Diagnosing Pelvic Organ Prolapse
A Physical Exam and Special Tests Help Diagnose Cystocele, Rectocele and Vaginal Vault Prolapse "
01/06/2014 // TWM // Eva Hvingelby
Difficulty urinating, urinary incontinence, painful intercourse and pelvic pressure are just a few symptoms of pelvic organ prolapse that affect around 25% of U.S. women. Joanne, a 49 year old woman suffering from these symptoms recently made an appointment with her gynecologist for an initial evaluation. Joanne’s symptoms were affecting her quality of life. She was tired of constantly need to use the bathroom, and it was taking a toll on her productivity at work. She suspected she was suffering from prolapse of the uterus and wondered if she would need urinary incontinence surgery.
What to do about pelvic organ prolapse
“Pelvic relaxation is a weakness or laxity in the supporting structures of the pelvic region. Bladder, rectal, or uterine tissue may then bulge into the vagina. This is called pelvic organ prolapse”
Read more about pelvic organ prolapse at http://www.health.harvard.edu/fhg/updates/update0805c.shtml
Speaking with her physician, Joanne learned that straining during childbirth is one of the most common causes of prolapse and incontinence. Connective tissue and muscles hold pelvic organs in place, but pregnancy and childbirth cause these tissues to stretch and weaken. Over time organs shift position, and complications, such as the ones experienced by Joanne, develop. Prolapse is much more common than most women suspect. Unfortunately, not many women know about treatment for uterine prolapse until they experience urinary stress incontinence or other symptoms and seek help.
Diagnosis of Pelvic Organ Prolapse
“By observing the position of the vaginal walls and cervix, the physician can identify areas of prolapse.”
Read more about the diagnosis of pelvic organ prolapse at http://www.hopkinsmedicine.org/gynecology_obstetrics/specialty_areas/gynecological_services/conditions/pelvic_organ_prolapse.html
A thorough history and physical exam is performed when prolapse is suspected. The physician asks about number of pregnancies, current symptoms and other health problems. A vaginal exam is completed during which a woman is asked to bear down. The doctor is able to see if the pelvic organs are pushing into the front, or anterior wall of the vagina, the back, or posterior vaginal wall, or from the top. A prolapse of the bladder is known as a cystocele and affects the anterior portion of the vagina. If the rectum shifts this is known as a rectocele, and affects the posterior wall of the vagina. A dropped uterus is also known as a vault prolapse.
A series of tests, such as x-rays, CT scans and urodynamics, which determine how well the bladder empties, may be performed. These help the doctor determine what kind of prolapse a woman is experiencing.
Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity.
“Pelvic organ prolapse is a common condition in older women. The risk for prolapse differs between ethnic groups, which suggests that the approaches to risk-factor modification and prevention may also differ.”
For more information about the Women's Health Initiative, visit http://www.ncbi.nlm.nih.gov/pubmed/12066091
There are numerous factors that affect a woman’s likelihood of developing prolapse. Seeing a specialist trained in diagnosing and treating the condition is important. A specialist understands unique risk factors for different women, and suggests appropriate treatment based on the severity of the prolapse.
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