Azerbaijan

Medical
University

Name: Zakarya kamal AlSattouf

Group:180B
Sub: POP
Date: 2/17/2022
Introduction:
The pelvic organ prolapse (POP ) : "Prolapse" refers to a descending or drooping of organs.
Pelvic organ prolapse refers to the prolapse or drooping of any of the pelvic floor organs,
including the:
•Bladder
•Uterus
•Vagina
•Small bowel
•Rectum
+ it can be divided into two parts 1- vaginal prolapse 2- uterine prolapse

Incidence: Pelvic organ prolapse, a type of pelvic floor disorder, affects almost 3% of U.S.
women
Anatomy:
The pelvic organs are fixed in their locations by different
aspects such as

1- ligaments
A. Pubocervical lig
B. Cardinal lig
C. uterosacral lig

2- muscles:
ex- levator ani ( pelvic floor M )

3- Fascia
Predisposing factors:
1. Repeated child birth
2. Menopause
3. Congenital

Precipitate factors:
1) Cough & Strain
2) ↑ intra abdominal pressure
3) Obesity / Ascites
Symptoms:
In all types : Sensation of Heaviness & or Mass protruding from vagina
Depending on the type
Vaginal :
Vaginal Ant wall > urinary symptoms like
1-urinary incontinence
2- dysuria
3-disre to urinate
Vaginal post wall > rectal Symptoms like
A- defection difficulty that might need a manual help
B- sexual sensation ( widening )

Uterine : Back pain

Signs : there might be ulceration if the uterus is out the vulva

Investigations:
A. History taking
B. Visual exam
C. Pelvic exam
D. Urine analysis

Treatment :
It can be divided as
Prevention: spacing – kegel exercise – proper management of 1-2-3 stages of labor
Temporary: pessary
Permanent : Surgical repair
Vaginal > ant wall > ant repair ( colporrhaphy )
Post > post repair ( colpoperineorrhaphy )
Both > classic repair
Uterine prolapse management : depending on the stage and desire for infertility
 Stage 1 :
• shortening of meckenrodt lig + classic repair if there is any association
Stage 2: Manchester operation

 Depending on desire for fertility on the 2 and 3 stages

• desire for fertility :
 vaginal sacrospinous fixation
 Abd sacrocolpopexy

• No desire for fertility

 vaginal hysterectomy
 Le Fort operation
Reference:
https://www.nhs.uk/conditions/pelvic-organ-prolapse/#:~:text=Pelvic%20organ%20prolapse%20is
%20when,can%20cause%20pain%20and%20discomfort
.
https://www.webmd.com/women/guide/pelvic-organ-prolapse
https://www.slideshare.net/yapa87/manchester-repair