to prevent prolapse? It is much better to prevent prolapse than try to fix it! If any women in your close family have had a prolapse, you are more at risk.[continence.org.au]
  • Prevention While there are some causes of prolapse that you can’t prevent, there are ways to decrease your chances of developing pelvic organ prolapse.[uihc.org]

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