Pelvic Health Flashcards
Pelvic Organ Prolapse (POP)
What is it?
Pelvic Organ Prolapse (POP) is a condition where one or more of the pelvic organs (bladder, uterus, rectum, or small bowel) drop from their normal position and push against or into the walls of the vagina.
Pelvic Organ Prolapse (POP)
How does it occur?
It occurs when the muscles and connective tissues in the pelvic floor become weakened or stretched, causing the pelvic organs to shift downward.
This weakening can be due to various factors such as pregnancy, childbirth, aging, hormonal changes (especially after menopause), or chronic pressure on the pelvic floor (e.g., from constipation, obesity, or heavy lifting).
Pelvic Organ Prolapse (POP)
When can it occur?
It can develop gradually, often after childbirth or during menopause when the pelvic floor muscles weaken due to hormonal changes.
It is more common in women who have had vaginal deliveries, especially multiple births, but it can also occur in women who haven’t had children.
Pelvic Organ Prolapse (POP)
Who does it affect?
Pelvic organs prolapse primarily affects women, particularly those who have had children or are post-menopausal.
It can also occur in older men, though it is less common.
Pelvic Organ Prolapse (POP)
How does it present?
Symptoms can include:
A sensation of heaviness or pressure in the pelvic region.
A visible bulge or lump in the vagina.
Difficulty with urination, such as incontinence or incomplete emptying of the bladder.
Constipation or difficulty passing stool.
A feeling of vaginal or pelvic fullness, especially after standing or physical activity.
Sexual discomfort or pain during intercourse.
Pelvic Organ Prolapse (POP)
How is it treated?
Conservative treatments:
Pelvic floor exercises (Kegel exercises): Strengthening the pelvic floor muscles can provide support to the prolapsed organs.
Pessaries: A device inserted into the vagina to support the pelvic organs.
Lifestyle modifications: Weight management, avoiding heavy lifting, and managing constipation.
Physical therapy: A specialized pelvic floor physical therapist can work with the patient on exercises and techniques to improve pelvic floor strength.
Surgical treatments: If conservative treatments are ineffective, surgery may be required to repair the prolapse or provide further support to the pelvic organs.
Explaining an Internal Pelvic Floor Assessment
Explanation to the Patient:
“An internal pelvic floor assessment is a physical exam that allows us to evaluate the muscles and tissues of the pelvic floor.
For this assessment, you’ll be asked to lie down or position yourself in a way that makes it easiest for us to examine the pelvic area. I will insert one or two gloved fingers into the vaginal canal or, in some cases, the rectum.
The exam helps assess the strength, tone, and coordination of the pelvic floor muscles. During the exam, I’ll ask you to contract and relax your pelvic floor muscles as we evaluate their function.
It’s important to note that the procedure is usually well-tolerated, though you might feel some pressure or mild discomfort. If at any point you feel uncomfortable, please let me know, and we can stop or adjust the examination.
This assessment will give us valuable information on the condition of your pelvic floor and help guide treatment options.”
Pelvic Health
Subjective Questioning for Pelvic Floor Dysfunction
Explanation to the Patient:
When asking about pelvic floor dysfunction, it’s important to gather information regarding your symptoms and lifestyle. Here’s an example of how to approach subjective questioning:
Urinary Symptoms:
“Do you experience any leakage of urine, such as when you cough, sneeze, or laugh?”
“Do you ever feel a sudden, uncontrollable urge to urinate?”
“Do you feel like you’re unable to completely empty your bladder?”
Bowel Symptoms:
“Do you have difficulty passing stool or experience constipation?”
“Do you ever feel like something is bulging or falling out of your vagina when you have a bowel movement?”
“Do you ever experience a feeling of incomplete emptying after using the bathroom?”
Pelvic Pressure or Heaviness:
“Do you ever feel a sensation of heaviness or pressure in your pelvic area?”
“Is there any visible bulging or protrusion from the vagina?”
Sexual Symptoms:
“Do you experience any discomfort or pain during sexual intercourse?”
“Has the sensation in your vagina changed since the onset of these symptoms?”
Medical and Obstetric History:
“Have you had any pregnancies or vaginal deliveries?”
“Do you have any history of heavy lifting or chronic constipation?”
“Have you experienced any significant weight changes recently?”
Quality of Life:
“How have these symptoms affected your daily life or activities?”
“Do you feel self-conscious about your symptoms in social situations?”
Past Treatments or Interventions:
“Have you tried any treatments for these symptoms, such as pelvic floor exercises, physical therapy, or medications?”
“If so, what kind of treatments have been most effective, and what hasn’t worked for you?”
Urinary Incontinence definition
Urinary incontinence refers to the involuntary loss of urine. It can occur in various forms, each with different causes, presentations, and treatments.
Stress Incontinence
What is it?
Stress incontinence is the involuntary leakage of urine when there is pressure or stress on the bladder, such as during coughing, sneezing, laughing, or physical activity.
Stress Incontinence
How does it occur?
This occurs when the pelvic floor muscles or the sphincter that controls urine flow becomes weakened or damaged, making it difficult to prevent urine leakage under pressure.
Stress Incontinence
When can it occur
It can occur during physical activities that increase abdominal pressure, such as lifting, exercising, or sudden movements.
Stress Incontinence
Who does it affect?
It often affects women, especially after childbirth, menopause, or pelvic surgery, but it can also occur in men, particularly after prostate surgery.
Stress Incontinence
How does it present?
Leaking small amounts of urine during activities like sneezing, coughing, or laughing.
Stress Incontinence
How is it treated?
Treatment may include pelvic floor exercises (Kegel exercises), lifestyle changes (weight management, caffeine reduction), bladder training, and, in some cases, surgery or medications.
Urge Incontinence
What is it?
Urge incontinence, also called overactive bladder (OAB), is the sudden, intense urge to urinate followed by an involuntary loss of urine before reaching the bathroom.
Urge Incontinence
How does it occur?
It occurs due to involuntary contractions of the bladder muscles, which create a strong urge to urinate.
Urge Incontinence
When can it occur?
It can occur at any time, even when the bladder isn’t full. It may also happen at night (nocturia).
Urge Incontinence
How does it present?
A strong urge to urinate followed by involuntary leakage. It can happen suddenly and without warning.
Urge Incontinence
Who does it affect?
It can affect both men and women, especially older adults. Conditions like bladder infections, neurological disorders, and diabetes can also contribute to this type of incontinence.
Urge Incontinence
How is it treated?
Treatments include anticholinergic medications (to relax the bladder), bladder training, pelvic floor exercises, and lifestyle changes (e.g., reducing fluid intake or avoiding bladder irritants like caffeine and alcohol).
Overflow Incontinence
What is it?
Overflow incontinence occurs when the bladder doesn’t empty completely, leading to frequent dribbling of urine.
Overflow Incontinence
How does it occur?
This can happen when the bladder becomes too full, and the urine overflows because the bladder muscles are too weak to expel the urine. It is often related to obstruction of urine flow or nerve damage.
Overflow Incontinence
When can it occur?
It can occur when the bladder is too full due to urinary retention, commonly seen in conditions like benign prostatic hyperplasia (BPH), spinal cord injuries, or diabetic neuropathy.
