Vaginal Prolapse Tube
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Vaginal Prolapse Tube
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Pelvic organ prolapse (POP) is a condition where weakened muscles in your pelvis cause one or more organs in your pelvis (vagina, uterus, bladder and rectum) to sag. In more severe cases, an organ bulges onto another organ or outside your body. Your healthcare provider can recommend treatments to repair your prolapse and relieve symptoms.
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What type of POP do I have?
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Friedman T, Eslick GD, Dietz HP. Risk factors for prolapse recurrence: systematic review and meta-analysis. (https://pubmed.ncbi.nlm.nih.gov/28921033/) Int Urogynecol J . 2018;29(1):13-21. Accessed 8/22/2022.
Kudish BI, Iglesia CB, Gutman RE, et al. Risk factors for prolapse development in white, black, and Hispanic women. (https://pubmed.ncbi.nlm.nih.gov/22453694/) Female Pelvic Med Reconstr Surg . 2011;17(2):80-90. Accessed 8/22/2022.
Nygaard I, Barber MD, Burgio KL, et al. Prevalence of symptomatic pelvic floor disorders in US women. (https://pubmed.ncbi.nlm.nih.gov/18799443/) JAMA . 2008;300(11):1311-1316. Accessed 8/22/2022.
Whitcomb EL, Rortveit G, Brown JS, et al. Racial differences in pelvic organ prolapse. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879888/) Obstet Gynecol . 2009;114(6):1271-1277. Accessed 8/22/2022.
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Pelvic organ prolapse (POP) is a condition in which your pelvic floor (the muscles, ligaments and tissues that support your pelvic organs) become too weak to hold your organs in place. Your pelvic floor muscles act like a powerful sling that supports organs like your vagina, uterus, bladder and rectum. If these muscles become too loose or sustain damage, the organs they support shift out of place.
With mild cases of POP, your organs may drop. In more severe cases, they may extend outside your vagina and cause a bulge.
Pelvic organ prolapse is one type of pelvic floor disorder, along with urinary and fecal incontinence. Sometimes these other disorders occur together with POP.
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The type of prolapse you have depends on where the weaknesses are in your pelvic floor and what organs are affected.
People of all sexes can experience POP, but you’re at greater risk if you’re a woman or person assigned female at birth (AFAB). Men and people assigned male at birth (AMAB) can experience a dropped bladder and a dropped rectum.
Around 3% to 11% of people AFAB experience POP. About 37% of people with pelvic floor disorders, including POP, are between ages 60 and 79. Over half are 80 or older. POP doesn’t always cause symptoms, though. As a result, it’s hard to know how common POP is among people who don’t see their healthcare providers for symptom relief.
The most common symptom is feeling a bulge in your vagina, as if something were falling out of it. Other symptoms include:
Your symptoms depend on where your prolapse is located. Telling your healthcare provider about your symptoms helps them locate the spots where your pelvic floor is weakest.
Stress incontinence, urge incontinence and fecal incontinence often coexist with POP because they share similar risk factors. Symptoms include:
Your pelvic floor can weaken for many reasons. A weak pelvic floor increases your likelihood of a prolapse.
During your appointment, your healthcare provider will review your symptoms and perform a pelvic exam . During the exam, your provider may ask you to cough so that they can see the full extent of your prolapse when you’re straining and when you’re relaxed. They may examine you while you’re lying down and while you’re standing. Often, a pelvic exam is all it takes to diagnose a prolapse.
The Pelvic Organ Prolapse Quantification (POP-Q) system classifies POP based on how mild or severe your prolapse is. The scale ranges from zero to four. Stage Zero means your organs haven’t shifted out of place at all. Stage Four means you have a complete prolapse. A complete prolapse is the most severe kind. It may involve an organ bulging out of your body.
Both the type of prolapse and the extent of the prolapse will shape your treatment.
Because any surgical procedure may pose risks or create complications, nonsurgical procedures are usually the first line of treatment for POP. If more conservative treatments don’t work, your provider may recommend surgery.
Surgery may be an option if your symptoms haven’t improved with conservative treatments and if you no longer wish to have children. Childbirth following surgery may increase the risk of your prolapse returning.
Two types of surgeries are available: obliterative surgery and reconstructive surgery. Obliterative surgery sews your vaginal walls shut, preventing organs from slipping out. Reconstructive surgery repairs the weakened parts of your pelvic floor.
Your provider may suggest additional procedures while you’re in surgery for POP. For instance, some procedures may require a hysterectomy so that pelvic floor muscles can be accessed and repaired. Your provider may treat other conditions that may accompany POP, like stress urinary incontinence, during surgery.
Many causes of POP are out of your control. But you can put healthy habits into place to reduce your risk.
Your prognosis depends on your prolapse (where it’s located, it’s severity) and your goals (to have children, to continue having penetrative sex, to have a less invasive surgery, etc.). Talk to your healthcare provider about how your prolapse shapes your treatment options. Discuss how the benefits of treatment will allow you to achieve your goals, and ask about any risks that may prevent you from achieving them, too. Grounding your expectations in honest conversations with your provider will improve your experience with POP.
Left untreated, your prolapse and your symptoms can worsen. Your healthcare provider can monitor your prolapse and recommend treatments if it progresses to the point where it’s negatively impacting your quality of life.
Most people with POP describe a feeling of bulge, fullness or pressure in their vagina, as if something were falling out. Your symptoms will depend on what type of prolapse you have and how severe it is.
Common symptoms like pressure or fullness in your vagina or issues related to incontinence may be signs of a prolapse. Your provider can diagnose POP during a pelvic exam.
It can, with treatment. With mild POP, you can strengthen your muscles so that they hold the organs in their correct locations. Reconstructive surgeries strengthen the weaknesses in your pelvic walls so that your organs return to their original locations.
With more severe prolapse, you may have to push the bulging organ out of the way to poop or pee. The fix is temporary. See your healthcare provider for treatment if your prolapse is this severe.
Pelvic organ prolapse can harm your body image and your sexuality. It can cause symptoms that prevent you from living your life to the fullest. But POP isn’t something you have to accept. Don’t be embarrassed to talk to your healthcare provider if you have POP symptoms or if you suspect you have a weakened pelvic floor. They can suggest procedures, medical devices and even lifestyle modifications that can repair your prolapse and improve your quality of life.
Last reviewed by a Cleveland Clinic medical professional on 08/22/2022.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.
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URL: https://www.sciencedirect.com/science/article/pii/B978032344732400011X
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URL: https://www.sciencedirect.com/science/article/pii/B9780323549417000050
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Moreover, fallopian tube prolapse has been associated with an exuberant angiomyofibroblastic stromal response.
Tubal prolapse occasionally occurs following a hysterectomy, when the tubes are fixed near the apex of the vaginal cuff. It usually follows vaginal hysterectomy but also occurs with an abdominal or laparoscopic hysterectomy if the tubes are spared. 20,21 Patients may present with abdominal pain, dyspareunia, postcoital bleeding, and/or vaginal discharge. 22
A small nodule resembling granulation tissue is visible at the vaginal apex. A cytologic diagnosis of tubal prolapse is rare. The cytologic appearance of a prolapsed fallopian tube includes classic columnar cells with cilia and sheets of cells with small granular uniform nuclei in an orderly arrangement. Squamous metaplasia, with nuclear enlargement and an increased nuclear-to-cytoplasmic ratio corresponding to reactive atypia, but with fine and evenly distributed chromatin and smooth nuclear contours, may occur. 23
The biopsy discloses tubal plicae with a bland tubal epithelial lining ( Fig. 11.11 ). 24-26 However, misdiagnosis as neoplasia can occur if the tubal epithelium is not recognized. Moreover, fallopian tube prolapse has been associated with an exuberant angiomyofibroblastic stromal response. The richly vascularized stroma is arranged in a retiform pattern, with mildly atypical glandular inclusions derived from tubal epithelium. 27 If the tubal glandular component is overlooked, this might be erroneously diagnosed as a mesenchymal lesion of the vagina, such as vaginal fibroepithelial polyp, angiomyofibroblastoma, or aggressive angiomyxoma (see Chapter 9 ). 27
Anais Malpica , in Gynecologic Pathology , 2009
Prolapse of the fallopian tube most commonly occurs following a vaginal hysterectomy, but it can also occur after abdominal hysterectomy or colpotomy. Predisposing factors include significant bleeding after surgery, incomplete peritoneal closure, drains left in the Douglas pouch as well as postoperative infections.
The most common symptoms include vaginal bleeding, lower abdominal pain, watery or foul-smelling vaginal discharge, and dyspareunia. Some patients are asymptomatic. Symptoms may occur from 2 weeks up to 28 years after surgery; however, they often appear within 6 months postoperatively. On vaginal examination, an erythematous mass is seen in the vaginal vault. The diagnosis of fallopian tube prolapse can be suspected if a probe can be passed through a discernible lumen, or if traction of the mass induces pain.
FALLOPIAN TUBE PROLAPSE – FACT SHEET
Most commonly seen following vaginal hysterectomy, but also after abdominal hysterectomy or colpotomy (from 2 weeks to 28 years)
Most frequently vaginal bleeding and lower abdominal pain
Watery or foul-smelling vaginal discharge, and dyspareunia
The lesions tend to be relatively small, red or gray to tan granular and polypoid, measuring up to 2 cm. Sometimes, the prolapsed fallopian tube fimbria may be identified.
FALLOPIAN TUBE PROLAPSE – PATHOLOGIC FEATURES
Small red, gray or tan, granular to polypoid, measuring up to 2 cm
Occasionally prolapsed fallopian tube fimbria is identified
Clubbed folds (plicae) at the surface of the lesion or rounded or slit-like structures containing luminal spaces that are buried in fibroconnective tissue or granulation tissue
Fallopian tube epithelium with variable degrees of hyperplasia (cribriforming and papillary formation)
Loss of cilia, and loss of the secretory and intercalated cells
Variable degree of cytologic atypia with cell enlargement and nuclear hyperchromasia
Numerous thick-walled blood vessels and variable amounts of smooth muscle fibers deeper in the lesion
Frequently admixed with numerous plasma cells
The hallmark of fallopian tube prolapse is the finding of tubal-type epithelium either forming clubbed folds (plicae) at the surface of the lesion or rounded or slit-like structures with luminal spaces buried in fibroconnective or granulation tissue ( Figure 3.14 ). The fallopian tube epithelium may show variable degrees of proliferation with cribriforming and papillary formation, and some degree of cytologic atypia (i.e., enlargement of the cells, nuclear hyperchromasia). It may also exhibit lack of cilia, and loss of the secretory and intercalated cells. Numerous plasma cells can be seen. Deeper in the lesion, there are numerous thick-walled blood vessels and variable amounts of smooth-muscle fibers.
Although the gross appearance of fallopian tube prolapse overlaps with that seen in granulation tissue , on microscopic examination, this distinction is easy. Rarely, on low-power scrutiny, an adenocarcinoma with papillary features may be confused with fallopian tube prolapse, as complex architecture as well as occasional cytologic atypia may be seen in the latter. It is important to recognize that the complex infolding of papillae corresponds to the plicae covered by tubal-type epithelium.
Treatment consists of excision with complete resolution of the symptoms. It does not recur.
Prolapse of the fallopian tube results in a small, red or gray to tan granular and polypoid lesion, measuring up to 2 cm. The fimbriated portion of the fallopian tube is most commonly involved, but frequently missed on gross examination.
The hallmark of fallopian tube prolapse is the finding of tubal-type epithelium either forming clubbed folds (plicae) at the surface of the lesion or rounded or slit-like structures with luminal spaces buried in fibroconnective or granulation tissue ( Fig. 5.15 ). The fallopian tube epithelium may show variable degrees of proliferation with papillary formation, and may show mild cytologic atypia (i.e., enlargement of the cells, nuclear hyperchromasia). Ciliated, secretory or intercalated cells may be depleted or absent. Numerous plasma cells, thick-walled blood vessels, and variable amounts of smooth-muscle fibers are often noted. Rarely, it has been associated with a florid mesenchymal proliferation mimicking angiomyofibroblastoma or aggressive angiomyxoma.
NOEL WEIDNER , ... MICHAEL PETERSON , in Modern Surgical Pathology (Second Edition) , 2009
Tubal prolapse can occur following hysterectomy, after the fallopian tubes are fixed at the vaginal apex. Clinically, this can have the appearance of a small nodule at the vaginal apex and may mimic granulation tissue or even recurrent carcinoma. Microscopic examination reveals tubal epithelium that is in continuity with overlying squamous mucosa of the vagina, frequently with a brisk inflammatory response. The tubal epithelium may become hyperplastic and atypical and may even simulate an in situ papillary serous carcinoma. Recognition of the ciliated tubal epithelium is critical in diagnosing this entity ( Fig. 38-12 ).
JUAN C. FELIX , ... CHARLES A. AMEZCUA , in Modern Surgical Pathology (Second Edition) , 2009
Prolapsed fallopian tubes occur after vaginal or, less commonly, abdominal hysterectomies and manifest as painful, hyperemic, nodular masses at the vaginal cuff. Microscopically, they may display papillary architecture or features reminiscent of chronic salpingitis with blunted and fused plicae and pseudoglands. Ciliated cells may be readily evident or difficult to find. Usually, one also notes congestion and inflammation that may be accompanied by reactive nuclear atypia. The differential diagnosis includes endometriosis and adenocarcinoma. The absence of endometrial stroma and the presence of tubal architecture and epithelial constituents distinguish a prolapsed fallopian tube from endometriosis. The absence of cellular proliferation lacking stromal support, prominent mitotic activity with atypical mitoses, and moderate to severe nuclear atypia assist in excluding the diagnosis of serous or clear cell carcinoma.
On rare occasions, postoperative spindle cell nodules may arise in the vagina. Proppe and associates 265 described four cases of vaginal lesions occurring up to 10 weeks after a surgical procedure. The lesions ranged up to 4 cm in greatest dimension and often had ulcerated surfaces. Microscopically, postoperative spindle cell nodules are characterized by a haphazard proliferation of spindle cells thrown into intersecting fascicles, focal to numerous mitoses, and a chronic inflammatory cell background infiltrate. Reflective of their infiltrative nature, several of the lesions reported by Proppe and associates were incompletely removed. None of the patients with vaginal lesions had additional treatment or recurrences after removal.
Antonio Lopez-Beltran , Robert H. Young , in Urologic Surgical Pathology (Fourth Edition) , 2020
Polyps composed of prostatic epithelium resembling those more commonly seen in the prostatic urethra rarely occur in the bladder. 369-373 Reported cases have occurred in men from 20 to 67 years of age, and hematuria has been the most consistent symptom. About two-thirds of the lesions arise in the trigone, and the architecture varies from papillary to polypoid. The stroma contains prostatic glands, and the surface is covered by columnar epithelium or urothelium ( Fig. 5.76 ). Immunohistochemistry for PSA, prostate-specific membrane antigen (PSMA), and PAP confirms the prostatic character of the glands and columnar cells. Prostatic hyperplasia may also expand into the bladder lumen as a polypoid mass. 374-376
Fibroepithelial polyps of the bladder are rare and resemble their more common counterpart in the ureter. 377-380 They are distinguished from polypoid cystitis by being solitary, with a more fibrous core and a paucity of inflammatory cells. Rare cases of collagen polyps (collagenoma) resulting from the accumulation of injected collagen in the bladder to control stress incontinence have been reported. 381
Hamartoma of the bladder is a rare (fewer than a dozen reported cases) polypoid mass ( Fig. 5.77 ) composed of epithelial elements resembling von Brunn nests, cystitis glandularis, or cystitis cystica distributed irregularly in a stroma that may be muscular, fibrous, or edematous. 382-386 Occasional cases have intestinal metaplasia of the glands, small tubules resembling renal tubules, or markedly cellular stroma.
More than 100 cases of primary amyloidosis of the bladder have been reported. 387-398 The lesions appear throughout adulthood and are equally common in both sexes. In most cases, the deposits are limited to the bladder, but in some the ureters and urethra have also been involved. Hematuria is almost always the presenting symptom. 399 On cystosco
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