Master Class

Fad or Future?


As credited to the Ebers papyrus, prolapse was first described in 1500 B.C. Hippocrates described several methods in the treatment of prolapse, including suspending the patient upside down. Another technique championed by Hippocrates included irrigation of the displaced uterus with wine. Once the uterus was reduced, the position was maintained with a pomegranate “pessary.”

Just after the birth of Christ, Soranus of Ephesus placed perfumes at the patient's head and foul-smelling substances near the prolapsed portion of the uterus to draw the uterus cephalad.

Needless to say, great advancements have occurred since antiquity in the treatment of pelvic organ prolapse.

Most recently, the use of nonabsorbable polypropylene mesh has become increasingly popular. The latest permutation of this technique is the use of a total pelvic floor repair kit.

I have asked Dr. Dennis P. Miller to discuss the use of total pelvic floor repair kits.

Dr. Miller currently serves as the medical director of urogynecology at Wheaton Franciscan Medical Group, Milwaukee. Since 1995, he has proctored hundreds of surgeons in urogynecologic surgery, including laparoscopic and minimally invasive vaginal approaches to incontinence and prolapse.

Currently, Dr. Miller serves on the American Urogynecologic Society Presidential Task Force on graft procedures as well as the International Urogynecologic Association's graft outcomes committee.

Enjoy reading Dr. Miller's excellent article, which is the latest addition in the Master Class in Gynecologic Surgery.

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