Management of pelvic organ prolapse: A unitary or multidisciplinary approach?

Abstract

Until recently urologists, gynecologists, proctologists, and colorectal surgeons had worked independently in their pelvic compartments neglecting the other specialties. In the last two decades, studies of the role of muscles, connective tissue, and innervations of the pelvic floor have radically changed the methods for coping with perineal dysfunctions. The new approach, whether a transdisciplinary or a interdisciplinary one, needs to consider the perineum as a unit. Often pelvic dysfunctions involve more than one compartment, and an organ-specific approach may fail to recognize a more complex problem resulting in a partial or incorrect treatment. In order to improve the study of the perineum, it is mandatory to better understand the interactions between the compartments, to create a common language, and to use randomized controlled studies with long follow-up to evaluate the anatomical and functional results of the new prosthestic surgery. Expert physicians and surgeons are needed in this new specialty, which we call perineology. © 2010 Springer-Verlag Milan.