Prolapse Flashcards Preview

A1. Women's Health > Prolapse > Flashcards

Flashcards in Prolapse Deck (15):
1

What is the definition of a pelvic organ prolapse (POP)?

Protrusion of pelvic structures into vaginal canal or through introitus (opening of vagina)

2

What percentage of parous women will have some POP? What percentage will be symptomatic?

50% of parous women get POP, 10-20% will be symptomatic

3

How many layers of support are there for pelvic organs?

3 layers

4

Name 4 types of POP and what organs are affected in each prolapse

Anterior vaginal wall descent - cystocoele (bladder prolapse)
Apical descent - uterine/vault prolapse (uterus affected) +/- enterocoele (POD outpouches containing small or large bowel)
Posterior vaginal wall descent - rectocoele (rectum)
Procidentia - complete prolapse of uterus beyond hymen

5

Name 5 risk factors for developing POP

Parity/vaginal delivery
Age
Menopause
Previous Sx for POP or hysterectomy
Congenital defects (connective tissue disease, collagen defects, spina bifida)
Lifestyle (lifting, high impact activities)
Chronic disease - cough, constipation, diabetes
Obesity
Smoking

6

What is the recurrence rate for POP after Sx? What location does the recurrent POP usually occur in relative to the first POP?

10-30%, often at site opposite original one (surgery pulls too hard in the other direction)

7

Name 4 potential symptoms of someone with POP

Protruding bulge from vagina
Pelvic or back pain after prolonged standing
Ulceration, bleeding from prolapsed vaginal skin
Problems with urinating or defecating (either obstruction or incontinence)

8

What position is useful for doing a speculum examination for POP?

Left lateral position (Sims speculum examination)

9

What is the name of the most widely used scale for assessing POP on examination?

POP-Q scale

10

How do you tell the difference between a rectocoele and enterocoele on examination?

Can see waves of peristalsis in enterocoele
Can see finger going up prolapse of rectocoele on DRE

11

Name 3 complications of a POP

Bleeding
Infection
Incontinence
Obstruction
Ischaemia and necrosis

12

What are the 3 main approaches to treatment of a POP?

No treatment (watch and wait)
Conservative treatment
Surgical treatment

13

Name 4 interventions for conservative treatment of a POP

Pelvic floor exercises/physio
Oestrogen replacement
Lifestyle changes (weight loss, smoking cessation)
Pessary

14

How does a pessary work? Name 2 side effects

Acts as a supporting device to restore pelvic organ to normal position.

SE - UTI/vaginal infections, vaginal erosions or discharge, bleeding

15

What are the 3 main approaches for surgery of a POP?

Vaginal
Abdominal
Laparoscopic