Female genital prolapse

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Female Genital prolapse / Pelvic organ prolapse
Pelvic Organ Prolapse Quantification System.svg
Classification and external resources
Specialty Gynecology
ICD-10 N81
ICD-9-CM 618
DiseasesDB 25265
Patient UK Female genital prolapse
MeSH D014596
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Female genital prolapse (or vaginal prolapse or pelvic organ prolapse) is characterized by a portion of the vaginal canal protruding (prolapsing) from the opening of the vagina. The condition usually occurs when the pelvic floor collapses as a result of childbirth or heavy lifting which can tear soft tissues, i.e. herniating fascia membranes so that the vaginal wall collapses, resulting in cystocele, rectocele or both. Remediation typically involves dietary and lifestyle changes, physical therapy, or surgery.

Types

The term uterovaginal prolapse is sometimes defined as any or several of the above,[1] and sometimes as uterine prolapse specifically.[2]

Grading

Pelvic organ prolapses are graded either via the Baden-Walker System, Shaw's System, or the Pelvic Organ Prolapse Quantification (POP-Q) System.[3]

Shaw's System

Anterior wall

  • Upper 2/3 cystocele
  • Lower 1/3 urethrocele

Posterior wall

  • Upper 1/3 enterocele
  • Middle 1/3 rectocele
  • Lower 1/3 deficient perenium

Uterine prolapse

  • Grade 0 Normal position
  • Grade 1 descent into vagina not reaching introitus
  • Grade 2 descent up to the introitus
  • Grade 3 descent outside the introitus
  • Grade 4 Procidentia

Baden-Walker

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

POP-Q

POP-Q Points
Pelvic Organ Prolapse Quantification System (POP-Q)
Stage description
0 No prolapse 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.

Management

Vaginal prolapses are treated according to the severity of symptoms. They can be treated:

Epidemiology

Genital prolapse occurs in about 316 million women worldwide as of 2010 (9.3% of all females).[7]

See also

References

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External links