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Year Three - Reproductive System > Pelvic Organ Prolapse > Flashcards

Pelvic Organ Prolapse Flashcards

1
Q

What is pelvic organ prolapse?

A

It refers to the descent of pelvic organs into the vagina

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2
Q

What is the general cause of pelvic organ prolapse?

A

It occurs as the result of muscle and ligament the weakening surrounding the uterus, rectum and bladder

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3
Q

What is urethrocele prolapse?

A

A urethrocele involves prolapse of the lower anterior vaginal wall involving the urethra

This allows the urethra to descend backwards into the vagina

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4
Q

What is cystocele prolapse?

A

A cystocele involves prolapse of the upper anterior vaginal wall involving the urinary bladder

This allows the urinary bladder to descend backwards into the vagina

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5
Q

What is an enterocoele prolapse?

A

An enterocele involves prolapse of the upper posterior vaginal wall involving the small bowel

This allows the small bowel to descend forwards into the vagina

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6
Q

What is a rectocele prolapse?

A

A rectocele involves prolapse of the lower posterior vaginal wall involving the rectum

This allows the rectum to descend forwards into the vagina

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7
Q

What can occur as a result of rectocele prolapse?

A

Faecal loading in the part of the rectum that has prolapsed into the vagina

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8
Q

What is another term for uterovaginal prolapse?

A

Apical prolapse

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9
Q

What is a uterovaginal prolapse?

A

It involves descent of the uterus, cervix and upper vagina

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10
Q

What is a common subtype of uterovaginal prolapse?

A

Vault prolapse

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11
Q

What is a vault prolapse?

A

It involves descent of top of the vagina (vault) into the vagina

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12
Q

In which patients does a vault prolapse occur in?

A

Hysterectomy

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13
Q

What are the nine risk factors of pelvic organ prolapse?

A

Multiple Vaginal Deliveries

Instrumental, Prolonged or Traumatic Delivery

Pelvic Surgery

Advanced Age

Menopause

Obesity

Chronic Constipation

Chronic Respiratory Disease

High Impact Exercise

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14
Q

What are the six clinical features of pelvic organ prolapse?

A

Vaginal Protrusion Sensation

Heavy Pelvis Sensation

Sexual Dysfunction

Urinary Incontinence/Urgency/Retention

Constipation

Bowel Incontinence/Urgency

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15
Q

What investigation is used to diagnose pelvic organ prolapse?

A

Pelvic examination

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16
Q

What equipment is used during pelvic examination to aid diagnosis of pelvic organ prolapse?

A

Sim’s speculum

It can be used to support the anterior or posterior vaginal wall while the other vaginal walls are examined

17
Q

What are the two grading methods used to assess the severity of pelvic organ prolapse?

A

Pelvic Organ Prolapse Quantification (POP-Q) Score

Baden-Walker-Halfaway Grading

18
Q

In which three circumstances do we use conservative management for pelvic organ prolapse?

A

When women are experiencing mild symptoms

When patients have a POP-Q score 1/2

When patients are not suitable for surgery

19
Q

How do we conservatively manage pelvic organ prolapse?

A

It involves advising patients on how to conduct pelvic floor exercises, used to strengthen the pelvic muscles and relieve their symptoms

20
Q

How do we pharmacologically manage pelvic organ prolapse?

A

It involves the insertion of a vaginal pessary

21
Q

What are vaginal pessary?

A

They are silicone structures inserted into the vagina to provide extra support to the pelvic organs

They should be removed and cleaned, or changed periodically – every four months

22
Q

What are the five types of vaginal pessaries?

A

Ring

Gellhorn

Cube

Donut

Hodge

23
Q

What are the two side effects of vaginal pessaries? How do we relieve these?

A

Vaginal irritation

Vaginal erosion

Oestrogen cream

24
Q

In which two circumstances is surgical management used for pelvic organ prolapse?

A

When patients are are experiencing severe symptoms impacting their quality of life

When patients have a POP-Q score 3/4

25
Q

What is the definitive treatment option for pelvic organ prolapse?

A

Surgical management - usually relieving symptoms and restoring bladder/bowel function

25
Q

Describe the surgical management of pelvic organ prolapse

A

The surgery conducted is directed towards the prolapsing compartment

This means that if the prolapsing compartment is the anterior wall of the vagina, we conduct an anterior vaginal wall repair

25
Q

What are the three surgeries used to treat apical prolapse?

A

Hysterectomy

Sacrospinous fixation

Abdominal sacrocolpopexy.

26
Q

What surgery can be used to treat pelvic organ prolapse in elderly patients who are no longer interested in sexual intercourse?

A

Colpoclesisis surgery

27
Q

What is colpoclesis?

A

A procedure that involves closure of the vagina

Year Three - Reproductive System (52 decks)

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