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Pelvic Organ Prolapse Quantification System (POP-Q) Stage Description 0: No prolapse anterior and posterior points are all −3 cm, and C or D is between −TVL and −(TVL−2) cm. 1: The criteria for stage 0 are not met, and the most distal prolapse is more than 1 cm above the level of the hymen (less than −1 cm). 2
A urethral caruncle is a benign cutaneous condition characterized by distal urethral lesions that are most commonly found in post-menopausal women. They appear red, and can be various sizes. They can have the appearance of a tumor. These epidermal growths are found around the posterior portion of the urethral meatus.
Urethral syndrome is defined as symptoms suggestive of a lower urinary tract infection but in the absence of significant bacteriuria with a conventional pathogen. [1] It is a diagnosis of exclusion in patients with dysuria and frequency without demonstrable infection. [2] In women, vaginitis should also be ruled out. [3]
The most common kind is ring shaped, and is typically recommended to correct vaginal prolapse. The pessary compresses the urethra against the symphysis pubis and elevates the bladder neck. For some women this may reduce stress leakage, however it is not clear how well these mechanical devices help women with stress urinary incontinence. [14]
A urethrocele is the prolapse of the female urethra into the vagina. Weakening of the tissues that hold the urethra in place may cause it to protrude into the vagina. [3] [4] Urethroceles often occur with cystoceles (involving the urinary bladder as well as the urethra). [5] In this case, the term used is cystourethrocele. [6] [7]
Anatomical and congenital variations of vaginal support structures can predispose a woman to further dysfunction and prolapse later in life. [1] The urethra is part of the anterior wall of the vagina and damage to the support structures there can lead to incontinence and urinary retention .
The incidence of cystocele is around 9 per 100 women-years. The highest incidence of symptoms occurs between ages of 70 and 79 years. Based on population growth statistics, the number of women with prolapse will increase by a minimum of 46% by the year 2050 in the US. Surgery to correct prolapse after hysterectomy is 3.6 per 1,000 women-years. [13]
Treatment, depending on cause, may require prompt drainage of the bladder via catheterization, medical instrumentation, surgery (e.g., endoscopy, lithotripsy), hormonal therapy, or a combination of these modalities.