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yr 3 - reproduction > Pelvic Organ Prolapse > Flashcards

Pelvic Organ Prolapse Flashcards

1
Q

What is female POP?

A

Descent of pelvic organs towards/through the vagina

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2
Q

How common is POP?

A

12-30% of multiparous women

2% of nulliparous women

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3
Q

What is the role of the pelvic floor?

A

Regulate intra-abdominal pressure

Support pelvic viscera

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4
Q

What are the layers of the pelvic floor?

A

Endo-pelvic fascia
Pelvic diaphragm
Urogenital diaphragm

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5
Q

What makes up the endopelvic fascia?

A

Fibro-muscular tissue which surrounds the visceral structure

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6
Q

What makes up the pelvic diaphragm?

A

Layer of striated muscle

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7
Q

What makes up the urogenital diaphragm?

A

Superficial + deep transverse perineal muscles with their fascia

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8
Q

How does the utero-sacral ligament break?

A

Medially around the cervix

Causes the cervix to drop

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9
Q

What is the role of the pubocervical fascia?

A

Provide main support to anterior vaginal wall

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10
Q

How does the pubocervical fascia tend to break?

A

Lateral attachments

Immediately in front of cervix

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11
Q

How does the rectovaginal fascia tend to break?

A

Centrally
Upper: Enterocele
Lower: Perineal body descent & rectocele

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12
Q

What are the risk factors for POP?

A 
Multiparity
Old age
Obesity
Forcep delivery
Big baby
Prolonged second stage
Previous pelvic surgery
Constipation
Exercise
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13
Q

What surgeries are risk factors for POP?

A

Continence procedures
Burch colposuspension
Hysterectomy

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14
Q

What are the main types of prolapse?

A 
Urethrocele
Cystocele
Uterovaginal prolapse
Enterocele 
Rectocele
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15
Q

What is urethrocele?

A

Lower anterior vaginal wall containing urethra only

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16
Q

What is cystocele?

A

Upper anterior vaginal wall involving bladder

17
Q

What is enterocele?

A

Upper posterior vaginal wall and small bowel

18
Q

What is rectocele?

A

Lower posterior vaginal wall and rectum

19
Q

What are the typical POP symptoms?

A 
Sensation of bulge/protrusion
Pressure
Heaviness
Difficulty inserting tampons
Incontinence/frequency
Weak stream 
Incontinence bowel/urgency
Straining
Digital evacuation to complete 
Splinting
20
Q

What is splinting?

A

Pressing on the perineum to complete a bowel movement

21
Q

How is POP assessed?

A

Most excluse pelvic mass
Baden-Walker-Halfawy Grading
POPQ Score (gold standard)

22
Q

Which investigations are used for POP?

A

USS/MRI - fascial weakness
Urodynamics
IVU/renal USS

23
Q

How is POP prevented?

A

Avoid constipation
Manage chest pathology
Smaller family size

24
Q

How is POP treated?

A

Physiotherapy (Pelvic floor muscle training)
Pessaries
Surgery

yr 3 - reproduction (37 decks)

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