Middle and Anterior Pelvic Compartment: Issues for the Colorectal Surgeon

Danielle Patterson, Susan L. Gearhart, Elisa Birnbaum
Middle and Anterior Pelvic Compartment: Issues for the Colorectal Surgeon is a topic covered in the ASCRS Textbook of Colon and Rectal Surgery.

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Key Concepts

  • When considering pelvic organ prolapse, the pelvis is divided into anterior, middle, and posterior compartments. The anterior and middle compartments are typically more susceptible to pelvic organ prolapse.
  • When considering surgical intervention, looking at the pelvis as a whole and considering all compartments is desired. Therefore a multidisciplinary approach offers the chance to coordinate testing and plan treatment.
  • Urogynecologists use a designation called the Pelvic Organ Prolapse Quantification (POP-Q) exam to objectively describe and stage middle compartment prolapse.
  • From the gynecology, urogynecology, or urology standpoint, addressing the middle and anterior compartments can be performed via transvaginal route when indicated. For posterior compartment surgeons, this may be combined with a perineal approach to rectal prolapse.
  • An abdominal approach, either open, laparoscopic, or robotic, can combine surgeons with technical expertise from all three compartments and allow addressing all prolapse issues at the same operation.

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Key Concepts

  • When considering pelvic organ prolapse, the pelvis is divided into anterior, middle, and posterior compartments. The anterior and middle compartments are typically more susceptible to pelvic organ prolapse.
  • When considering surgical intervention, looking at the pelvis as a whole and considering all compartments is desired. Therefore a multidisciplinary approach offers the chance to coordinate testing and plan treatment.
  • Urogynecologists use a designation called the Pelvic Organ Prolapse Quantification (POP-Q) exam to objectively describe and stage middle compartment prolapse.
  • From the gynecology, urogynecology, or urology standpoint, addressing the middle and anterior compartments can be performed via transvaginal route when indicated. For posterior compartment surgeons, this may be combined with a perineal approach to rectal prolapse.
  • An abdominal approach, either open, laparoscopic, or robotic, can combine surgeons with technical expertise from all three compartments and allow addressing all prolapse issues at the same operation.

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Last updated: January 26, 2022