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Grade 0 1 2 3 4 Displacement of Prolapse No prolapse Halfway to the hymen At the hymen Halfway out of the hymen Total prolapse

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(1) Nonsurgical treatment such as pessaries and symptom-directed therapies (ie, weight loss, pelvic floor muscles rehabilitation, behavior modifications) (2) Surgical intervention It is a prosthesis usually made out of rubber or silicone-based material with a spring frame that is placed in the vaginal vault to support the prolapsing vaginal walls or uterus There are several types available which come in varying shapes and sizes See Fig 6-6

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When is a pessary contraindicated There are few contraindications to using a pessary: allergy to the product material untreated vaginitis or pelvic inflammatory disease and in a patient who is unable/unlikely to follow up When a patient is symptomatic from her prolapse and has been counseled regarding her treatment options

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nheritance is one of the cornerstones of OOP because it allows the creation of hierarchical classifications With inheritance, it is possible to create a general class that defines traits common to a set of related items This class may then be inherited by other, more specific classes, each adding only those things that are unique to the inheriting class In standard C++ terminology, a class that is inherited is referred to as a base class The class that does the inheriting is called the derived class Further, a derived class can be used as a base class for another derived class In this way, a multilayered class hierarchy can be achieved

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What is the traditional procedure for an anterior vaginal prolapse (cystocele) What does it involve

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G4; theDoc.SetInfo(0, "ImageCompression", "4"); theDoc.Rendering.Save(@"C:\ TestFiles\" + String.Format("{0}-{1}. tif ", name, idx + 1)); } theDoc.

Anterior vaginal colporrhaphy It involves dissecting the vaginal epithelium from the underlying fibromuscular connective tissue and bladder, and plicating the vaginal muscularis across the midline Posterior vaginal colporrhaphy It involves dissecting the vaginal epithelium from the underlying fibromuscular connective tissue and rectum, and plicating the vaginal muscularis across the midline If a site-specific defect is noted, this is repaired

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What is the traditional procedure for a posterior vaginal prolapse (rectocele) What does it involve

C++ supports inheritance by allowing one class to incorporate another class into its declaration Before discussing the theory and details, let s begin with an example of inheritance The following class, called road_vehicle, very broadly defines vehicles that travel on the road It stores the number of wheels a vehicle has and the number of passengers it can carry

What are the different surgical options for treatment of an apical prolapse (enterocele)

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Colpocleisis: usually reserved for severe uterovaginal prolapse It is an obliterative procedure that closes off the genital hiatus, and therefore should only be considered in patients who do not desire future sexual intercourse It is minimally invasive, so it is a good consideration for patients in whom major surgery is contraindicated Sacrospinous ligament fixation: attachment of the vaginal apex to the sacrospinous ligament, usually unilaterally Iliococcygeus suspension: attachment of the vaginal apex to the iliococcygeus muscle, either uni- or bilaterally Uterosacral ligament suspension: attachment of the vaginal apex to the uterosacral ligament bilaterally Abdominal sacral colpopexy: an abdominal procedure attaching the vaginal apex to the sacral promontory

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For treatment of uterine prolapse or if concomitant uterine pathology is present at the time of prolapse surgery

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