توضیحات

UTERINE AND PELVIC ORGAN PROLAPSE PPT

UTERINE PROLAPSE PPT :BASICS
DESCRIPTION

• Symptomatic descent of one or more of (1,2)
– The anterior vaginal wall (bladder or cystocele)
– The posterior vaginal wall (rectum or rectocele)
– The apex of the vagina (uterine cervix descent and prolapse)
– The vault (cuff) after hysterectomy (vault prolapse)

• Prolapses above or to the hymen are not symptomatic (2).

• Associated symptoms (2)

– Feeling of vaginal or pelvic pressure
– Heaviness
– Bulging
– Bowel or bladder symptoms

• Cost associated with treatment is more than $1 billion annually (~200,000
surgeries/year) (2).

EPIDEMIOLOGY

Incidence
Pelvic organ prolapse (POP) is common but not always symptomatic. It does not
always progress with time. In a 3-year prospective cohort study of 249 women,
prolapse increased by at least 2 cm in 11% and regressed by 2 cm in 3% (2).

Prevalence

>>>> A national survey of 7,924 women (over 20 years of age) found a prevalence
of 25% for one or more pelvic floor disorders (including urinary incontinence,
fecal incontinence, and POP). Prevalence of POP was 2.9% (3).
The prevalence of lower urinary tract symptoms is as high as 50% in parous
women. 11% of all women have surgery for POP or lower urinary tract
symptoms by 80 years old (4).
3–6% of women who present for gynecologic care have a prolapse beyond
hymen (2).
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ETIOLOGY AND PATHOPHYSIOLOGY

RISK FACTORS

GENERAL PREVENTION

COMMONLY ASSOCIATED CONDITIONS

DIAGNOSIS

HISTORY

PHYSICAL EXAM

DIFFERENTIAL DIAGNOSIS

DIAGNOSTIC TESTS & INTERPRETATION

Initial Tests (lab, imaging)

Follow-Up Tests & Special Considerations

TREATMENT