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Medicine ︱醫學專欄
84
最後可以根據POP-Q系統將脫垂的嚴重區分為五種分期
分期 定義
零度 無脫垂,點Aa、Ap、Ba、Bp都是-3,
第一度 脫垂的最遠端位於處女膜以內1cm
第二度 脫垂的最遠端位於處女膜內或外1cm以內
第三度 脫垂的最遠為位處女膜外>1cm,但小於tvl-2cm
第四度 下生殖道完全翻出陰道口,脫垂的最遠端至少tvl-2cm
D相當於tvl的負值,C比D短2公分
Aa:前陰道壁距離
尿道口3公分處
Ba:Aa點至陰道前穹窿
之前陰道壁最脫出處
C:子宮頸或陰道頂
Aa、Ap、Ba、Bp、C、D有正負號,正號代表臟器脫出陰道口,
負號表示臟器仍在陰道口。數字表示的是長度,以公分計。
在未有脫垂的情況下,點Aa,Ap,Ba,Bp都是-3,
D相當於tvl的負值,C比D短 2 cm。
gh:陰道開口 pb:會陰長度 tvl:陰道長度
Ap:後陰道壁距離
尿道口3公分處
Bp:Aa點至陰道後穹窿
之後陰道壁最脫出處
D:陰道後穹窿
。
85
Medicine ︱醫學專欄
Reference:
1.Genitourinary syndrome of menopause: an overview of clinical
manifestations,pathophysiology, etiology, evaluation, and
management. Am J Obstet Gynecol. 2016Dec;215(6):704-711.
2.Genitourinary syndrome of menopause in five Asian countries:
results from the Pan-Asian REVIVE survey.Climacteric. 2017
Aug;20(4):367-373.
3.Laser Therapy in the Treatment of Female Urinary Incontinence
and Genitourinary Syndrome of Menopause: An Update. BioMed
Research International 2019(6):1-9)
4.Assessment of the long-term outcome of TVT procedure for stress
urinary incontinence in a female population: results at 17 years'
follow-up. Int UrogynecolJ. 2019 Feb;30(2):265-269.
5.Prevalence of Symptomatic Pelvic Floor Disorders in US Women.
JAMA. 2008 Sep 17; 300(11): 1311–1316.
6.The standardization of terminology of female pelvic organ prolapse
and pelvic floor dysfunction. Am J ObstetGynecol1996;175:10–17
7.Individualised pelvic floor muscle training in women with pelvic
organ prolapse (POPPY): a multicentrerandomised controlled
trial.Lancet. 2014 Mar 1;383(9919):796-806.
8.An International Urogynecological Association (IUGA)/
International ContinenceSociety (ICS) joint report on the
terminology for the conservative and non-pharmacological
management of female pelvic floor dysfunction, Int. Urogynecol.
J.28 (2) (2017) 191–213.
9.The efficacy of pelvic floor muscle training for pelvic organ
prolapse: a systematic review and meta-analysis, Int. Urogynecol.
J. 27 (7) (2016) 981–992.
10.Incidence and management of graft erosion, wound granulation,
and dyspareunia
following vaginal prolapse repair with graft materials:
a systematic review. Int Urogynecol J, 2011.
11.Committee Opinion No. 694: Management of Mesh and Graft
Complications in Gynecologic Surgery. ObstetGynecol, 2017.
129(4): p. e102-e108
12.US Food and Drug Administration (2011) FDA public health
notification: update on serious complications associated with
transvaginal placement of surgical mesh in the repair of pelvic
organ prolapse and stress urinary incontinence.
86

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高雄醫師會誌106期-醫學專欄/婦產科~沈靜茹-熟女的悄悄話:停經後婦女的生殖泌尿道困擾

  • 2. 最後可以根據POP-Q系統將脫垂的嚴重區分為五種分期 分期 定義 零度 無脫垂,點Aa、Ap、Ba、Bp都是-3, 第一度 脫垂的最遠端位於處女膜以內1cm 第二度 脫垂的最遠端位於處女膜內或外1cm以內 第三度 脫垂的最遠為位處女膜外>1cm,但小於tvl-2cm 第四度 下生殖道完全翻出陰道口,脫垂的最遠端至少tvl-2cm D相當於tvl的負值,C比D短2公分 Aa:前陰道壁距離 尿道口3公分處 Ba:Aa點至陰道前穹窿 之前陰道壁最脫出處 C:子宮頸或陰道頂 Aa、Ap、Ba、Bp、C、D有正負號,正號代表臟器脫出陰道口, 負號表示臟器仍在陰道口。數字表示的是長度,以公分計。 在未有脫垂的情況下,點Aa,Ap,Ba,Bp都是-3, D相當於tvl的負值,C比D短 2 cm。 gh:陰道開口 pb:會陰長度 tvl:陰道長度 Ap:後陰道壁距離 尿道口3公分處 Bp:Aa點至陰道後穹窿 之後陰道壁最脫出處 D:陰道後穹窿 。 85
  • 3. Medicine ︱醫學專欄 Reference: 1.Genitourinary syndrome of menopause: an overview of clinical manifestations,pathophysiology, etiology, evaluation, and management. Am J Obstet Gynecol. 2016Dec;215(6):704-711. 2.Genitourinary syndrome of menopause in five Asian countries: results from the Pan-Asian REVIVE survey.Climacteric. 2017 Aug;20(4):367-373. 3.Laser Therapy in the Treatment of Female Urinary Incontinence and Genitourinary Syndrome of Menopause: An Update. BioMed Research International 2019(6):1-9) 4.Assessment of the long-term outcome of TVT procedure for stress urinary incontinence in a female population: results at 17 years' follow-up. Int UrogynecolJ. 2019 Feb;30(2):265-269. 5.Prevalence of Symptomatic Pelvic Floor Disorders in US Women. JAMA. 2008 Sep 17; 300(11): 1311–1316. 6.The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J ObstetGynecol1996;175:10–17 7.Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentrerandomised controlled trial.Lancet. 2014 Mar 1;383(9919):796-806. 8.An International Urogynecological Association (IUGA)/ International ContinenceSociety (ICS) joint report on the terminology for the conservative and non-pharmacological management of female pelvic floor dysfunction, Int. Urogynecol. J.28 (2) (2017) 191–213. 9.The efficacy of pelvic floor muscle training for pelvic organ prolapse: a systematic review and meta-analysis, Int. Urogynecol. J. 27 (7) (2016) 981–992. 10.Incidence and management of graft erosion, wound granulation, and dyspareunia following vaginal prolapse repair with graft materials: a systematic review. Int Urogynecol J, 2011. 11.Committee Opinion No. 694: Management of Mesh and Graft Complications in Gynecologic Surgery. ObstetGynecol, 2017. 129(4): p. e102-e108 12.US Food and Drug Administration (2011) FDA public health notification: update on serious complications associated with transvaginal placement of surgical mesh in the repair of pelvic organ prolapse and stress urinary incontinence. 86