医学
外科
阶段(地层学)
性器官
天然组织
体格检查
肛提肌
盆底
普通外科
组织工程
遗传学
生物
生物医学工程
古生物学
作者
Anne‐Cécile Pizzoferrato,C. Thuillier,Aurélien Vénara,Nicole Bornsztein,Sylvain Bouquet,Mélanie Cayrac,Martine Cornillet-Bernard,Odile Cotelle,F. Cour,Sophie Cretinon,P. De Reilhac,J. Loriau,Françoise Pellet,Marie‐Aimée Perrouin‐Verbe,Anne-Gaëlle Pourcelot,Christine Revel-Delhom,Benoit Steenstrup,Thomas Vogel,L. Le Normand,Xavier Fritel
标识
DOI:10.1016/j.jogoh.2023.102535
摘要
When a patient presents with symptoms suggestive of pelvic organ prolapse (POP), clinical evaluation should include an assessment of symptoms, their impact on daily life and rule out other pelvic pathologies. The prolapse should be described compartment by compartment, indicating the extent of the externalization for each. The diagnosis of POP is clinical. Additional exams may be requested to explore the symptoms associated or not explained by the observed prolapse. Pelvic floor muscle training and pessaries are non-surgical conservative treatment options recommended as first-line therapy for pelvic organ prolapse. They can be offered in combination and be associated with the management of modifiable risk factors for prolapse. If the conservative therapeutic options do not meet the patient's expectations, surgery should be proposed if the symptoms are disabling, related to pelvic organ prolapse, detected on clinical examination and significant (stage 2 or more of the POP-Q classification). Surgical routes for POP repair can be abdominal with mesh placement, or vaginal with autologous tissue. Laparoscopic sacrocolpopexy is recommended for cases of apical and anterior prolapse. Autologous vaginal surgery (including colpocleisis) is a recommended option for elderly and fragile patients. For cases of isolated rectocele, the posterior vaginal route with autologous tissue should be preferentially performed over the transanal route. The decision to place a mesh must be made in consultation with a multidisciplinary team. After the surgery, the patient should be reassessed by the surgeon, even in the absence of symptoms or complications, and in the long term by a primary care or specialist doctor.
科研通智能强力驱动
Strongly Powered by AbleSci AI