Pelvic Organs

Abstract

More than 300,000 women undergo surgery for pelvic floor prolapse each year in the United States.Yet little is known about the prevalence or risk factors for this common women's health problem.What is normal, and what needs treatment? This article reviews the types and prevalence of pelvic floor prolapse, the current knowledge about the prevalence and risk factors, and treatment options for symptomatic women. The term pelvic floor prolapse refers to the loss of support to the structures contained within the bony pelvis and describes the descent of the pelvic organs into the vagina. The resulting relaxation presents as a variety of syndromes , including: • Cystocele, herniation of the bladder into the anterior vagina (Figure 1) • Rectocele, extrusion of the rectum into the posterior vagina (Figure 2) • Enterocele, descent of the small intestine into the vaginal vault (Figure 3) • Uterine descensus, loss of support of the uterus Defining prolapse in clinical practice is a little like defining art. As women's health providers, we often know it when we see it, yet there is a huge gray area between the recognition of normal vagi