Pelvic Organ Prolapse Flashcards

1
Q

What are the parts of the pelvic floor?

A
  • Endopelvic fascia
  • Pelvic Diaphragm
  • Urogenital Diaphragm
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2
Q

What structures make up the endopelvic fascia?

A
  • Uterosacral ligament
  • Pubocervical fascia
  • Rectovaginal fascia
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3
Q

Risk factors for POP?

A
  • Forceps delivery
  • Macrosomia
  • Prolonged 2nd stage of labour
  • Parity
  • Age
  • Obesity
  • Previous pelvic surgery incl hysterectomy and colposuspension
  • Constipation
  • Heavy lifting
  • Exercise
  • Hormonal
  • CT disease
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4
Q

Traditionally how do we classify POP?

A
  • Urethrocele
  • Cystocele
  • Uterovaginal prolapse
  • Enterocele
  • Rectocele
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5
Q

Describe the symptoms of having a POP?

A
  • Bulge/protrusion sensation
  • Bulge/protrusion visible/palpable
  • Pressure
  • HEaviness
  • Tampon insertion difficulties

Urge incontinence
Frequency, urgency, hesitancy & incomplete voiding

Needing to manually reduce the prolapse to void

Same symptoms as urinary but for bowel

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6
Q

How can you score POP?

A

POPQ score is gold standard

Gives a staging from 0-6

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7
Q

How can you investigate POP?

A
  • Urodynamics (for UI)
  • IVU/Renal US (for ureteric obstruction)
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8
Q

How do we prevent a POP?

A
  • Avoid constipation
  • Manage chest pathology e.g. COPD to avoid coughing/straining
  • Less kids
  • Pelvic floor muscle training antenatally and post-partum
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9
Q

How can we treat POP?

A
  • Pelvic Floor muscle Training (PFMT)
  • Pessaries
  • Surgery
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