Pelvic Organ Prolapse

摘要

The levator ani pelvic muscles and surrounding connective tissues provide support for the pelvic organs. Disrup- tion of this natural anatomic system re- sults in descent or prolapse of one or more of the pelvic structures: bladder and ure- thra, rectum, uterus and cervix, and small bowel. Patients with prolapse often present with associated urinary, defecatory, and sexual dysfunction, al- though many women who have prolapse on examination are clinically not af- fected. 1 The finding of prolapse on exam is not well correlated with symptoms. Thus, pelvic organ prolapse encompasses a wide range of disorders, from asymp- tomatic altered anatomy to complete eversion of the vagina. The lifetime risk that a woman in the United States will have surgery for prolapse and urinary incontinence is estimated at 11%. 2 The direct cost of prolapse surgery is greater than $1 billion per year.