Rovner E S
Division of Urology, Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia, Pa., USA.
Ostomy Wound Manage. 2000 Dec;46(12):24-37.
Pelvic organ prolapse is a common medical problem in parous women. This condition usually refers to a combination of deficiencies of the pelvic organs as they relate to support mechanisms of the vaginal wall. Symptoms vary--an accurate diagnosis requires a careful and complete physical examination with attention directed toward the pelvis and perineum. Although many patients will not require surgical treatment for pelvic organ prolapse, a comprehensive approach to repair in which all of the anatomic defects affecting support are addressed is necessary for successful treatment. Patients presenting with pelvic organ prolapse often provide some of the most complex, challenging, and rewarding cases in reconstructive pelvic surgery. This article addresses the definitions and classifications, prevalence and risk factors, and anatomy and pathophysiology relevant to pelvic organ prolapse. Discussion also includes diagnosis and approaches to management (surgical and nonsurgical) of anterior vaginal wall prolapse, cystourethrocele, apical vaginal prolapse, uterine prolapse and enterocele, posterior vaginal wall prolapse, rectocele, and pelvic floor relaxation and perineal laxity, with indications for and approaches to surgery, along with possible complications.
盆腔器官脱垂是经产妇常见的医学问题。这种情况通常是指盆腔器官在与阴道壁支撑机制相关方面存在多种缺陷。症状各不相同——准确诊断需要仔细、全面的体格检查，并重点关注骨盆和会阴。虽然许多盆腔器官脱垂患者不需要手术治疗，但成功治疗需要采用综合修复方法，解决所有影响支撑的解剖学缺陷。盆腔器官脱垂患者往往是重建盆腔手术中最复杂、最具挑战性但也最有意义的病例之一。本文阐述了与盆腔器官脱垂相关的定义和分类、患病率及危险因素，以及解剖学和病理生理学。讨论内容还包括阴道前壁脱垂、膀胱尿道膨出、阴道顶端脱垂、子宫脱垂和肠膨出、阴道后壁脱垂、直肠膨出以及盆底松弛和会阴松弛的诊断及处理方法（手术和非手术）、手术指征和方法以及可能的并发症。
