1. Apical Vaginal Support: The Often Forgotten Piece of the Puzzle.
- Author
-
Lowder JL
- Subjects
- Aged, Female, Humans, Hysterectomy methods, Middle Aged, Pelvic Floor physiopathology, Pelvic Floor Disorders economics, Pelvic Floor Disorders epidemiology, Pelvic Organ Prolapse classification, Pelvic Organ Prolapse psychology, Practice Patterns, Physicians' statistics & numerical data, Risk Factors, United States epidemiology, Vagina physiopathology, Vagina surgery, Hysterectomy adverse effects, Pelvic Floor anatomy & histology, Pelvic Organ Prolapse etiology, Pelvic Organ Prolapse surgery, Vagina anatomy & histology
- Abstract
Pelvic organ prolapse is common among women who have delivered vaginally or had a hysterectomy. In a total hysterectomy, the apical vaginal support is transected. Although evidence supports re-establishment of apical support, our research showed that this rarely occurs in hysterectomies. To address our lack of definitions of "significant" apical support loss and recommendations to guide surgeons as to when they should perform an apical support procedure, we analyzed patient data and found that a simple assessment of the genital hiatus can effectively screen for significant apical support loss. Our work will hopefully highlight the importance of apical support loss and current deficits in research and clinical guidelines.
- Published
- 2017