Prolapse Flashcards Preview

Gynaecology > Prolapse > Flashcards

Flashcards in Prolapse Deck (11):
1

Features of cystoceles (3)

upper, anterior wall of vagina and bladder bulge out

urine in cystocele>frequency and dysuria

urethra can prolapse>cystourethrocele>stress incontinence

2

Features of rectoceles (2)

middle, posterior wall attached to rectum prolapses through weak levator ani

may have to reduce hernia w. finger in vagina to defaecate.

3

Features of eneteroceles (2)

bulge from upper posterior vaginal wall

may contain loops of bowel from pouch of douglas

4

Grading uterine prolapse

1st: cervix stays in vagina

2nd: cervix protrudes out of vagina on standing/straining

3rd: fundus lies outside vagina

5

RFs for uterine prolapse (5)

pregnancy/vaginal delivery

congenital factors e.g. EDS

chronic raised intra-abdominal pressure

menopause: oestrogen withdrawal>weakened connective tissue

iatrogenic: pelvic surgery

6

Sx of uterine prolapse (4)

dragging sensation

cystitis

urinary frequency, stress incontinence

constipation

7

Mx of mild prolapse (3)

lose weight, stop smoking, stop straining

insertion of a ring

topical oestrogen if post-menopausal

8

Mx of severe prolapse (6)

uterine prolapse:
-hysterectomy
-hysteropexy: uterus and cervix attached to sacrum via mesh

vault prolapse
-sacrocolpopexy: vaginal vault fixed to sacrum via mesh

urodynamic stress incontinence:
-TVT
-trans-obturator tape
-Burch colposuspension

9

Causes of vesico-vaginal fistulae (2)

in developing world: obstructed labour

in developed world: surgery

10

Ix for vesico-vaginal fistulae

catheter>methylene blue into bladder>speculum to see if it drains into vagina

11

Mx of vesico-vaginal fistulae

surgery