title: Pelvic Organ Prolapse in Female Patients Presenting to Transitional Urology Care Clinic.
abstract: OBJECTIVE
  Patients with congenital genitourinary abnormalities are growing into adulthood and their expectations, especially in the areas of sexual function and fertility are creating unforeseen challenges for health care providers. We review the incidence and management of pelvic organ prolapse at our Transitional Urology Clinic.
  
  
  METHODS
  This study is a retrospective chart review of the presentation and treatment of patients with clinically bothersome pelvic organ prolapse seen at our tertiary Transitional Urology Clinic during 2012 to 2015.
  
  
  RESULTS
  Seven patients with a mean age of 22.8 years presented to our clinic with clinically bothersome prolapse. Four patients had myelomeningocele, 2 had sacral agenesis and 1 had bladder exstrophy. All were on self-catheterization. Three patients were sexually active and 1 had an intact uterus and desired fertility. Bothersome symptoms included vaginal bulge in 6 cases, difficult vaginal intercourse in 1 and difficult catheterization in 1. For the leading edge of Bp (anterior compartment) prolapse the median POP-Q (Pelvic Organ Prolapse Quantification System) stage was 3 (range 1 to 3), for Bp (posterior compartment) prolapse it was 1 (range 0 to 3) and for C (vaginal vault or cervical) prolapse it was 2 (range 1 to 3). Management included pessary in 1 case, hysterectomy with bilateral uterosacral ligament suspension in 4, sacrocolpopexy in 1 and observation in 1. Mean followup was 17.6 months (range 1 to 92). One of the 5 patients treated with surgical intervention had recurrence in the anterior compartment and vaginal vault.
  
  
  CONCLUSIONS
  Females with congenital genitourinary anomalies present with pelvic organ prolapse at a much younger age and a more advanced stage. There is a paucity of literature on the epidemiology, presentation and management of pelvic organ prolapse in this patient population.
authors.affiliation: Baylor College of Medicine, Houston, Texas. Electronic address: rkhavari@houstonmethodist.org.
authors.forename: Rose
authors.initials: R
authors.lastname: Khavari
authors.affiliation: Department of Urology, Houston Methodist Hospital, Houston, Texas.
authors.forename: Molly Colleen
authors.initials: MC
authors.lastname: Tokaz
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Julie N
authors.initials: JN
authors.lastname: Stewart
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Boone
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D056887:Pelvic Organ Prolapse / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D010570:Pessaries; D012008:Recurrence; D012404:Round Ligament of Uterus / Q000601:surgery; D012447:Sacrum / Q000601:surgery; D000069341:Transitional Care; D014564:Urogenital Abnormalities / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D013519:Urogenital Surgical Procedures / Q000379:methods; D055815:Young Adult
keywords: abnormalities; female; pelvic organ prolapse; reconstructive surgical procedures; tertiary healthcare