Pelvic Organ Prolapse Flashcards
What is a prolapse?
Protrusion of an organ or structure beyond its normal anatomical confines
What is a female POP?
Refers to the descent of the pelvic organs towards or through the vagina
What are the three layers of pelvic floor?
Endo-pelvic fascia
Pelvic diaphragm
Urogenital diaphragm
What is in the endo-pelvic fascia?
Network of fibro-muscular connective-type tissue that has a “hammock-like” configuration and surrounds the various visceral structures
What is the pelvic diaphragm?
Layer of striated muscles with its fascial coverings (Levator ani & coccygeus)
What is the urogenital diaphragm?
The superficial & deep transverse perineal muscles with their fascial coverings
Risk factors of POP
Pregnancy and vaginal birth
Advancing age
Obesity
Previous pelvic surgery
Urethrocoele
Prolapse of the lower anterior vaginal wall involving the urethra only
Cystocoele
Prolapse of the upper anterior vaginal wall involving the bladder
Uterovaginal prolapse
Prolapse of the uterus, cervix and upper vagina
Enterocoele (apical prolapse)
Prolapse of the upper posterior wall of the vagina usually containing loops of small bowel
Rectocoele
Prolapse of the lower posterior wall of the vagina involving the rectum bulging forwards into the vagina
Symptoms in women with POP (vaginal)
Sensation of a bulge or protrusion Seeing or feeling a bulge or protrusion Pressure Heaviness Difficulty in inserting tampons
Symptoms in women with POP (urinary)
Urinary Incontinence
Frequency/ Urgency
Weak or prolonged urinary stream/ Hesitancy/ Feeling of incomplete emptying
Manual reduction of prolapse to start or complete voiding
Symptoms in women with POP (bowel)
Incontinence of flatus, or liquid or solid stool
Feeling of incomplete emptying/ Straining
Urgency
Digital evacuation to complete defecation
Splinting, or pushing on or around the vagina or perineum, to start or complete defecation
