Sacrocolpopexy
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Sacrocolpopexy
Uterine prolapse is when the uterus descends towards or through the opening of the vagina. Symptoms may include vaginal fullness, pain with sex, trouble urinating, urinary incontinence, and constipation. Often it gets worse over time. Low back pain and vaginal bleeding may also occur. Risk factors include pregnancy, childbirth, obesity, constipation, and chronic coughing. Diagnosis is based on examination. It is a form of pelvic organ prolapse, together with bladder prolapse, large bowel prolapse, and small bowel prolapse. Preventive efforts include managing chronic breathing problems, not smoking, and maintaining a healthy weight. Mild cases may be treated with a pessary together with hormone replacement therapy. More severe cases may require surgery such as a vaginal hysterectomy. About 14% of women are affected. It occurs most commonly after menopause. Causes The most common cause of uterine prolapse is trauma during childbirth, in particular multiple or difficult bir ...
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Cystocele
A cystocele, also known as a prolapsed bladder, is a medical condition in which a woman's bladder bulges into her vagina. Some may have no symptoms. Others may have trouble starting urination, urinary incontinence, or frequent urination. Complications may include recurrent urinary tract infections and urinary retention. Cystocele and a prolapsed urethra often occur together and is called a cystourethrocele. Cystocele can negatively affect quality of life. Causes include childbirth, constipation, chronic cough, heavy lifting, hysterectomy, genetics, and being overweight. The underlying mechanism involves weakening of muscles and connective tissue between the bladder and vagina. Diagnosis is often based on symptoms and examination. If the cystocele causes few symptoms, avoiding heavy lifting or straining may be all that is recommended. In those with more significant symptoms a vaginal pessary, pelvic muscle exercises, or surgery may be recommended. The type of surgery typicall ...
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Gynecology
Gynaecology or gynecology (see spelling differences) is the area of medicine that involves the treatment of women's diseases, especially those of the reproductive organs. It is often paired with the field of obstetrics, forming the combined area of obstetrics and gynecology (OB-GYN). The term comes from Greek and means "the science of women". Its counterpart is andrology, which deals with medical issues specific to the male reproductive system. Etymology The word "gynaecology" comes from the oblique stem (γυναικ-) of the Greek word γυνή (''gyne)'' semantically attached to "woman", and ''-logia'', with the semantic attachment "study". The word gynaecology in Kurdish means "jinekolojî", separated word as "jin-ekolojî", so the Kurdish "jin" called like "gyn" and means in Kurdish "woman". History Antiquity The Kahun Gynaecological Papyrus, dated to about 1800 BC, deals with gynaecological diseases, fertility, pregnancy, contraception, etc. The text is divided into th ...
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Pelvic Organ Prolapse
Pelvic organ prolapse (POP) is characterized by descent of pelvic organs from their normal positions. In women, the condition usually occurs when the pelvic floor collapses after gynecological cancer treatment, childbirth or heavy lifting. In men, it may occur after the prostate gland is removed. The injury occurs to fascia membranes and other connective structures that can result in cystocele, rectocele or both. Treatment can involve dietary and lifestyle changes, physical therapy, or surgery. Types * Anterior vaginal wall prolapse ** Cystocele (bladder into vagina) ** Urethrocele (urethra into vagina) ** Cystourethrocele (both bladder and urethra) * Posterior vaginal wall prolapse ** Enterocele (small intestine into vagina) ** Rectocele (rectum into vagina) ** Sigmoidocele * Apical vaginal prolapse ** Uterine prolapse (uterus into vagina) ** Vaginal vault prolapse (roof of vagina) – after hysterectomy Grading Pelvic organ prolapses are graded either via the Baden–Walker ...
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Hysterectomy
Hysterectomy is the surgical removal of the uterus. It may also involve removal of the cervix, ovaries (oophorectomy), Fallopian tubes (salpingectomy), and other surrounding structures. Usually performed by a gynecologist, a hysterectomy may be total (removing the body, fundus, and cervix of the uterus; often called "complete") or partial (removal of the uterine body while leaving the cervix intact; also called "supracervical"). Removal of the uterus renders the patient unable to bear children (as does removal of ovaries and fallopian tubes) and has surgical risks as well as long-term effects, so the surgery is normally recommended only when other treatment options are not available or have failed. It is the second most commonly performed gynecological surgical procedure, after cesarean section, in the United States. Nearly 68 percent were performed for conditions such as endometriosis, irregular bleeding, and uterine fibroids. It is expected that the frequency of hysterectom ...
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Pessaries
A pessary is a prosthetic device inserted into the vagina for structural and pharmaceutical purposes. It is most commonly used to treat stress urinary incontinence to stop urinary leakage and to treat pelvic organ prolapse to maintain the location of organs in the pelvic region. It can also be used to administer medications locally in the vagina or as a method of contraception. Pessaries come in different shapes and sizes, so it is important that individuals be fitted for them by health care professionals to avoid any complications. However, there are a few instances and circumstances that allow individuals to purchase pessaries from a store without a prescription or without seeking help from a health care professional. Some side effects may occur if pessaries are not sized properly or regularly maintained, but with the appropriate care, pessaries are generally safe and well tolerated. History Early use of pessaries dates back to the ancient Egyptians, as they described usin ...
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Kegel Exercise
Kegel exercise, also known as pelvic-floor exercise, involves repeatedly contracting and relaxing the muscles that form part of the pelvic floor, now sometimes colloquially referred to as the "Kegel muscles". The exercise can be performed many times a day, for several minutes at a time but takes one to three months to begin to have an effect. Kegel exercises aim to strengthen the pelvic floor muscles. These muscles have many functions within the human body. In women, they are responsible for: holding up the bladder, preventing urinary stress incontinence (especially after childbirth), vaginal and uterine prolapse. In men, these muscles are responsible for: urinary continence, fecal continence, and ejaculation. Several tools exist to help with these exercises, although various studies debate the relative effectiveness of different tools versus traditional exercises. The American gynecologist Arnold Kegel first published a description of such exercises in 1948. Mechanism of act ...
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Ovarian Ligament
The ovarian ligament (also called the utero-ovarian ligament or proper ovarian ligament) is a fibrous ligament that connects the ovary to the lateral surface of the uterus. Structure The ovarian ligament is composed of muscular and fibrous tissue; it extends from the uterine extremity of the ovary to the lateral aspect of the uterus, just below the point where the uterine tube and uterus meet. The ligament runs in the broad ligament of the uterus, which is a fold of peritoneum rather than a fibrous ligament. Specifically, it is located in the parametrium. Development Embryologically, each ovary (which forms from the gonadal ridge) is connected to a band of mesoderm, the gubernaculum. This strip of mesoderm remains in connection with the ovary throughout its development, and eventually spans this distance by attachment within the labia majora. During the latter parts of urogenital development, the gubernaculum forms a long fibrous band of connective tissue stretching from the ovar ...
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Broad Ligament Of The Uterus
The broad ligament of the uterus is the wide fold of peritoneum that connects the sides of the uterus to the walls and floor of the pelvis. Structure Subdivisions Contents The contents of the broad ligament include the following: * Reproductive ** uterine tubes (or Fallopian tube) ** ovary (some sources consider the ovary to be on the broad ligament, but not in it.) * vessels ** ovarian artery (in the suspensory ligament) ** uterine artery (in reality, travels in the cardinal ligament) * ligaments ** ovarian ligament ** round ligament of uterus ** suspensory ligament of the ovary (Some sources consider it a part of the broad ligament, while other sources just consider it a "termination" of the ligament.) Relations The peritoneum surrounds the uterus like a flat sheet that folds over its fundus, covering it anteriorly and posteriorly; on the sides of the uterus, this sheet of peritoneum comes in direct contact with itself, forming the double layer of peritoneum known as ...
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Uterosacral Ligaments
The uterosacral ligaments (or rectouterine ligaments) belong to the major ligaments of uterus. Structure The rectouterine folds contain a considerable amount of fibrous tissue and non-striped muscular fibers which are attached to the front of the sacrum and constitute the uterosacral ligaments.* Netter, Atlas of Human Anatomy, 371 (4th Edition) These ligaments travel from the uterus to the anterior aspect of the sacrum. The pelvic splanchnic nerves Pelvic splanchnic nerves or nervi erigentes are splanchnic nerves that arise from sacral spinal nerves S2, S3, S4 to provide parasympathetic innervation to the organs of the pelvic cavity. Structure The pelvic splanchnic nerves arise from t ... run on top of the ligament. References {{Authority control Ligaments Pelvis Uterus ...
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Round Ligament Of The Uterus
The round ligament of the uterus is a ligament that connects the uterus to the labia majora. Structure The round ligament of the uterus originates at the uterine horns, in the parametrium. The round ligament exits the pelvis via the deep inguinal ring. It passes through the inguinal canal, and continues on to the labia majora. At the labia majora, its fibers spread and mix with the tissue of the mons pubis. Development The round ligament develops from the gubernaculum which attaches the gonad to the labioscrotal swellings in the embryo. Blood supply The round ligament is supplied by the artery of the round ligament of uterus, also known as ''Sampson's artery''. Function The function of the round ligament is maintenance of the anteversion of the uterus (a position where the fundus of the uterus is turned forward at the junction of cervix and vagina) during pregnancy. Normally, the cardinal ligament is what supports the uterine angle (angle of anteversion). When the uterus gro ...
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Postmenopausal
Menopause, also known as the climacteric, is the time in women's lives when menstrual periods stop permanently, and they are no longer able to bear children. Menopause usually occurs between the age of 47 and 54. Medical professionals often define menopause as having occurred when a woman has not had any menstrual bleeding for a year. It may also be defined by a decrease in hormone production by the ovaries. In those who have had surgery to remove their uterus but still have functioning ovaries, menopause is not considered to have yet occurred. Following the removal of the uterus, symptoms typically occur earlier. In the years before menopause, a woman's periods typically become irregular, which means that periods may be longer or shorter in duration or be lighter or heavier in the amount of flow. During this time, women often experience hot flashes; these typically last from 30 seconds to ten minutes and may be associated with shivering, sweating, and reddening of the skin. ...
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Vaginal Hysterectomy
Hysterectomy is the surgical removal of the uterus. It may also involve removal of the cervix, ovaries (oophorectomy), Fallopian tubes (salpingectomy), and other surrounding structures. Usually performed by a gynecologist, a hysterectomy may be total (removing the body, fundus, and cervix of the uterus; often called "complete") or partial (removal of the uterine body while leaving the cervix intact; also called "supracervical"). Removal of the uterus renders the patient unable to bear children (as does removal of ovaries and fallopian tubes) and has surgical risks as well as long-term effects, so the surgery is normally recommended only when other treatment options are not available or have failed. It is the second most commonly performed gynecological surgical procedure, after cesarean section, in the United States. Nearly 68 percent were performed for conditions such as endometriosis, irregular bleeding, and uterine fibroids. It is expected that the frequency of hysterecto ...
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