Monday, 2-27-Pelvic relaxation and incontinence (Wootton)

Question 1

anterior vaginal prolapse is known as a __

Answer 1

cystocele

Question 2

lower posterior vaginal prolapse is known as ___

Answer 2

rectocele

Question 3

apical vaginal prolapse AKA __

Answer 3

uterine prolapse

Question 4

a sagging uterovaginal canal after hysterectomy AKA __

Answer 4

vaginal vault prolapse

Question 5

tx options for woman with anterior vaginal prolapse?

Answer 5

• do nothing
• pelvic floor PT
• pessary (those who want to avoid surgery)
• surgical correction-anterior colporrhaphy

Question 6

tx options for a uterine prolapse?

Answer 6

• pessary
• hysterectomy
• colpocleisis

Question 7

spontaneous leakage when coughing and sneezing?

Answer 7

stress incontinence

Question 8

tests to dx stress urinary incontinence?

Answer 8

• PE
• q tip test
• urodynamics
• postvoid residual (less than 50 mL is normal)

Question 9

tx options for stress urinary incontinence?

Answer 9

• topical estrogen
• pelvic floor PT/kegels
• pessary
• surgery
• suburethral sling

Question 10

clues to diagnosing a rectocele pt?

Answer 10

lots of babies
needing to splint to have a bowel movement
pressure sensation and fullness in vagina

Question 11

best tx option for a rectocele?

Answer 11

surgery is best option

Question 12

Tx for urge incontinence/overactive bladder?

Answer 12

• Behavior modification –> decrease caffeine, limit fluids after 7 pm, bladder training
• anti-spasmodics –> oxybutynin (Ditropan), tolterodine (Detrol)