In analyzing these various reasons why carcinoma of the cervix is seen so infrequently with procidentia
, the cornified cervical epithelium becoming resistant to the development of carcinoma and less vaginal secretion, absence of infection, and free drainage appear to be the commonest reasons given for the protection against carcinoma.
Sacrospinous colpopexy, introduced by Randall and Nichols (1) in 1971, has become a favored method for restoring vaginal support in women with vault prolapse, massive eversion of the vagina and procidentia
. Defects in apical vaginal support are crucial to recognize and address when undertaking surgery for prolapse.
Data collected on clinical characteristics included co-morbidities, such as hypertension, diabetes mellitus, asthma and history of urinary tract infections, past pelvic surgeries (POP repair, UI surgery, and abdominal/vaginal hysterectomy), urinary symptoms, type of prolapse (anterior, posterior, apical, procidentia
), menopause status, pessary type (Ring, Gellhorn, or if patient had a pessary change or size refit), use of localized vaginal lubricants (such as Trimo SanTM), and complications from wearing a pessary (vaginal erosion/ulceration, vaginal discharge, bowel and/or bladder fistula, yeast infection, impaction).
These displacements are typically graded on a scale of 0 to 4, with 0 being no prolapse and 4 being total prolapse (called procidentia
Patients requiring concomitant vaginal vault suspension such as sacrospinous ligament fixation, sacrocolpopexy for vaginal prolapse, uterine procidentia
, laparotomy, or laparoscopyfor anyreason were also excluded.
Stage IV involves full procidentia
of the hemorrhoids and rectal mucosa that cannot be manually reduced by the patient.
Intrarectal prolapse (IRP), also known as intussusception of the rectum, internal procidentia
, hidden prolapse and internal intussusception, is a specific clinical entity that is believed to be the precursor of complete transanal rectal prolapse.
All traditional maneuvers are performed comfortably from the sitting position: the vertex is controlled by hands-on, and a quick reach with the nonpredominant hand searches for a loop of cord or a small part procidentia
to resolve it.
Presenting a case of a 20 year old unmarried nulliparous woman operated successfully with an open Shirodkar's sling operation for uterine procidentia