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Pelvic organ prolapse

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are poor surgical candidates, or who may not be able to attend physical therapy. Pessaries require a provider to fit the device, but most can be removed, cleaned, and replaced by the woman herself; however, others have this done for them by a clinician biannually. A trial compared the two approaches and found that, compared with clinic-based care, self-management was associated with a similar quality of life, fewer complications, and was more cost-effective. Pessaries should be offered as a non-surgical alternative for women considering surgery.
49: 204: 110: 460:) is used to treat symptoms such as bowel or urinary problems, pain, or a prolapse sensation. When operating a pelvic organ prolapse, introducing a mid-urethral sling during or after surgery seems to reduce stress urinary incontinence. Transvaginal repair seems to be more effective than transanal repair in posterior wall prolapse, but adverse effects cannot be excluded. According to the 444:
device fitted to the patient is also a non-surgical option, it is inserted into the vagina and may be retained for up to several months. Vaginal pessaries can immediately relieve prolapse and prolapse-related symptoms. Pessaries are a good choice of treatment for women who wish to maintain fertility,
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Compared to native tissue repair, transvaginal permanent mesh likely reduces the perception of vaginal prolapse sensation, the risk of recurrent prolapse, and of having repeat surgery specifically only for prolapse. Transvaginal mesh (TVM) has a greater risk of bladder injury and of needing repeat
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compared with native tissue repair for anterior compartment prolapse owing to increased morbidity. For posterior vaginal repair, the use of mesh or graft material does not seem to provide any benefits.
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Yeung E, Baessler K, Christmann-Schmid C, Haya N, Chen Z, Wallace SA, Mowat A, Maher C (2024-03-13). "Transvaginal mesh or grafts or native tissue repair for vaginal prolapse".
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Tulikangas P, et al. (Committee on Practice Bulletins—Gynecology and the American Urogynecologic Society) (April 2017). "Practice Bulletin No. 176: Pelvic Organ Prolapse".
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For surgical treatment of apical vaginal prolapse, going through the abdomen (sacral colpopexy) may have better outcomes than a surgical approach that goes through the vagina.
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Hagen S, Kearney R, Goodman K, Best C, Elders A, Melone L, Dwyer L, Dembinsky M, Graham M, Agur W, Breeman S, Culverhouse J, Forrest A, Forrest M, Guerrero K (December 2023).
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collapses after gynecological cancer treatment, childbirth or heavy lifting. Injury incurred to fascia membranes and other connective structures can result in
975:"Clinical effectiveness of vaginal pessary self-management vs clinic-based care for pelvic organ prolapse (TOPSY): a randomised controlled superiority trial" 476:
surgery for stress urinary incontinence or mesh exposure. The use of a TVM in treating vaginal prolapses is associated with severe side effects including
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Pelvic organ prolapses are graded either via the Baden–Walker System, Shaw's System, or the Pelvic Organ Prolapse Quantification (POP-Q) System.
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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).
1158:"UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse: FDA Safety Communication" 1030: 89:) is characterized by descent of pelvic organs from their normal positions into the vagina. In women, the condition usually occurs when the 352: 56:
A 40 year old woman with uterine prolapse, which is visible only in standing position, with the cervix protruding through the vulva.
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The most distal prolapse is between 1 cm above and 1 cm below the hymen (at least one point is −1, 0, or +1).
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Investigation of sheep reproductive tract as an animal model for pelvic organ prolapse and urogyencological research
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Represents complete procidentia or vault eversion; the most distal prolapse protrudes to at least (TVL−2) cm.
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The most distal prolapse is more than 1 cm below the hymen but no further than 2 cm less than TVL.
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No prolapse anterior and posterior points are all −3 cm, and C or D is between −TVL and −(TVL−2) cm.
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To study POP, various animal models are employed: non-human primates, sheep, pigs, rats, and others.
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Genital prolapse occurs in about 316 million women worldwide as of 2010 (9.3% of all females).
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or both. Treatment can involve dietary and lifestyle changes, physical therapy, or surgery.
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Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. (December 2012).
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Baessler K, Christmann-Schmid C, Maher C, Haya N, Crawford TJ, Brown J (19 August 2018).
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Maher C, Yeung E, Haya N, Christmann-Schmid C, Mowat A, Chen Z, Baessler K (2023-07-26).
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Baden–Walker System for the Evaluation of Pelvic Organ Prolapse on Physical Examination
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Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Brown J (November 2016).
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Mowat A, Maher D, Baessler K, Christmann-Schmid C, Haya N, Maher C (5 March 2018).
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Beckley I, Harris N (2013-03-26). "Pelvic organ prolapse: a urology perspective".
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prolapse (descent of the roof of vagina) – after surgical removal of the uterus
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Ramaseshan AS, Felton J, Roque D, Rao G, Shipper AG, Sanses TV (April 2018).
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have been filed and settled against several manufacturers of TVM devices.
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Patnaik SS, Brazile B, Dandolu V, Damaser M, van der Vaart CH, Liao J.
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Vaginal prolapses are treated according to the severity of symptoms.
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Couri BM, Lenis AT, Borazjani A, Paraiso MF, Damaser MS (May 2012).
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ACOG Committee on Practice Bulletins—Gynecology (September 2007).
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Safety and efficacy of many newer meshes is unknown. Thousands of
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With conservative measures, such as changes in diet and fitness,
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National Institute of Diabetes and Digestive and Kidney Diseases
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Boyd S, Propst K, O'Sullivan D, Tulikangas P (March 2019).
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Chapter Six - Pelvic Floor Biomechanics From Animal Models
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Descent of the pelvic organs from their normal positions
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protruding through the vagina in a 73 year old woman.
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Pelvic Organ Prolapse Quantification System (POP-Q)
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Posterior urethral descent, lowest part other sites
467:Evidence does not support the use of transvaginal 273:Grade 1 descent into vagina not reaching introitus 2340:Noninflammatory disorders of female genital tract 1160:. U.S. Food and Drug Administration. 13 July 2011 2331: 726:"Surgery for women with apical vaginal prolapse" 546: 544: 1521: 887:American Journal of Obstetrics and Gynecology 821: 1362:Expert Review of Obstetrics & Gynecology 541: 1233:The Cochrane Database of Systematic Reviews 1188:The Cochrane Database of Systematic Reviews 730:The Cochrane Database of Systematic Reviews 676:Health & physical assessment in nursing 353:Pelvic Organ Prolapse Quantification System 151:Cystourethrocele (both bladder and urethra) 1528: 1514: 929: 706:: CS1 maint: location missing publisher ( 47: 21:For prolapse of pelvic organs in men, see 1381: 1207: 1133: 1081: 1006: 898: 798: 757: 625: 576: 308:normal position for each respective site 464:, serious complications are "not rare." 202: 120: 108: 76:316 million women (9.3% as of 2010) 1404: 1338: 340:maximum possible descent for each site 2332: 673: 1558: 1509: 1177: 1175: 1103: 1101: 279:Grade 3 descent outside the introitus 1409:. Academic Press. pp. 131–148. 1278:Michelle Llamas, BCPA (2022-11-11). 719: 717: 2315:Persistent genital arousal disorder 815: 606:International Urogynecology Journal 276:Grade 2 descent up to the introitus 13: 1415:10.1016/B978-0-12-803228-2.00006-4 1172: 1098: 800:10.1097/01.AOG.0000263925.97887.72 14: 2356: 2129:Hypoactive sexual desire disorder 1648:Ovarian hyperstimulation syndrome 1425: 714: 210:in a 71 year old woman, with the 230: 1398: 1349: 1345:. Mississippi State University. 1332: 1312:ASB 2015 Annual Conference 2015 1296: 1271: 1224: 1150: 1049: 1023: 966: 923: 501: 420: 332:descent halfway past the hymen 286: 157:Posterior vaginal wall prolapse 1743:Dysfunctional uterine bleeding 1245:10.1002/14651858.CD012079.pub2 1200:10.1002/14651858.CD004014.pub6 874: 850: 774: 742:10.1002/14651858.CD012376.pub2 667: 642: 593: 135:Anterior vaginal wall prolapse 1: 569:10.1016/S0140-6736(12)61729-2 534: 431:pelvic floor physical therapy 412: 316:descent halfway to the hymen 164:(small intestine into vagina) 1839:Menorrhagia (hypermenorrhea) 1810:Polymenorrhea (epimenorrhea) 1280:"Transvaginal Mesh Lawsuits" 991:10.1016/j.eclinm.2023.102326 944:10.1097/aog.0000000000002016 260:Lower 1/3 deficient perineum 7: 2256:Pelvic inflammatory disease 824:Journal of Clinical Urology 517: 509: 10: 2361: 2251:Pelvic congestion syndrome 1681:Fallopian tube obstruction 1114:Cochrane Database Syst Rev 1062:Cochrane Database Syst Rev 1043:10.3310/nihrevidence_62718 900:10.1016/j.ajog.2019.01.055 448: 350: 222: 20: 2300:Vestibular papillomatosis 2275: 2268: 2243: 2219: 2152: 2110: 2052: 2043: 1999: 1944: 1926: 1903: 1879: 1869:Metropathia haemorrhagica 1771: 1733: 1724: 1715: 1666: 1567: 1551: 1433: 1126:10.1002/14651858.CD012975 1074:10.1002/14651858.CD013108 932:Obstetrics and Gynecology 858:"Kegel Exercises | NIDDK" 787:Obstetrics and Gynecology 618:10.1007/s00192-017-3467-4 72: 60: 55: 46: 38: 33: 1636:Follicular cyst of ovary 836:10.1177/2051415812472675 346: 104: 2134:Sexual arousal disorder 2090:Candidal vulvovaginitis 1748:Endometrial hyperplasia 674:Donita D (2015-02-10). 650:"Pelvic organ prolapse" 270:Grade 0 Normal position 181:Apical vaginal prolapse 42:Female genital prolapse 1577:Endometriosis of ovary 219: 130: 118: 2021:Vesicouterine fistula 1964:Cervical incompetence 1889:Recurrent miscarriage 1827:Premenstrual syndrome 1688:Fallopian tube cancer 493:class action lawsuits 324:descent to the hymen 244:Lower 1/3 urethrocele 206: 148:(urethra into vagina) 142:(bladder into vagina) 124: 112: 83:Pelvic organ prolapse 34:Pelvic organ prolapse 2179:Rectovaginal fistula 1604:Poor ovarian reserve 257:Middle 1/3 rectocele 254:Upper 1/3 enterocele 188:(uterus into vagina) 170:(rectum into vagina) 2229:Postcoital bleeding 2157:Urogenital fistulas 2085:Bacterial vaginosis 1738:Asherman's syndrome 1405:Patnaik SS (2016). 1339:Patnaik SS (2015). 563:(9859): 2163–2196. 359: 293: 282:Grade 4 Procidentia 241:Upper 2/3 cystocele 2114:Sexual dysfunction 2080:Atrophic vaginitis 2016:Retroverted uterus 1979:Female infertility 1959:Cervical dysplasia 1884:Female infertility 1676:Female infertility 1631:Corpus luteum cyst 1587:Ovulatory disorder 1582:Female infertility 357: 291: 220: 131: 119: 2327: 2326: 2323: 2322: 2264: 2263: 2239: 2238: 2172:Obstetric fistula 2070:Vaginal discharge 2039: 2038: 1984:Cervical stenosis 1899: 1898: 1753:Endometrial polyp 1711: 1710: 1641:Theca lutein cyst 1503: 1502: 1374:10.1586/eog.12.24 1037:. 11 April 2024. 979:eClinicalMedicine 685:978-0-13-387640-6 478:organ perforation 410: 409: 344: 343: 80: 79: 28:Medical condition 2352: 2295:Kraurosis vulvae 2290:Bartholin's cyst 2273: 2272: 2224:Vaginal bleeding 2117: 2050: 2049: 2026:Uterine prolapse 1854:Menometrorrhagia 1778: 1731: 1730: 1722: 1721: 1621:Ovarian apoplexy 1565: 1564: 1556: 1555: 1530: 1523: 1516: 1507: 1506: 1431: 1430: 1419: 1418: 1402: 1396: 1395: 1385: 1353: 1347: 1346: 1336: 1330: 1329: 1327: 1326: 1320: 1314:. Archived from 1309: 1300: 1294: 1293: 1291: 1290: 1275: 1269: 1268: 1259: 10936147. 1228: 1222: 1221: 1211: 1194:(11): CD004014. 1179: 1170: 1169: 1167: 1165: 1154: 1148: 1147: 1137: 1105: 1096: 1095: 1085: 1053: 1047: 1046: 1027: 1021: 1020: 1010: 970: 964: 963: 927: 921: 920: 902: 878: 872: 871: 869: 868: 854: 848: 847: 819: 813: 812: 802: 778: 772: 771: 761: 721: 712: 711: 705: 697: 671: 665: 664: 662: 661: 654:womenshealth.gov 646: 640: 639: 629: 597: 591: 590: 580: 548: 360: 356: 294: 290: 265:Uterine prolapse 208:Uterine prolapse 186:Uterine prolapse 51: 31: 30: 2360: 2359: 2355: 2354: 2353: 2351: 2350: 2349: 2330: 2329: 2328: 2319: 2260: 2235: 2215: 2148: 2111: 2106: 2102:Vaginal atresia 2035: 1995: 1954:Cervical cancer 1940: 1922: 1918:Uterine fibroid 1895: 1875: 1859:Polymenorrhagia 1800:Oligoamenorrhea 1772: 1767: 1707: 1662: 1658:Ovarian torsion 1547: 1537:Female diseases 1534: 1504: 1499: 1498: 1442: 1428: 1423: 1422: 1403: 1399: 1354: 1350: 1337: 1333: 1324: 1322: 1318: 1307: 1301: 1297: 1288: 1286: 1276: 1272: 1239:(3): CD012079. 1229: 1225: 1180: 1173: 1163: 1161: 1156: 1155: 1151: 1120:(3): CD012975. 1106: 1099: 1068:(8): CD013108. 1054: 1050: 1029: 1028: 1024: 971: 967: 928: 924: 879: 875: 866: 864: 856: 855: 851: 820: 816: 779: 775: 736:(7): CD012376. 722: 715: 699: 698: 686: 672: 668: 659: 657: 648: 647: 643: 598: 594: 549: 542: 537: 520: 512: 504: 451: 442:silicone rubber 427:Kegel exercises 423: 415: 355: 349: 289: 233: 225: 214:visible in the 107: 29: 26: 23:Rectal prolapse 17: 12: 11: 5: 2358: 2348: 2347: 2342: 2325: 2324: 2321: 2320: 2318: 2317: 2312: 2307: 2302: 2297: 2292: 2287: 2281: 2279: 2270: 2266: 2265: 2262: 2261: 2259: 2258: 2253: 2247: 2245: 2241: 2240: 2237: 2236: 2234: 2233: 2232: 2231: 2220: 2217: 2216: 2214: 2213: 2212: 2211: 2206: 2201: 2196: 2191: 2181: 2176: 2175: 2174: 2169: 2164: 2162:Ureterovaginal 2153: 2150: 2149: 2147: 2146: 2141: 2139:Vaginal cancer 2136: 2131: 2126: 2120: 2118: 2108: 2107: 2105: 2104: 2099: 2094: 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Index

Rectal prolapse

Specialty
Gynecology
pelvic floor
cystocele
rectocele

cystocele

rectocele
Cystocele
Urethrocele
Enterocele
Rectocele
Sigmoidocele
Uterine prolapse
Vaginal vault
hysterectomy

Uterine prolapse
cervix
vaginal
Pelvic Organ Prolapse Quantification System
Kegel exercises
pelvic floor physical therapy
pessary
silicone rubber
Surgery
colpocleisis

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