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What's new in the functional anatomy of pelvic organ prolapse?
| Content Provider | Scilit |
|---|---|
| Author | DeLancey, John O. L. |
| Copyright Year | 2016 |
| Description | Journal: Current Opinion in Obstetrics and Gynecology Purpose of review Provide an evidence-based review of pelvic floor functional anatomy related to pelvic organ prolapse. Recent findings Pelvic organ support depends on interactions between the levator ani muscle and pelvic connective tissues. Muscle failure exposes the vaginal wall to a pressure differential producing abnormal tension on the attachments of the pelvic organs to the pelvic sidewall. Birth-induced injury to the pubococcygeal portion of the levator ani muscle is seen in 55% of women with prolapse and 16% of women with normal support. Failure of the lateral connective tissue attachments between the uterus and vagina to the pelvic wall (cardinal, uterosacral, and paravaginal) are strongly related with prolapse (effect sizes ∼2.5) and are also highly correlated with one another (r ∼ 0.85). Small differences exist with prolapse in factors involving the vaginal wall length and width (effect sizes ∼1). The primary difference in ligament properties between women with and without prolapse is found in ligament length. Only minor differences in ligament stiffness are seen. Summary Pelvic organ prolapse occurs because of injury to the levator ani muscles and failure of the lateral connections between the pelvic organs to the pelvic sidewall. Abnormalities of the vaginal wall fascial tissues may play a minor role. |
| Related Links | http://europepmc.org/articles/pmc5347042?pdf=render https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347042/pdf |
| Ending Page | 429 |
| Page Count | 10 |
| Starting Page | 420 |
| ISSN | 1040872X |
| e-ISSN | 1473656X |
| DOI | 10.1097/gco.0000000000000312 |
| Journal | Current Opinion in Obstetrics and Gynecology |
| Issue Number | 5 |
| Volume Number | 28 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2016-10-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Current Opinion in Obstetrics and Gynecology Endopelvic Fascia, Levator Ani Muscles, Pathophysiology, Pelvic Floor Anatomy, Pelvic Organ Prolapse |
| Content Type | Text |
| Resource Type | Article |
| Subject | Obstetrics and Gynecology |
