Pelvic Organ Prolapse Definition and Classification *A prolapse is a downward or forward displacement of one of the pelvic organs from its normal location. *A variety of terms are used to describe female genital prolapse. *A cystocele is a downward displacement of the bladder. *A cystourethrocele is a cystocele that imcludes the urethra as part of the prolapsing organ complex.

Symptoms of Prolapse *feeling of pressure *A uterine prolapse is a descent of the uterus and cervix down the vaginal canal toward the vaginal introitus. *rectocele *enterocele Symptoms of Prolapse *feeling of pressure *something is protruding from the vagina *stress urinary incontinence *voiding difficulty *inefficient rectal emptying

Stage of Pelvic Organ Prolapse Stage 0 No prolapse is demonstrated Stage 1 >1cm above the level of the hymen Stage 2 the plane of the hymen Stage 3 >1cm below the plane of the hymen Stage 4 nearly complete eversion of the vagina

Examination Treatment *all aspects of vaginal support should be carefully surveyed. *examining patients in the standing position as well as in the standard dorsal lithotomy position. Treatment *Asymptomatic prolapse *to undergo surgical bladder neck suspension

*Vaginal Hysterectomy Surgery *Vaginal Hysterectomy *Manchester Operation *Uteropexy *Paravaginal Defect Repair Operation *Posterior Colporrhaphy *Colpectomy and Colpocleisis *Colpopexy