Conservative Management of Pelvic Organ Prolapse: Indian Contribution

Gillian A. Ryan¹ · Nikhil C. Purandare² · Simran A. Ganeriwal³ · Chittaranjan N. Purandare^4,5

Dr Gillian A Ryan MB BCh BAO MRCPI MRCOG MD is a graduate from University College Dublin, Ireland. She has completed an MD through UCD. She is currently the Maternal and Fetal Medicine RCOG Subspecialty Fellow in the National Maternity Hospital Dublin. Dr Nikhil Purandare is a Consultant Obstetrician and Gynaecologist and Fertility sub specialist at University College Hospital Galway. He is Hon. Senior Lecturer in the department of Obstetrics and Gynaecology at the National University of Ireland. He is clinical director at Fertility and Fetal Health, Galway. Dr Simran Ganeriwal MB BCh BAO (Hons) Graduate of the Royal College of Surgeons Ireland 2020. She is due to begin residency in the USA in July 2021. Professor Chittaranjan N Purandare MD FICOG FRCOG: Emeritus Dean Indian College of Obstetrics and Gynecology, India; Past President FIGO.

gillian.ryan@nmh.ie

1 Department of Obstetrics and Gynecology, The National Maternity Hospital, Holles St, Dublin 2, Ireland

2 Department of Obstetrics and Gynecology, National University of Ireland Galway, Galway University Hospital, Galway, Ireland

3 School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland

4 Indian College of Obstetrics and Gynecology, Mumbai, India

5 FIGO, Mumbai, India

Dr Gillian A. Ryan MB BCh BAO MRCPI MRCOG MD is a graduate of medicine from University College Dublin. She is currently the Maternal and Fetal Medicine RCOG Subspecialty Fellow in the National Maternity Hospital, Dublin. She has a special interest in education and training and is involved in the Royal College of Physicians Ireland

Abstract

Pelvic organ prolapse (POP) is a very common condition which can greatly impact a woman’s quality of life. Treatment options are individualized and typically involve a combination of physiotherapy, pessary insertion and surgical treatments. It is well known that nulliparous prolapse in India constitutes 1.5–2% of genital prolapse, while the incidence is even higher (5–8%) for young women who have delivered one or two children, thus making it one of the highest rates in the world. This has necessitated the development of numerous conservative surgical treatment options for POP, which allows women to retain their sexual and reproductive function and therefore allows for subsequent pregnancies. With the controversy surrounding the use of mesh, a variety of surgical treatment options should be considered. Such alternative treatments include the use of surgical sling procedures, which have been used widely in Indian practice for the treatment of POP for over 60 years. This review outlines some of the well-established conservative treatment options for POP. It also highlights the unique contribution of Indian Obstetricians in the development of these conservative surgical treatment options, from prominent Indian Gynecologists including Dr VN Shirodkar, Dr BN Purandare, VN Purandare, RP Soonawala, Brigadier SD Khanna and Dr RM Nadkarni.

Keywords : Pelvic organ prolapse , Conservative management of pelvic organ prolapse , Conservative surgical procedures for pelvic organ prolapse