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Uterine Prolapse Workup

  • Author: George Lazarou, MD, FACOG, FACS; Chief Editor: Kris Strohbehn, MD  more...
 
Updated: Mar 27, 2016
 

Imaging Studies

If the uterus is to be preserved, ultrasonographic imaging is recommended.

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Other Tests

Prior to surgery, cervical cytology (Papanicolaou smear) should be considered as per current American Congress of Obstetrics and Gynecologists screening recommendations.

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Diagnostic Procedures

Endometrial biopsy is recommended prior to uterine preservation for women with postmenopausal vaginal bleeding.

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Contributor Information and Disclosures
Author

George Lazarou, MD, FACOG, FACS Chief of Gynecology, Director of Urogynecology and Reconstructive Pelvic Surgery, Winthrop University Hospital; Associate Professor, Department of Obstetrics, Gynecology, and Women's Health, Stony Brook University Hospital

George Lazarou, MD, FACOG, FACS is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Urogynecologic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Bogdan A Grigorescu, MD Attending Physician, Urogynecology Division, Department of Obstetrics and Gynecology, Maine Medical Center; Assistant Professor, Department of Obstetrics and Gynecology, Tufts University School of Medicine

Bogdan A Grigorescu, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, International Continence Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Kris Strohbehn, MD Professor of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth; Director, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center

Kris Strohbehn, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American College of Surgeons, American Urogynecologic Society, Society of Gynecologic Surgeons

Disclosure: Nothing to disclose.

Additional Contributors

Jordan G Pritzker, MD, MBA, FACOG Adjunct Professor of Obstetrics/Gynecology, Hofstra North Shore-LIJ School of Medicine at Hofstra University; Attending Physician, Department of Obstetrics and Gynecology, Long Island Jewish Medical Center; Medical Director, Aetna, Inc; Private Practice in Gynecology

Disclosure: Nothing to disclose.

References
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Lembert 0 absorbable sutures are placed from the pubovesical cervical fascia anteriorly to the perirectal fascia posteriorly over the portio of the cervix. Courtesy of Clifford R Wheeless, Jr, MD, and Marcella L Roenneburg, MD, Atlas of Pelvic Surgery website (http://www.atlasofpelvicsurgery.com/).
A sagittal view shows the suspension covered by the peritoneum. The strap is sutured to the periosteum of the sacrum and ultimately over the dome of the vaginal apex. The vagina should lie posteriorly over the rectosigmoid colon. Courtesy of Clifford R Wheeless, Jr, MD, and Marcella L Roenneburg, MD, Atlas of Pelvic Surgery website (http://www.atlasofpelvicsurgery.com/).
The completed sacrospinous ligament suspension with the apex of the vagina suspended from the sacrospinous ligament approximately 2 cm from the ischial spine is shown. A Foley catheter is inserted into the bladder and left for a minimum of 4 days. Thereafter, management of bladder function is similar to that following surgery for urinary incontinence. No vaginal packs or drains are used. Courtesy of Clifford R Wheeless, Jr, MD, and Marcella L Roenneburg, MD, Atlas of Pelvic Surgery website (http://www.atlasofpelvicsurgery.com/).
The upper vagina at rest (A) is reflected posteriorly during straining (B) and covers over the genital hiatus like a flap valve, preventing prolapse of other abdominal organs. Courtesy of Springer (Scotti RJ, et al. Chapter 3, Anatomy of the Pelvic Floor. In: Drutz HP, Herschorn S, Diamant NE, eds. Female Pelvic Medicine and Reconstructive Pelvic Surgery. Springer; 2003.).
 
 
 
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