Contents

## **Preface XI**


Preface

their lifetime.

on the subject.

considering effects of posture and gravity.

mers in biomedical applications.

Pelvic floor disorders (PFDs), which include urinary and fecal incontinence (FI) and pelvic organ prolapse (POP), are highly prevalent conditions in women. In the United States alone, this affects almost 25% of women. These disorders often affect women's daily life activities, their sexual function, their ability to exercise, and their social and psychological life. In addi‐ tion to these, the economic costs for individuals and the society can be astronomical. Conser‐ vative management is initially offered, but often enough patients have to be operated upon. In the western countries, for example, 11–21% of women undergo surgery for pelvic organ prolapse, and almost 5–10% of women who have recurrence need a second surgery during

This book *Pelvic Floor Disorders* includes chapters on pathophysiology of pelvic organ pro‐ lapse (POP), its treatment by the use of a new synthetic material, treatment for recurrent POP, and diagnostic urogynecology radiology suggesting the use of MRI to diagnose POP

The pathophysiology of pelvic floor disorders (PFDs) is less well understood because it in‐ cludes both anterior and posterior pelvic compartment disorders. The chapter covers both anatomy and pathophysiology of urinary and fecal incontinence and POP including updates

Pelvic organ prolapse is usually a clinical diagnosis. There have been many systems to grade and stage the POP, and yet the diagnosis varies among the experts due to the effects of grav‐ ity and posture in which the patients are examined. If it presents with complicated symp‐ toms of posterior compartment defects, then further evaluation is required. MRI is performed in the supine position regardless of the effect of posture and gravity on POP. A full chapter is dedicated to explain in detail the use of a new protocol and advanced techni‐

The use of mesh in vaginal surgery for pelvic floor disorders is very debatable. In the last few years, many of the mesh-driven surgical kits have been removed from the market, and surgeons are facing a new challenge to treat recurrent cases of both POP and stress urinary incontinence (SUI). The problems of currently used material polypropylene and designing the ideal material suggested a biodegradable material, poly-L-lactic acid (PLA). The fourth chapter describes a polymer of lactic acid, which is among the most commonly used poly‐

The last chapter covers the biggest challenge of treating the recurrent cases of POP. Surgical techniques of suspending the vaginal vault with autologous tissue and synthetic mesh are

que to evaluate the changes of POP in different positions using open MRI (MRO).
