Bladder disorders/Prolapse Flashcards
Prolapse grading:
POPQ
Stage 0- no prolapse
Stage 1- the most distal point in greater than 1 cm above distal to hymen
Stage 2-the most distal point is equal to or less than 1cm above or below hymen
Stage 3- the most distal point is greater than 1 cm below the Hymen protruding 3/4 length of vagina
Stage 4- complete ever soon of total vaginal length, >2 cm
Brighton hyper mobility scoring
Scoring 0-9
One point for each L and R limb
- Extension of 5th MCP > 90 deg
- oppose thumb to volatility aspect of forearm
- hyperextend elbow >10 deg
- hyperextend knee >10 deg
- hands flat to floor without knee bend (1 PT total)
Posture associated with prolapse
Increased kyphosis and lack of lordosis
Vaginal rague
Structure is the vagina that are transverse ridges formed out of the supporting tissues and epithelium in females. Healthy connective tissue appearance. Disappearance associated with dysfunction (childbirth/prolapse).
Delanceys levels of support
Level 1: superior region
Level 2: middle region
Level 3: inferior region
Delanceys Level one support structures
Cardinal ligament (mackenrodts)
Uterosacral ligament
Broad ligament
Delanceys level two support structures
Pubo-vesicular-cervical (mid level)
ATLA
ATPF
Delanceys level 3 support structures
Pubo-urethral ligaments
Vagina directly connecting to LA (laterally), urethra (anteriorly), and perineum (posteriorly)
Level 1 Delanceys defect symptoms
Back pain* (not in level 2) Hesitancy/straining Slow, start/stop stream Post-void dribble A need to lean forward or digitally elevate bladder base
Level 2 (delanceys) defect symptoms
Visceral dysfunction
Voiding difficulty or stress incontinence
Incomplete fecal evacuation or soiling
NO low back pain
Level 3 (delanceys) defect symptoms
Introital gapping
Rolling out of lower vagina
Perineal body is broader and inferior
