Definition and Classification
*A prolapse is a downward or forward displacement
of one of the pelvic organs from its normal location,
*A variety of terms are used to describe female
genital prolapse,
*A cystocele is a downward displacement of the bladder,
*A cystourethrocele is a cystocele that imcludes the
urethra as part of the prolapsing organ complex,
*A uterine prolapse is a descent of the uterus and cervix
down the vaginal canal toward the vaginal introitus,
*rectocele
*enterocele
Symptoms of Prolapse
*feeling of pressure
*something is protruding from the vagina
*stress urinary incontinence
*voiding difficulty
*inefficient rectal emptying
Stage 0 No prolapse is demonstrated
Stage 1 >1cm above the level of the hymen
Stage 2 the plane of the hymen
Stage 3 >1cm below the plane of the hymen
Stage 4 nearly complete eversion of the vagina
*all aspects of vaginal support should be
carefully surveyed,
*examining patients in the standing
position as well as in the standard dorsal
lithotomy position,
Examination
Treatment
*Asymptomatic prolapse
*to undergo surgical bladder neck suspension
Surgery
*Vaginal Hysterectomy
*Manchester Operation
*Uteropexy
*Paravaginal Defect Repair Operation
*Posterior Colporrhaphy
*Colpectomy and Colpocleisis
*Colpopexy