Pelvic Relaxation

ANATOMY OF PELVIC FLOOR SUPPORT

Several crucial structures make up the support of the female pelvic floor. Dis turbance of any of the following can result in prolapse:

■ Bony structure

■ Broad and round ligaments

■ Endopelvic fascia

■ Pelvic diaphragm

■ Urogenital diaphragm

PROLAPSE

Prolapse is the downward displacement of an organ from its normal position. There are several types.

Types of Prolapse

Prolapses can be classified according to the location of the protruding structure: Anterior, apical, and posterior.

Anterior

■ Cystourethrocele

FIGURE 29-1. Cystocele.

(Reproduced, with permission, from Pernoll ML. Benson & Pernoll's Handbook of Obstetrics and Gynecology, 10th ed. New York: McGraw-Hill, 2001:807.)

FIGURE 29-1. Cystocele.

(Reproduced, with permission, from Pernoll ML. Benson & Pernoll's Handbook of Obstetrics and Gynecology, 10th ed. New York: McGraw-Hill, 2001:807.)

The pelvic diaphragm is made up of the levator ani and coccygeal muscles.

FIGURE 29-2. Rectocele.

(Reproduced, with permission, from Pernoll ML. Benson & Pernoll's Handbook of Obstetrics and Gynecology, 10th ed. New York: McGraw-Hill, 2001:807.)

FIGURE 29-2. Rectocele.

(Reproduced, with permission, from Pernoll ML. Benson & Pernoll's Handbook of Obstetrics and Gynecology, 10th ed. New York: McGraw-Hill, 2001:807.)

In general, think of prolapse as either limited to the upper vagina, to the introitus, or protruding from the body.

Anything that increases pelvic pressure can cause a prolapse:

■ Constipation

■ Chronic obstructive pulmonary disease

Apical

■ Vaginal prolapse

Posterior

■ Enterocele (intestine)—see Figure 29-3

Grading of Prolapse

Organ displacement:

To the level of the ischial spines

Grade I

Between ischial spines and introitus

Grade II

Within introitus

Grade III

Past introitus

Grade IV

Risk Factors for Prolapse

Many conditions can cause prolapse by disturbing the anatomical supports (childbirth), disrupting the innervations, or increasing the pressure load. The following are some examples:

■ Increased load—obesity, cough (e.g., chronic obstructive pulmonary disease)

FIGURE 29-3. Enterocele and prolapsed uterus.

(Reproduced, with permission, from Pernoll ML. Benson & Pernoll's Handbook of Obstetrics and Gynecology, 10th ed. New York: McGraw-Hill, 2001:808.)

FIGURE 29-3. Enterocele and prolapsed uterus.

(Reproduced, with permission, from Pernoll ML. Benson & Pernoll's Handbook of Obstetrics and Gynecology, 10th ed. New York: McGraw-Hill, 2001:808.)

■ Loss of levator ani function—postpartum

■ Disturbance of parts—postsurgical

■ Loss of innervation—amyotrophic lateral sclerosis (ALS), paralysis

■ Loss of connective tissue—spina bifida, myelomeningocele

Get Pregnant - Cure Infertility Naturally

Get Pregnant - Cure Infertility Naturally

Far too many people struggle to fall pregnant and conceive a child naturally. This book looks at the reasons for infertility and how using a natural, holistic approach can greatly improve your chances of conceiving a child of your own without surgery and without drugs!

Get My Free Ebook


Post a comment