扬州大学：《妇产科学》课程教学课件（PPT讲稿）31 盆腔器官脱垂 Pelvic Organ Prolapse

Pelvic OrganProlapseDefinition and Classification*A prolapse is a downward or forward displacementof one of the pelvic organs from its normal location*A variety of terms are used to describe femalegenitalprolapse.*A cystocele is a downward displacement of the bladder.*A cystourethrocele is a cystocele that imcludes theurethra as part of the prolapsing organ complex

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 cervixdown the vaginal canal toward the vaginal introitus*rectocele*enteroceleSymptomsof Prolapse*feeling of pressure*something is protruding from the vagina*stress urinary incontinence*voiding difficulty*inefficient rectal emptying

*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 of Pelvic Organ ProlapseStage 0No prolapse is demonstratedStage 1 >lcm above the level of the hymenStage 2the plane of the hymenStage 3 >lcm below the plane of the hymenStage 4 nearly complete eversion of the vagina

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

Examination*all aspects of vaginal support should becarefully surveyed.*examining patients in the standingposition as well as in the standard dorsallithotomy position.Treatment*Asymptomaticprolapse*to undergo surgical bladder neck suspension

*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*ManchesterOperation*Uteropexy*Paravaginal Defect Repair Operation*Posterior Colporrhaphy*Colpectomy and Colpocleisis*Colpopexy

Surgery *Vaginal Hysterectomy *Manchester Operation *Uteropexy *Paravaginal Defect Repair Operation *Posterior Colporrhaphy *Colpectomy and Colpocleisis *Colpopexy