, - VagGna achterwandprolaps = rectocèle (dGkke darm verzakkGng)
- MGddelste compartment: Descensus uterG (baarmoederverzakkGng), VagGnatop prolaps en
Enterocèle (dunne darm verzakkGng): typGsch loze aandrang
Symptomen verzanning:
- Balgevoel
- Cystocèle: moeGte met uGtplassen, soms dGgGtale ondersteunGng nodGg
o ResGdugevoel (blaasontstekGngen)
o UrgeGncontnente
o Geen stressGncontnente, door knGk Gn urethra
- Rectocèle: Gncomplete ledGgGng bGj defecate
o Soms ook dGgGtale ondersteunGng nodGg (met handen terugdrukken)e.
Oorzanen:
- Zwangerschap en bevallGng of menopauze
- Verhoogde Gntra-abdomGnale druk, RecGdGef of Aangeboren afwGjkGngen
Diagnosten:
POP-Q systeem
- Vaste punten: GH (genGtale hGatus) en PB (perGneaal body), TVL (totale vagGnale lengte)
- Ba en Bp zGten normalGter -3cm boven hymenaal rGnge.
- StadGum 0: Geen prolaps aanwezGge.
- StadGum I: Het meest verzakte punt bevGnd zGch >1 cm voor hymenaal rGnge.
- StadGum II: Het meest verzakte punt bevGnd zGch tussen 1 cm voor en 1 cm voorbGj de
hymenaal rGnge.
- StadGum III: Het meest verzakte punt Gs mGnGmaal 1cm voorbGj hymenaal rGng, maar er Gs geen
complete vagGnale eversGee.
- StadGum IV: Complete verzakkGng van totale lengte van genGtalGae.
Behandeling: alleen bGj klachten!
- BekkenfysGotherapGe
- PessarGumrGngen
- Operatef (nGet bGj kGnderwens)
o KlassGek: Voor- en achterwandplastek of VUE / SSF (sacrospGnale feate)
o Mesh-behandelGng: bGj recGdGeven (erosGekans 10%)
AbdomGnaal (sacrocolpopeeGe) of VagGnaal
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