Pelvic Organ Prolapse Flashcards Preview

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Flashcards in Pelvic Organ Prolapse Deck (13):
1

what are the three distinct layers of the pelvic floor?

> pelvic diaphragm (striated muscle)
> endopelvic fascia (network of fibro-muscular connective tissue)
> urogenital diaphragm (superficial and deep transverse perineal muscles with fascial coverings)

2

what fascia make up the pelvic floor?

> uterosacral ligaments
> pubocervical fascia
> rectovaginal fascia

3

what muscle does the uterosacral fascia cover?

the piriformis

4

what fascia provides main support for the abdominal wall?

pubocervical fascia

5

what are the risk factors for pelvic organ prolapse?

> pregnancy and childbirth
- forceps delivery
- large baby
- prolonged second stage
> advancing age
> obesity
> previous pelvic surgeries (continence procedures)
> quality of the connective tissue
> heavy lifting
> constipation
> exercise

6

what different classifications are there for pelvic wall prolapse?

> posterior wall prolapse
> anterior wall prolapse (bladder or urethra)
> atypical prolapse (upper wall of vagina)

7

what vaginal symptoms can prolapse cause?

> sensation of bulge (seeing protrusion)
> pressure
> heaviness
> difficulty inserting tampon

8

what urinary symptoms may prolapse cause?

> urgency
> incontinence
> frequency
> hesitancy
> feeling of incomplete voiding
> manual reduction of prolapse to void (splinting)

9

what bowel symptoms may prolapse cause?

> incontinence
> urgency
> feeling of incomplete emptying
> splinting to defecate
> digital evacuation to complete
> straining

10

what objective grading scores are there in pelvic organ prolapse?

> Braden walker halfway grading
> POPQ score

11

what investigations can you carry out in pelvic organ prolapse?

> USS/MRI (identify fascial defects)
> urodynamics
> IVU/ renal USS (exclude uretic obstruction)

12

how can pelvic organ prolapse be prevented?

> avoid constipation
> manage chronic chest pathology
> smaller family size
> improve antenatal and intrapartum care (pelvic floor training exercises)

13

what management options are there for pelvic organ prolapse?

> silicone pessaries
> surgery aiming to relieve symptoms, restore bowel and bladder function and maintain vaginal capacity for sex