Posterior Compartment Prolapse: A Urogynecology Perspective
Division of Urogynecology and Pelvic Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, CA 94305, USA.Urologic Clinics of North America (Impact Factor: 1.2). 08/2012; 39(3):361-9. DOI: 10.1016/j.ucl.2012.06.005
Posterior compartment prolapse is often caused by a defect in the rectovaginal septum, also known as Denonvillier's fascia. Patients with symptomatic posterior compartment prolapse can present with bulge symptoms as well as defecatory dysfunction, including constipation, tenesmus, splinting, and fecal incontinence. The diagnosis can successfully be made on clinical examination. Treatment of posterior prolapse includes pessaries and surgery. Both traditional colporrhaphy and site-specific defect repair have excellent success rates. Complications from surgery can include sexual dysfunction, de novo dyspareunia, and defecatory dysfunction. Compared with native tissue repair, biological and synthetic grafting has not improved overall anatomic and subjective outcomes.
- Journal of Clinical Urology 03/2013; 6(2):68-76. DOI:10.1177/2051415812472675
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ABSTRACT: Pelvic floor dysfunction is a growingly frequent condition in aging individuals. Urinary or rectal incontinence, constipation, pelvic organ prolapse, pelvic pain or sexual dysfunction are common problems in this age range. Such conditions carry a severe impact on quality of life, but also limit individual independence in daily activities, favor social isolation and carry health risks. Diagnosis and treatment of pelvic floor dysfunction in aging women is tricky, since multiple interfering conditions affecting muscle tone and nerve function are common in these individuals. Diabetes mellitus, sarcopenia, use of drugs that affect cognition or impact bowel or urinary function are just a few examples. These conditions need to be thoroughly taken into account during pre-operative work up for their potential impact on the success of surgery and vice versa. Functional reconstruction aimed at treating symptoms rather than anatomic defects is key to success. The recent advancements in surgical treatment of urinary incontinence and pelvic organ prolapse allow for more options to achieve the best surgery in each patient. Copyright © 2015. Published by Elsevier Ireland Ltd.Maturitas 06/2015; 82(1). DOI:10.1016/j.maturitas.2015.06.032 · 2.94 Impact Factor
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