Пролапс тазовых органов – это распространенное среди женщин доброкачественное заболевание, которое характеризуется изолированным или комбинированным опущением передней, задней стенки влагалища, матки, а также купола влагалища после гистерэктомии. Учитывая тот факт, что большая часть операций проводится среди пациенток среднего и пожилого возраста, увеличивается вероятность обнаружения ранее недиагностированных новообразований органов брюшной полости и области малого таза, что может быть связано с ограниченным объемом базовой предоперационной диагностики. Цель сообщения – привлечение внимания клиницистов к проблеме недостаточного обследования женщин при планировании лечения пролапса тазовых органов на примере нашего опыта ведения пациентки с данной патологией в сочетании с образованием малого таза.
Ключевые слова: пролапс тазовых органов, опухоль яичников, рак и пролапс тазовых органов, обследование при пролапсе
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Pelvic organ prolapse is a common benign disease among women that is characterized by an isolated or combined descent of the anterior, posterior vaginal wall, uterus, and vaginal dome after hysterectomy. Given the fact that most of the operations are performed among middle-aged and elderly patients, the probability of detecting previously undiagnosed tumor of the abdominal cavity and pelvic region increases, which may be due to the limited volume of basic preoperative diagnosis. The purpose of our report is to draw the attention of clinicians to the problem of insufficient examination of women when planning treatment of pelvic organ prolapse on the example of our experience in managing a patient with this pathology in combination with pelvic tumor.
Keywords: pelvic organ prolapse, ovarian tumor, cancer and pelvic organ prolapse, examination for prolapse
1. Abrams P, Blaivas JG, Stanton SL, Andersen JT. The standardisation of terminology of lower urinary tract function. Neurourol Urodyn. 2002; 21: 167–78. DOI: 10.1002/nau.10052
2. Nygaard I, Bradley C, Brandt D. Women’s Health Initiative. Pelvic organ prolapse in older women: prevalence and risk factors. Obstet Gynecol. 2004; 104: 489–97. DOI: 10.1097/01.AOG.0000136100.10818.d8
3. Rortveit G, Brown JS, Thom DH, et al. Symptomatic pelvic organ prolapse: prevalence and risk factors in a population-based, racially diverse cohort. Obstet Gynecol. 2007; 109 (6): 1396–403. DOI: 10.1097/01.AOG.0000263469.68106.90
4. Reproduced with permission from Barber MD: Symptoms and outcome measures of pelvic organ prolapse. Clin Obstet Gynecol. 2005; 48 (3): 648–61. DOI: 10.1097/01.grf.0000170424.11993.73
5. Wu JM, Matthews CA, Conover MM, et al. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014; 123 (6): 1201. DOI: 10.1097/AOG.0000000000000286
6. Kato K, Suzuki S, Kawanishi H, et al. Abdominal mass and ascites as risk factors of pelvic organ prolapse. Jap J Urol. 2018; 109 (2): 96–101. DOI: 10.5980/jpnjurol.109.96
7. Yin H, Mittal K. Incidental Findings in Uterine Prolapse Specimen: Frequency and Implications. Int J Gynecol Pathol. 2004; 23 (1): 26–8. DOI: 10.1097/01.pgp.0000101142.79462.be
8. Elkattah R, Brooks A, Huffaker RK. Gynecologic Malignancies Post-LeFort Colpocleisis. Case Rep Obstet Gynecol. 2014; 2014: 1–5.
DOI: 10.1155/2014/846745
9. Dick-Biascoechea MA, Roque DM, Schwartz PE. Appearances can be deceiving: ovarian mass presents as vaginal prolapse. Am J Obstet Gynecol. 2014. DOI: 10.1016/j.ajog.2014.05.006
10. Cui N, Zormpa M, Lazarou G. A case of a large rectovaginal mass presenting as posterior vaginal wall prolapse. Int Urogynecol J. 2011; 22 (9): 1185–8.
DOI: 10.1007/s00192-011-1385-4
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1. Abrams P, Blaivas JG, Stanton SL, Andersen JT. The standardisation of terminology of lower urinary tract function. Neurourol Urodyn. 2002; 21: 167–78. DOI: 10.1002/nau.10052
2. Nygaard I, Bradley C, Brandt D. Women’s Health Initiative. Pelvic organ prolapse in older women: prevalence and risk factors. Obstet Gynecol. 2004; 104: 489–97. DOI: 10.1097/01.AOG.0000136100.10818.d8
3. Rortveit G, Brown JS, Thom DH, et al. Symptomatic pelvic organ prolapse: prevalence and risk factors in a population-based, racially diverse cohort. Obstet Gynecol. 2007; 109 (6): 1396–403. DOI: 10.1097/01.AOG.0000263469.68106.90
4. Reproduced with permission from Barber MD: Symptoms and outcome measures of pelvic organ prolapse. Clin Obstet Gynecol. 2005; 48 (3): 648–61. DOI: 10.1097/01.grf.0000170424.11993.73
5. Wu JM, Matthews CA, Conover MM, et al. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014; 123 (6): 1201. DOI: 10.1097/AOG.0000000000000286
6. Kato K, Suzuki S, Kawanishi H, et al. Abdominal mass and ascites as risk factors of pelvic organ prolapse. Jap J Urol. 2018; 109 (2): 96–101. DOI: 10.5980/jpnjurol.109.96
7. Yin H, Mittal K. Incidental Findings in Uterine Prolapse Specimen: Frequency and Implications. Int J Gynecol Pathol. 2004; 23 (1): 26–8. DOI: 10.1097/01.pgp.0000101142.79462.be
8. Elkattah R, Brooks A, Huffaker RK. Gynecologic Malignancies Post-LeFort Colpocleisis. Case Rep Obstet Gynecol. 2014; 2014: 1–5.
DOI: 10.1155/2014/846745
9. Dick-Biascoechea MA, Roque DM, Schwartz PE. Appearances can be deceiving: ovarian mass presents as vaginal prolapse. Am J Obstet Gynecol. 2014. DOI: 10.1016/j.ajog.2014.05.006
10. Cui N, Zormpa M, Lazarou G. A case of a large rectovaginal mass presenting as posterior vaginal wall prolapse. Int Urogynecol J. 2011; 22 (9): 1185–8.
DOI: 10.1007/s00192-011-1385-4
1 ФГБОУ ВО «Санкт-Петербургский государственный университет», Санкт-Петербург, Россия;
2 ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова» Минздрава России
*baybooz@yandex.ru
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Dmitrii V. Baibuz*1, Oleg L. Molchanov2, Zhanna V. Glushchenko1, Yanina A. Lebedeva1, Sergei V. Utkin1, Artem A. Kravtsov2, Rustam A. Shakhaliev2, Polina D. Baibuz2
1 Saint Petersburg State University, Saint Petersburg, Russia;
2 Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
*baybooz@yandex.ru