Pelvic Floor Dysfunction Flashcards
what is a prolapse
descend of vaginal/pelvic organs through the vagina
what are the risk factors for a prolapse
obesity pelvic surgery menopause - reduced oestrogens multiple vaginal births chronic constipations smoking - chronic cough heavy lifting uterine fibroids
what are the 3 types of prolapse
anterior - cystocele
middle - apical
posterior - rectocyele
what is an anterior prolapse and how does it present
bladder protruding onto anterior vaginal wall
bulging pressure/dragging sensation
pain on urination, intercourse
difficulty inserting tampon
what is a middle prolapse and how does it present
vaginal vault prolapse
similar to anterior, dragging sensation, pain on urination
difficulty inserting tampon
pain on intercourse
what is a posterior prolapse and how does it present
front wall or rectum bulges onto back wall of vagina difficulty or pain on defaecation incomplete emptying difficulty inserting tampon dragging pressure
what is a first degree vaginal prolapse
cervix into vaginal wall
what is a second degree vaginal prolapse
cervix descends to the level of intriotus
what is a third degree vaginal prolapse
cervix descends outside the vagina
what is procidentia
cervix entirely outside the vagina - similar to 4th degree prolapse
outline conservative methods of managing a prolapse
avoid heavy lifting, stop smoking, weight loss
if signs of atrophic vaginitis give vaginal oestrogens
if a prolapse is found incidentally and asymptomatic, is treatment required
no, if no symptoms no management required
what are some of the physical methods of managing a prolapse
pelvic floor exercises if prolapse is within the vagina
pessaries
state the indications for a pessary
women unfit for surgeries
women awaiting surgeries to provide relief of symptoms
what are the surgical options for prolapse
mesh to repair vaginal vault prolapse
amputate the cervix and shorten uterosacral ligaments
supraspinous fixation
vaginal hysterectomy
