Prolapso uterino
Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- protuberância/saliência vaginal
- sensação de pressão vaginal
Other diagnostic factors
- incontinência urinária
- disfunção defecatória
- dor pélvica
- Disfunção da micção
- disfunção sexual
Risk factors
- parto vaginal
- idade avançada
- obesidade
- cirurgia prévia para prolapso
- fatores genéticos
- ascendência branca
- doenças do tecido conjuntivo
- aumento da pressão intra-abdominal
Diagnostic tests
1st tests to order
- avaliação do volume de resíduo pós-miccional (RPM)
- urinálise
Tests to consider
- urodinâmica
Treatment algorithm
assintomático
pacientes sintomáticos
Contributors
Authors
Lior Lowenstein, MD, MS, MHA, MBA
Associate Clinical Professor and Head of Gynecology Division
Rambam Health Care Campus
Rappaport Faculty of Medicine
Technion-Israel Institute of Technology
Haifa
Israel
Disclosures
LL declares that he has no competing interests.
Omer Anis, MD
Urology Department
Chaim-Sheba Medical Center
Tel Aviv
Israel
Disclosures
OA declares that she has no competing interests.
Agradecimientos
Dr Lior Lowenstein and Dr Omer Anis would like to thank Dr Linda Brubaker, a previous contributor to this topic.
Divulgaciones
LB has received editorial honoraria from JAMA, UpToDate, and the Female Pelvic Medicine and Reconstructive Surgery journal. LB is an author of some of the references cited in this topic.
Revisores por pares
Sarah Collins, MD
Associate Professor of Obstetrics and Gynecology
Northwestern University
Feinberg School of Medicine
Chicago
IL
Divulgaciones
SC declares that she has no competing interests.
Sushma Srikrishna, MRCOG
Locum Consultant Urogynaecologist and Obstetrician
Kings College Hospital
London
UK
Divulgaciones
SS declares that she has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
American College of Obstetricians and Gynecologists. Practice bulletin no. 214: pelvic organ prolapse. Nov 2019 [internet publication].Texto completo
Winters JC, Dmochowski RR, Goldman HB, et al; American Urological Association; Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction. Urodynamic studies in adults: AUA/SUFU guideline. J Urol. 2012 Dec;188(6 Suppl):2464-72. Resumen
National Institute for Health and Care Excellence. Urinary incontinence and pelvic organ prolapse in women: management. Jun 2019 [internet publication].Texto completo
Maher C, Feiner B, Baessler K, et al. Surgery for women with anterior compartment prolapse. Cochrane Database Syst Rev. 2016 Nov 30;(11):CD004014.Texto completo Resumen
Baessler K, Christmann-Schmid C, Maher C, et al. Surgery for women with pelvic organ prolapse with or without stress urinary incontinence. Cochrane Database Syst Rev. 2018 Aug 19;(8):CD013108.Texto completo Resumen
Brubaker L, Cundiff GW, Fine P, et al; Pelvic Floor Disorders Network. Abdominal sacrocolpopexy with Burch colposuspension to reduce urinary stress incontinence. N Engl J Med. 2006 Apr 13;354(15):1557-66.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Alongamento hipertrófico do colo do útero
- Cisto vaginal
- Câncer ginecológico
Más DiferencialesGuías de práctica clínica
- Non-neurogenic female LUTS
- AAGL practice report: practice guidelines on the prevention of apical prolapse at the time of benign hysterectomy
Más Guías de práctica clínica
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