30) Pelvic Organ Prolapse; Uterine Prolapse

Question 1

What is the Definition of “Pelvic Organ Prolapse”?

Answer 1

• It’s the Herniation or Abnormal Descent of Pelvic Organs from normal anatomical position
• These are bladder, rectum, intestine, uterus-cervix-vagina

DUE TO = Pelvic Floor Muscle INSUFFICIENCY

Question 2

What are the Causes of POP?

Answer 2

• multiple vaginal deliveries
• injury / weakness to pelvic floor muscles
• low oestrogen (post-menopause)
• Diabetes

Question 3

What are the Types of POP?

Answer 3

1) CYSTOCELE = Bladder protrusion behind anterior wall of vagina

2) URETHROCELE = Urethra Descent

3) ENTEROCELE = Peritoneum + Small Intestine HERNIATION thru posterior wall of vagina

4) RECTOCELE

5) UTERINE PROLAPSE = Uterus Descents - due to weak uterosacral ligaments

Question 4

What are the Clinical Features of POP?

Answer 4

• Pelvic / Vaginal Pressure
• Dyspareunia (painful sex)
• Tissue Bulging thru Vaginal Canal
• Urinary Symptoms

Question 5

How is POP Diagnosed & Treatment?

Answer 5

DIAGNOSIS - in Standing Position

• Checking if distal part of prolapse is either - proximal or distal to Hymen Plane

TREATMENT

• Vaginal Pessaries
• Kegel Exercises
• For Cystocele = Anterior Repair
• For Rectocele = Posterior Repair
• For Uterine Prolapse = Hysterectomy