Pelvic Organ Prolapse Workup

  • Author: George Lazarou, MD, FACS, FACOG; Chief Editor: Kris Strohbehn, MD   more...
 
Updated: Jan 26, 2012
 

Laboratory Studies

  • Urine sample, clean midstream to rule out infection in patients with incontinence and prolapse
  • BUN, creatinine, glucose, and calcium recommended in patients with compromised renal function, or if polyuria is present
  • Urine cytology in patients with microscopic hematuria to exclude bladder neoplasm
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Imaging Studies

  • If the uterus is to be preserved, ultrasonographic imaging is strongly recommended.
  • Some surgeons have used MRI, contrast radiology, and ultrasonography to describe the nature of the support defects. Patients with defecatory dysfunction may benefit from defecating proctography and proctosigmoidoscopy. Colonic transit studies are indicated in patients with motility disorders. Dynamic MRI defecography can be used to provide defecatory and high-quality soft tissue imaging; however, this expensive test has not been shown to change clinical decision making.
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Diagnostic Procedures

  • In patients who are planning to undergo LeFort colpocleisis (see Surgical Management of Apical Vaginal Prolapse and Uterine Prolapse section) , cervical cytology and either pelvic ultrasonography or endometrial biopsy is recommended to rule out endometrial pathology.
  • Urodynamic testing can be considered to evaluate urinary incontinence and to rule out potential incontinence.
  • Cystoscopy is recommended for patients with symptoms of bladder pain, hematuria, or urinary urgency/frequency who are not responding to medications.
  • Cervical cytology should be considered if cervical screening is not current. (See eMedicine article Cervical Cancer.)
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Contributor Information and Disclosures
Author

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

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

Disclosure: Nothing to disclose.

Coauthor(s)

Bogdan A Grigorescu, MD  Director of Urogynecology Division, Department of Obstetrics and Gynecology, New York Hospital Queens, Flushing, New York; Assistant Professor, Department of Obstetrics and Gynecology, Louisiana State University, New Orleans, Louisiana

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

Disclosure: Nothing to disclose.

Specialty Editor Board

Suzanne R Trupin, MD, FACOG  Clinical Professor, Department of Obstetrics and Gynecology, University of Illinois College of Medicine at Urbana-Champaign; CEO and Owner, Women's Health Practice; CEO and Owner, Hada Cosmetic Medicine and Midwest Surgical Center

Suzanne R Trupin, MD, FACOG is a member of the following medical societies: American Association of Gynecologic Laparoscopists, American College of Obstetricians and Gynecologists, American Institute of Ultrasound in Medicine, American Medical Association, Association of Reproductive Health Professionals, International Society for Clinical Densitometry, and North American Menopause Society

Disclosure: Nothing to disclose.

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

Disclosure: Medscape Salary Employment

Frederick B Gaupp, MD  Consulting Staff, Department of Family Practice, Hancock Medical Center

Frederick B Gaupp, MD is a member of the following medical societies: American Academy of Family Physicians

Disclosure: Nothing to disclose.

Chief Editor

Kris Strohbehn, MD  Professor of Obstetrics/Gynecology, Dartmouth Medical School; Director, Division of Urogynecology/Reconstructive Pelvic Surgery, Department of Obstetrics/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, and Society of Gynecologic Surgeons

Disclosure: Astellas Grant/research funds Investigator

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Abdominal approach.
Sacrospinous ligament suspension procedure for apical vaginal prolapse.
 
 
 
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