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Uterine and Pelvic Organ Prolapse

Deepali Maheshwari, DO, MPH and Michael Flynn, MD, MHS Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Symptomatic descent of one or more of (1),(2)

    • The anterior vaginal wall (bladder or cystocele)

    • The posterior vaginal wall (rectum or rectocele)

    • The uterus and cervix

    • The vaginal apex (va...

DIAGNOSIS

Less than half of women discuss symptoms with PCP. Only 10–12% seek medical attention. Barriers include embarrassment, social stigma, ability to cope, belief that POP is part of the aging pr...

TREATMENT

GENERAL MEASURES

  • Treatment is generally guided by degree of bother for the patient. It is important to document the patient’s desire, goals, and expectations.

  • Treatment should consider type an...

ONGOING CARE

PATIENT EDUCATION

  • Patients should have POP explained to them with diagrams and descriptions of their anatomy.

  • Important to emphasize that surgery is geared toward improving quality of life

  • P...

REFERENCES

1
Dumoulin C, Hunter KF, Moore K, et al. Conservative management for female urinary incontinence and pelvic organ prolapse review 2013: summary of the 5th International Consultation on Incon...

CODES

ICD10

  • N81.9 Female genital prolapse, unspecified

  • N81.10 Cystocele, unspecified

  • N99.3 Prolapse of vaginal vault after hysterectomy

  • N81.4 Uterovaginal prolapse, unspecified

  • N81.6 Rectocele

ICD9

  • 618.9 Uns...

CLINICAL PEARLS

  • Many women do not discuss POP with their doctor—ask routinely.

  • Vaginal pessary should be considered in all patients with symptomatic prolapse.

  • Treatment should be guided by degree of bot...

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