Lecture 4: Pelvic Relaxation and Incontinence Flashcards
What is another name fo when the bladder prolapses into the vagina?
Anterior vaginal prolapse (aka Cystocele)
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What is a pathognomonic sign that a patient has a lower posterior vaginal prolapse (rectocele)?
Pt has to “splint” to have a bowel movement
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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?
Apical vaginal/uterine prolapse
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What type of pelvic floor prolapse is commonly seen post-hysterectomy?
Vaginal vault prolapse
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What ar 4 treatment options for an anterior vaginal prolapse (cystocele)?
- 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)
What are 3 treatment options for a uterine prolapse?
- Pessary
- Hysterectomy
- Colpocleisis
What are some ways to diagnose stress incontinence?
- Physical exam
- Q tip test –> tests for ↑ mobility of urethra
- Urodynamics
- Postvoid residual (<50 mL is normal)
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List 4 treatment options for stress incontinence?
- Topical estrogen
- Pelvic floor PT/kegals
- Pessary
- Surgery –> suburethral sling (transvaginal tape or transobturator tape for vaginal approach)
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What is the best treatment option for patient with a rectocele?
Surgery
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What type of bladder incontinence is caused by detrusor m. hyperactivity?
Urge incontinence