Bureau Michel, Carlson Kevin V
Section of Urology, Department of Surgery, University of Calgary, Calgary, AB, Canada.
Can Urol Assoc J. 2017 Jun;11(6Suppl2):S125-S130. doi: 10.5489/cuaj.4634.
Pelvic organ prolapse (POP) results from weakness or injury of the pelvic floor supports with resulting descent of one or more vaginal compartments (anterior, apical and/or posterior). Women typically become symptomatic from the bulging vaginal wall or related organ dysfunction once this descent reaches the introitus. POP is a common condition, affecting more than half of adult women. Many women presenting to an urologist for stress urinary incontinence or overactive bladder will have associated POP; therefore, it is important for urologists who treat these conditions to be familiar with its diagnosis and management. While POP is part of the core urology training curriculum in some jurisdictions, it is not in Canada.1 This article reviews the diagnosis of POP, including pertinent symptoms to query in the history, important facets of a systematic pelvic examination, and the appropriate use of ancillary tests. Treatment options are also discussed, including conservative measures, pessaries, and various reconstructive and obliterative techniques.
盆腔器官脱垂(POP)是由盆底支持结构的薄弱或损伤导致一个或多个阴道腔室(前壁、顶部和/或后壁)下降引起的。一旦这种下降到达阴道口,女性通常会因阴道壁膨出或相关器官功能障碍而出现症状。POP是一种常见疾病,影响超过一半的成年女性。许多因压力性尿失禁或膀胱过度活动症就诊于泌尿科医生的女性会伴有POP;因此,治疗这些疾病的泌尿科医生熟悉其诊断和管理很重要。虽然在某些司法管辖区,POP是泌尿外科核心培训课程的一部分,但在加拿大并非如此。本文回顾了POP的诊断,包括病史中需询问的相关症状、系统盆腔检查的重要方面以及辅助检查的合理应用。还讨论了治疗选择,包括保守措施、子宫托以及各种重建和闭塞技术。