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NU314 OB > Benign Disorders of Reproductive Tract > Flashcards

Benign Disorders of Reproductive Tract Flashcards

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1
Q

Pelvic Organ Prolapse (POP)

A

the abnormal decent or herniation of the pelvic organs from their original attachment sites or normal position in the pelvis

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2
Q

Pelvic Support Disorders

A

Pelvic organ prolapse
Urinary and Fecal Incontinence
-cause significant physical and psychological morbidity

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3
Q

What causes pelvic support disorders?

A

weakening of the connective tissue and muscular support of pelvic organs due to a number of factors:

  • vaginal childbirth
  • age
  • heavy work
  • poor nutrition
  • increasing body mass
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4
Q

What are the 4 types of Pelvic Organ Prolapse?

A
  • Cystocele
  • Rectocele
  • Enterocele
  • Uterine Prolapse
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5
Q

Cystocele

A

occurs when the posterior bladder wall protrudes downward through the anterior vaginal wall

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6
Q

Rectocele

A

occurs when the rectum sags and pushes against or into the posterior vaginal wall

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7
Q

Enterocele

A

when the small intestine bulges through the posterior vaginal wall (straining)

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8
Q

Uterine prolapse

A

the uterus descends through the pelvic floor and into the vaginal canal

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9
Q

Stages of Pelvic Organ Prolapse

A

Stages 0-4

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10
Q

Stage 0

A

NO descent of pelvic structure during straining

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11
Q

Stage 1

A

prolapsed descending organ is > 1 cm above the hymenal ring

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12
Q

Stage 2

A

prolapsed organ extends 1 cm below the hymenal ring

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13
Q

Stage 3

A

prolapsed organ extends 2-3 cm below the hymenal ring

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14
Q

Stage 4

A

the vagina is completely everted or the prolapsed organ is > 3 cm below the hymenal ring

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15
Q

Risk factors for Pelvic Organ Prolapse

A
  • constant downward gravity
  • atrophy of supporting tissues b/c aging
  • childbirth trauma
  • reproductive surgery (hysterectomy)
  • family history
  • young age at first birth
  • connective tissue disorders
  • straining
  • obesity
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16
Q

Symptoms of Pelvic Organ Prolapse

A
  • feeling of dragging, a lump in the vagina, or something “coming down”
  • vaginal bulging
  • pelvic pressure
  • difficulty defecating
  • stress/urge incontinence
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17
Q

Therapeutic Management for POP

A
  • Kegel exercises
  • Hormone replacement therapy
  • Dietary and lifestyle modifications
  • Pessaries Colpexin Sphere
  • Surgery
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18
Q

Vaginal Pessaries

A

synthetic devices inserted into the vagina to provide support to the bladder and other pelvic organs as a corrective measure

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19
Q

What type of individuals would be recommended to use Pessaries rather than surgery?

A
  • Elderly clients
  • Woman who wish to have more children
  • Woman who prefer it over surgery
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20
Q

Surgical Options for POP

A
  • Anterior or posterior colporrhaphy (cystocele/rectocele)

- Vaginal Hysterectomy (uterine)

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21
Q

What to look for on physical examination for POP

A

Pelvic exam for any obvious protrusions and bladder function

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22
Q

Diagnostic tests for POP

A

urinalysis, ultrasound, urine culture, postvoid urine volume

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23
Q

What are the most common types of urinary incontinence?

A

Urge, stressed, and mixed

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24
Q

Management of Urge Incontinence

A
  • Kegel exercises
  • Pessary ring
  • Pharmacotherapy-Anticholinergics
  • Surgery if all else fails
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25
Management of Stress Incontinence
- weight loss - smoking cessation - avoid constipation - Kegel exercises - Meds-Duloxetine - Estrogen replacement therapy - Pessaries, weighted vaginal cones - surgery
26
Most Common Benign Growths
``` Polyps Fibroids Cysts Fistulas Bartholin cysts ```
27
Cervical Polyps
small benign growths; frequently result from infection | -grayish white
28
Where are Polyps most commonly found?
Cervix and uterus
29
When do cervical polyps typically appear?
After menstruation
30
What are the three types of polyps?
Cervical Polyps , Endocervical polyps and Endometrial polyps
31
Endocervical Polyps
- multiparous women age 40 to 60 | - cherry red
32
Endometrial Polyps
benign tumors or localized over growths of the endometrium | -rare in women under 20; peak in fifth decade; and decline after menopause
33
Symptoms of Polyps
Usually asymptomatic | abnormal vaginal bleeding or discharge
34
Nursing Management for Polyps
- explanation of condition - rationale for removal - follow-up care instructions
35
Uterine Fibroids
"Leimyomas" | benign tumors composed of smooth muscle and fibrous connective tissue in the uterus
36
When do Uterine fibroids experience rapid growth and when do they shrink?
Rapid growth during childbearing years due to estrogen dependency and will shrink during menopause
37
What are the three classifications of uterine fibroids?
Subserosol fibroids, Intramural fibroids, and Submucosal fibroids
38
Subserosol Fibroids
lie underneath the outermost peritoneal layer of the uterus and grow outside the uterus; attached to uterus by a stalk or peduncle
39
Intramural Fibroids
grow within the wall of the uterus and are the most common
40
Submucosal Fibroids
grow immediately below the inner uterine surface (endometrium) into the uterine cavity
41
Predisposing factors for Fibroids
- age - genetic predisposition - African American ethnicity - Hypertension - Nulliparity - Obesity
42
Medical Management for Fibroids
GnRH agonists Progestin agonists Uterine artery embolization
43
Surgical Management of Fibroids
Myomectomy Laser surgery Hysterectomy
44
Myomectomy
removing the fibroid alone; for women who still want to have children
45
Laser Surgery
destroying small fibroids with lasers
46
Hysterectomy
the surgical removal of the uterus
47
Symptoms of Fibroids
chronic pelvic pain, low back pain, anemia, bloating, constipation, infertility, dysmenorrhea, miscarriage, sciatica, dyspareunia, urinary frequency/incontinence, menorrhagia, feeling of heaviness
48
What are the 3 most common types of fistulas?
- Vesicovaginal - Urethrovaginal - Rectovaginal
49
Vesicovaginal Fistula
communication between the bladder and genital tract
50
Urethrovaginal Fistula
communication between the urethra and the vagina
51
Rectovaginal Fistula
communication between the rectum and the vagina
52
Managing small fistulas
heal without treatment
53
Managing large fistulas
will require surgical repair
54
Fistula Symptoms
urine leakage, flatus leakage, discomfort
55
Bartholin Cysts
swollen, fluid-filled, sac-like structure that results when one of the ducts of the Bartholin gland becomes blocked
56
What can happen because of a Bartholin cyst?
infection and an abscess may develop
57
Management of Bartholin Cysts
- may heal on their own - sitz baths and analgesics for discomfort - antibiotics if infected - surgery
58
Symptoms of Bartholin Cysts
- asymptomatic if small and not infected - pain with walking/sitting - unilateral edema - redness around gland - dyspareunia - abscess
59
Ovarian Cyst
fluid-filled sac that forms on the ovary
60
What are the 4 types of ovarian cysts?
- Follicular - Corpus luteum - Theca lutein - Polycystic ovarian syndrome (PCOS)
61
Polycystic Ovarian Syndrome
Most common endocrine condition of women of reproductive age - multiple inactive follicle cysts within ovary - interfere with ovarian function - multifaceted disorder
62
What is the central pathogenesis for PCOS?
hyperandrogenemia or hyperinsulinemia

NU314 OB (21 decks)

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