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Flashcards in FPMRS Deck (11)
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1

Level I support

Support at the vaginal apex where the cardinal–uterosacral ligament complex is attached to the pubocervical and rectovaginal fascial rings and suspends the apex of the vagina

2

Level II support

Midvaginal lateral support where the pubocervical fascia is attached laterally to the arcus tendineus fasciae pelvis

3

Level III support

Support via the distal vaginal attachments to the perineal membrane ventrally and perineal body dorsally

4

Benefit in adding pessary when already doing pelvic PT

None! Next best non-surgical intervention is weight loss

5

Risks of retropubic MUS and their percentage

UTI: most common - 30%
Post-op voiding dysfunction/retention: 3-45%
Bladder perforation - 5%
Hematologic events - <3%

6

What is the next step after post-op vesicovaginal fistula is diagnosed?

Evaluate for concominant ureteral injury (12%) with CT urogram OR bilateral retrograde pyelography

7

How long to monitor post-sling retention before surgical intervention?

2-3w of self-cath with documentation of PVR. If not improving and symptomatic, needs sling lysis to prevent chronic issues like OAB and recurrent UTIs. 1-2% of post-op retention patients will need surgical intervention

8

Woman with stage II+ apical prolapse and no urinary symptoms - what is best surgery?

Abdominal sacrocolpopexy (4% recurrent prolapse vs. 15% for vaginal sacrospinous ligament suspension) WITH Burch colposuspension

9

Next step of patient with symptoms of painful bladder syndrome

1) education, self-care, stress management
2) pelvic floor PT
3) amytryptyline or pentosan polysulphate (coating)

10

UTI med with rare AE of interstitial lung disease

nitrofurantoin

11

what is noctural polyuria

More than 35% of of 24hr UOP at night