Lecture 4: Pelvic Relaxation and Incontinence Flashcards

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1
Q

What is another name fo when the bladder prolapses into the vagina?

A

Anterior vaginal prolapse (aka Cystocele)

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2
Q

What is a pathognomonic sign that a patient has a lower posterior vaginal prolapse (rectocele)?

A

Pt has to “splint” to have a bowel movement

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3
Q

A female pt complaining that is feels like “something is falling out of her vagina” and that she is “ doesn’t empy her bladder completely and only voids small amounts,” is likely suffering from what pelvic floor dysfunction?

A

Apical vaginal/uterine prolapse

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4
Q

What type of pelvic floor prolapse is commonly seen post-hysterectomy?

A

Vaginal vault prolapse

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5
Q

What ar 4 treatment options for an anterior vaginal prolapse (cystocele)?

A
  • Do nothing
  • Pelvic floor physical therapy
  • Pessary
  • Surgical correction = anterior colporrhaphy (pubocervical fascia is sutured in the midline and laterally to the arcus tendinous fascia)
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6
Q

What are 3 treatment options for a uterine prolapse?

A
  • Pessary
  • Hysterectomy
  • Colpocleisis
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7
Q

What are some ways to diagnose stress incontinence?

A
  • Physical exam
  • Q tip test –> tests for ↑ mobility of urethra
  • Urodynamics
  • Postvoid residual (<50 mL is normal)
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8
Q

List 4 treatment options for stress incontinence?

A
  • Topical estrogen
  • Pelvic floor PT/kegals
  • Pessary
  • Surgery –> suburethral sling (transvaginal tape or transobturator tape for vaginal approach)
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9
Q

What is the best treatment option for patient with a rectocele?

A

Surgery

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10
Q

What type of bladder incontinence is caused by detrusor m. hyperactivity?

A

Urge incontinence

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