Pelvic Organ Prolapse Flashcards
1
Q
What are the parts of the pelvic floor?
A
- Endopelvic fascia
- Pelvic Diaphragm
- Urogenital Diaphragm
2
Q
What structures make up the endopelvic fascia?
A
- Uterosacral ligament
- Pubocervical fascia
- Rectovaginal fascia
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
4
Q
Traditionally how do we classify POP?
A
- Urethrocele
- Cystocele
- Uterovaginal prolapse
- Enterocele
- Rectocele
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
6
Q
How can you score POP?
A
POPQ score is gold standard
Gives a staging from 0-6
7
Q
How can you investigate POP?
A
- Urodynamics (for UI)
- IVU/Renal US (for ureteric obstruction)
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
9
Q
How can we treat POP?
A
- Pelvic Floor muscle Training (PFMT)
- Pessaries
- Surgery
