Female Flashcards
A Gartner’s duct cyst is a vestigial remnant of the:
Mesonephric duct
How is stage of prolapse determined?
By most distal compartment
POP Q point of reference
Plane of hymen is 0
Above hymen is NEGATIVE
Below hymen is POSITIVE
What is Bp/Ba in POPQ?
Dynamic, most distal position of vaginal wall
Is -3 if no prolapse
What is Aa?
Vesicourethral junction
What is point D?
Posterior fornix/pouch of Douglas
Level of uterosacral ligament attachment
define genital hiatus
middle of urethral meatus to posterior hymen
define perineal body
posterior margin of genital hiatus to midanal opening
what is point C?
most distal edge of cervix or leading edge of vaginal cuff post hysterectomy
define stages of prolapse
Stage 1 - leading edge is < -1
Stage 2 leading edge -1 to +1
Stage 3 leading edge is > +1 to 2cm less than vag length
Stage 4 leading edge all the way out within 2cm of vaginal length
define Ba
between -3 and +TVL
what surgical options are there for apical prolapse?
transvaginal: sacrospinous ligament suspension, uterosacral ligament suspension
transabdominal: abdominal sacrocolpopexy
What is a caruncle?
how does it present?
how do you treat?
outpouching of urethra, 6 o’clock position, can have vaginal bleeding, tx with vaginal estrogen
What do you do if ureterovesical fistula?
Stent, consider hysterectomy. Will need transperitoneal repair
What are the best options for stress incontinence with fixed urethra or ISD?
Autologous sling > Retropubic midurethral sling > bulking agent
