Vaginal prolapse

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List of terms related to Vaginal prolapse

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Eman Alademi, M.D.[2]

Synonyms and keywords: Female genital prolapse, procidentia and ptosis.

Overview

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 and is inherent among tall Caucasian women.

Types of vaginal prolapse

• Cystocele (bladder into vagina)
• Enterocele (small intestine into vagina)
• Rectocele (rectum into vagina)
• Urethrocele (urethra into vagina)
• Uterine prolapse (uterus into vagina)
• Vaginal vault prolapse (roof of vagina, after hysterectomy)

Historical Perspective:

vaginal prolapse was first discovered in era of the pharaohs, about 1500 years before Christ. then [diagnostic test/therapy] was developed by Hippocrates to treat/diagnose vaginal prolapse over the centuries, different treatment modalities, some of which we can currently seem strange.

Classification :

vaginal prolapse may be classified according to Uterine cervical elongation that found in patients undergoing hysterectomy for pelvic organ prolapse into Cervical elongation grades and prolapse stages are correlated. calssified as physiological uterine cervical elongation based on corpus/cervix ratio to (grade 0, CCR>1.5) grade I (CCR>1 and ≤1.5) grade II (CCR>0.5 and ≤1), and grade III (CCR≤0.5)

Pathophysiology

The pathogenesis of Pelvic organ prolapse is not well understood, however, it’s characterized by two main theories predominate: either the fibromuscular layer of the vagina develops a defect/tears away from its supports, or its tissues are stretched and attenuated.

Differentiating vaginal prolapse from other Diseases

• Vaginal prolapse must be differentiated from other diseases that cause urethral prolapse ,cystocele, enterocele, urethral diverticulum, and Gartner duct cyst. such as:

• urethral prolapse
• cystocele
• enterocele
• enterocele
• Gartner duct cyst

Epidemiology and Demographics

• The prevalence of vaginal prolapse is approximately [number or range] per 100,000 individuals worldwide.

Age

• vaginal prolapse is more commonly observed among patients aged 25-64 years old.

Gender

• female are more commonly affected with vaginal prolapse.

Race

• Vaginal prolapse usually affects individuals of the African Americans and Caucasians race.

Risk Factors

• Common risk factors in the development of vaginal prolapse are Genetic contribution which decrease in the expression of the genes HOXA13,sex steroids , pregnancy, Parity, vaginal delivery, age,obesity (increase BMI),vaginal hysterectomy ,Vaginal birth

Natural History, Complications and Prognosis

• The majority of patients with [disease name] remain asymptomatic for [duration/years].
• If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
• Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
• Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with [disease name] is approximatel

Diagnosis

Diagnostic Criteria

• The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:

• [criterion 1]
• [criterion 2]
• [criterion 3]
• [criterion 4]

Symptoms

• [Disease name] is usually asymptomatic.
• Symptoms of [disease name] may include the following:

• [symptom 1]
• [symptom 2]
• [symptom 3]
• [symptom 4]
• [symptom 5]
• [symptom 6]

Physical Examination

• Patients with [disease name] usually appear [general appearance].
• Physical examination may be remarkable for:

• [finding 1]
• [finding 2]
• [finding 3]
• [finding 4]
• [finding 5]
• [finding 6]

Laboratory Findings

• There are no specific laboratory findings associated with vaginal prolapse.

Imaging Findings

• [Imaging study 1] is the imaging modality of choice for [disease name].
• On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
• [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

• [Disease name] may also be diagnosed using [diagnostic study name].
• Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].

Treatment

Vaginal prolapses must be treated according to the severity of symptoms.

Non-Surgical Therapy

• With conservative measures (changes in diet and fitness, Kegel exercises, etc.)
• With a pessary, to provide support to the weakened vaginal walls

Surgical Therapy

A new minimally invasive surgical procedure is effective in restoring a woman's anatomy to the condition it was before childbirth with a recovery time of only 2 weeks. It is performed vaginally using a laparoscope and surgical mesh to repair the cystocele and rectocele and a laser to tighten the vaginal canal creating a natural support for the uterus.

Prevention

• Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3

Related Chapters

• Prolapse

References

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