TY - CHAP M1 - Book, Section TI - Apical Pelvic Organ Prolapse A1 - Muffly, Tyler M. A1 - Jelovsek, J. Eric A1 - Walters, Mark D. A2 - Rogers, Rebecca G. A2 - Sung, Vivian W. A2 - Iglesia, Cheryl B. A2 - Thakar, Ranee PY - 2014 T2 - Female Pelvic Medicine and Reconstructive Surgery: Clinical Practice and Surgical Atlas AB - Pelvic organ prolapse (POP) is the downward descent of the female pelvic organs that results in a protrusion of the vagina and/or uterus. It usually involves descent of the bladder, uterus, or posthysterectomy vaginal cuff, and the small and/or large bowel. Vaginal delivery, hysterectomy, chronic straining, normal aging, and abnormalities of connective tissue or connective tissue repair predispose some women to disruption, stretching, or dysfunction of the levator ani complex and/or the connective tissue attachments of the vagina, resulting in prolapse. Women often present with multiple complaints including bladder, bowel, and pelvic symptoms. However, with the exception of vaginal bulging symptoms, none of these symptoms are specific to prolapse. Patients presenting with symptoms suggesting prolapse should undergo a history and pelvic examination. Radiographic evaluation is usually unnecessary. Many women with POP are asymptomatic and do not require treatment. When prolapse is symptomatic, options include observation, pessary use, and surgery. Surgical therapy for prolapse can be broadly categorized into reconstructive and obliterative techniques. Reconstructive techniques may be performed using an abdominal or vaginal approach. Although no effective strategy to prevent prolapse recurrence has been identified, weight loss, minimizing heavy lifting, treating constipation, modifying or reducing obstetrical risk factors, and maintaining or improving pelvic floor muscle strength through pelvic floor physical therapy can be considered. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - obgyn.mhmedical.com/content.aspx?aid=1105830566 ER -