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In women, the condition usually occurs when the pelvic floor collapses after gynecological cancer treatment, childbirth or heavy lifting. [2] Injury incurred to fascia membranes and other connective structures can result in cystocele, rectocele or both. Treatment can involve dietary and lifestyle changes, physical therapy, or surgery. [3]
Prolapse can occur at a different site in the vagina. Further surgery after the initial repair can be to treat complications of mesh displacement, pain, or bleeding. Further surgery may be needed to treat incontinence. [13] One goal of surgical treatment is to restore the vagina and other pelvic organs to their anatomically normal positions.
Vaginal pessaries can immediately relieve prolapse and prolapse-related symptoms. [7] A high fiber diet, consisting of 25–30 grams of fiber daily, as well as increased water intake (typically 6–8 glasses daily), help to avoid constipation and straining with bowel movements, and can relieve symptoms of rectocele. [8] [9]
These are often used as a first-line treatment and used for earlier stage prolapse since individuals can easily insert and remove them on their own without a doctor's help. These can be easily folded in half for insertion. [12] [14] Gellhorn pessaries are considered a type of supporting and space-occupying pessary. [5]
Minor prolapse can be treated with exercises to strengthen the pelvic floor muscles (pelvic physiotherapy); more serious prolapse, e.g., complete procidentia, requires pessary use or reconstructive surgical treatment. Reconstructive pelvic prolapse surgery may be done without resorting to complete hysterectomy by hysteropexy, [2] the ...
Rectopexy is a surgery for rectal prolapse. [3] A newer version of the procedure is termed ventral mesh rectopexy, which has also been used for SRUS. [11] It may be performed with or without anterior resection (removal of a portion of the front wall of the rectum). [9] It may be used with or without mesh to reinforce the anterior rectal wall. [8]
A urethrocele is the prolapse of the female urethra into the vagina. Weakening of the tissues that hold the urethra in place may cause it to protrude into the vagina. [3] [4] Urethroceles often occur with cystoceles (involving the urinary bladder as well as the urethra). [5] In this case, the term used is cystourethrocele. [6] [7]
Although the use of surgery in the treatment of uterine prolapse had been described previously, the 19th century saw advances in surgical techniques. [15] During the mid to late 1800s, surgical attempts to manage uterine prolapse included narrowing the vaginal vault, suturing the perineum, and amputating the cervix. [15]
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