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Pelvic Organ Prolapse.

Abstract Pelvic organ prolapse is the descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus (cervix), or the apex of the vagina (vaginal vault or cuff scar after hysterectomy). Prevalence increases with age. The cause of prolapse is multifactorial but is primarily associated with pregnancy and vaginal delivery, which lead to direct pelvic floor muscle and connective tissue injury. Hysterectomy, pelvic surgery, and conditions associated with sustained episodes of increased intra-abdominal pressure, including obesity, chronic cough, constipation, and repeated heavy lifting, also contribute to prolapse. Most patients with pelvic organ prolapse are asymptomatic. Symptoms become more bothersome as the bulge protrudes past the vaginal opening. Initial evaluation includes a history and systematic pelvic examination including assessment for urinary incontinence, bladder outlet obstruction, and fecal incontinence. Treatment options include observation, vaginal pessaries, and surgery. Most women can be successfully fit with a vaginal pessary. Available surgical options are reconstructive pelvic surgery with or without mesh augmentation and obliterative surgery.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title american family physician
Publication Year Start




PMID- 28762694
OWN - NLM
STAT- MEDLINE
DA  - 20170801
DCOM- 20170807
LR  - 20170807
IS  - 1532-0650 (Electronic)
IS  - 0002-838X (Linking)
VI  - 96
IP  - 3
DP  - 2017 Aug 01
TI  - Pelvic Organ Prolapse.
PG  - 179-185
AB  - Pelvic organ prolapse is the descent of one or more of the anterior vaginal wall,
      posterior vaginal wall, the uterus (cervix), or the apex of the vagina (vaginal
      vault or cuff scar after hysterectomy). Prevalence increases with age. The cause 
      of prolapse is multifactorial but is primarily associated with pregnancy and
      vaginal delivery, which lead to direct pelvic floor muscle and connective tissue 
      injury. Hysterectomy, pelvic surgery, and conditions associated with sustained
      episodes of increased intra-abdominal pressure, including obesity, chronic cough,
      constipation, and repeated heavy lifting, also contribute to prolapse. Most
      patients with pelvic organ prolapse are asymptomatic. Symptoms become more
      bothersome as the bulge protrudes past the vaginal opening. Initial evaluation
      includes a history and systematic pelvic examination including assessment for
      urinary incontinence, bladder outlet obstruction, and fecal incontinence.
      Treatment options include observation, vaginal pessaries, and surgery. Most women
      can be successfully fit with a vaginal pessary. Available surgical options are
      reconstructive pelvic surgery with or without mesh augmentation and obliterative 
      surgery.
FAU - Iglesia, Cheryl B
AU  - Iglesia CB
AD  - Georgetown University School of Medicine, Washington, DC, USA.
FAU - Smithling, Katelyn R
AU  - Smithling KR
AD  - Georgetown University School of Medicine, Washington, DC, USA.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Am Fam Physician
JT  - American family physician
JID - 1272646
SB  - AIM
SB  - IM
MH  - Female
MH  - Humans
MH  - Pelvic Organ Prolapse/*diagnosis/etiology/surgery/therapy
EDAT- 2017/08/02 06:00
MHDA- 2017/08/08 06:00
CRDT- 2017/08/02 06:00
AID - d13031 [pii]
PST - ppublish
SO  - Am Fam Physician. 2017 Aug 1;96(3):179-185.