Recurrent Pelvic Organ Prolapse

Abstract

The treatment of recurrent pelvic organ prolapse is challenging. The pelvic floor symptom needs to be treated, a high quality of life has to be ensured and complications have to be minimized. There is a wide range of surgical options that may be used. The surgeon should be able to discuss and offer native tissue procedures for prolapse. In addition, for the clinically challenging situations of recurrent prolapse, mesh augmented procedures may need to be discussed with the patient. A thorough knowledge of mesh and graft options, as well as knowledge of prolapse recurrence and adverse events rate, can help guide clinicians in counseling their patients effectively. Ultimately, this will allow surgeons to choose a personalized treatment option that best align with a woman's lifestyle and treatment goals. In this chapter the anatomical concepts of supports of vagina are elaborated. The pelvic diaphragm, lateral attachment of vagina to arcus tendineus fascia pelvis, intrinsic and extrinsic sphincter control mechanisms are elaborated. The surgical techniques of suspending the vaginal vault with autologous tissue and synthetic mesh are discussed. Finally, the role of minimally invasive surgery of pelvic floor is discussed as an integral part of management of recurrent vaginal prolapse.

Maternal and Neonatal Outcome in Pregnant Women with Chronic Energy Deficiency in Cipto Mangunkusumo General Hospital, Indonesia

“…The incidence of IUGR is also correlated with malnutrition in pregnancy with other complications such as prematurity and congenital defects [35]. The mechanism of IUGR is caused by abnormal placental growth and development, deficiency in nutrition transfer in the placenta, endocrine disorders, and metabolism disorders [36].…”