Female genital prolapse
Female genital prolapse (or vaginal prolapse) is characterized by a portion of the vaginal canal protruding from the opening of the vagina. The condition usually occurs when the pelvic floor collapses as a result of childbirth.
Types
Grading
They are graded either via the Pelvic Organ Prolapse Quantification (POP-Q) system or the Baden-Walker System.[1]
Baden-Walker System for the Evaluation of Pelvic Organ Prolapse on Physical Examination
| Grade |
posterior urethral descent, lowest part other sites |
| 0 |
normal position for each respective site |
| 1 |
descent halfway to the hymen |
| 2 |
descent to the hymen |
| 3 |
descent halfway past the hymen |
| 4 |
maximum possible descent for each site |
Pelvic Organ Prolapse Quantification System
| Stage |
description |
| 0 |
No prolapsel anterior and posterior points are all -3 cm, and C or D is between -TVL and -(TVL-2) cm. |
| 1 |
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). |
| 2 |
The most distal prolapse if between 1 cm above and 1 cm below the hymen (at least one point is -1, 0, or +1). |
| 3 |
The most distal prolapse is more than 1 cm below the hymen but no further than 2 cm less than TVL. |
| 4 |
Represents complete procidentia or vault eversion; the most distal prolapse protrudes to at least (TVL-2) cm. |
Therapy
Vaginal prolapses must be treated according to the severity of symptoms. They can be treated:
- With conservative measures (changes in diet and fitness, Kegel exercises, etc.) Also included are alternative measures proposed by Whole Woman (TM)[2] which believes that prolapse usually occurs slowly, over time, due to changes in the natural pelvic organ support system, and that it can be controlled and even reversed, naturally, through proper posture and lifestyle.
- With a pessary, to provide support to the weakened vaginal walls
- With surgery. Surgery is used to treat symptoms, such as bowel or urinary problems, pain, or a prolapse sensation. A Cochrane Collaboration review[3] found that limited data are available on optimal surgical approaches, including the use of surgical mesh, in the form of a patch or sling, similar to its implementation for abdominal hernia. Further development of techniques and more research is essential in order to improve outcomes from surgery.
See also
External links
Notes