Pelvic organ prolapse in women from the viewpoint of a urologist

Overview

Anatomical disorders of the pelvic floor manifested by different degrees of pelvic organ prolapse (POP) are either isolated in the compartments of the vagina (anterior, middle, posterior), or combined. Reference is made to the Baden-Walker Halfway Scoring System and to classification according to the ICS using the standard 6 point pelvic organ prolapse quantification system. Anterior vaginal wall prolapse can be repaired surgically by means of anterior colpography or paravaginal repair (PVR) - using the retropubic or vaginal route, by Burch colposuspension or by a mesh. Middle compartment prolapse is repaired by the vaginal, abdominal or laparoscopic routes. Different modifications of sacrocolpofixation or colpocleisis are the most frequently used methods. Posterior compartment prolapse (rectocele) can be repaired using the vaginal route (colporaphia posterior), levator plastic or by mesh application, using the transanal, abdominal or laparoscopic routes. Approach to pelvic organ prolapse treatment should be interdisciplinary. Both the gynaecologist, urologist, and in some cases also proctologist are involved in the diagnostic-therapeutic algorithm.

Key words:
pelvic organ prolapse (POP), anterior, middle, posterior compartment, half way system, International Continence Society (ICS )