Pelvic Organ Prolapse Flashcards
What is Level I of the endopelvic support comprised of?
Utero-sacral ligaments, cardinal ligaments
What is Level II of the endopelvic support comprised of?
Pubocervial/rectovaginal fascia
What is Level III of the endopelvic support comprised of?
Urogenital diaphragm
Perineal body
What are the risk factors for pelvic organ prolapse?
Pregnancy/vaginal delivery Age Obesity Previous pelvic surgery Hormone issue Weakened connective tissue Constipation Heavy lifting Exercise
What is a utherocoele?
Urethral prolapse. Lower anterior vaginal wall weakened.
What is a cystocoele?
Bladder prolapse. Upper anterior vaginal wall weakened.
What is uterovaginal prolapse?
Prolapse of the uterus, cervix and upper vagina.
What is a enterocoele?
Small bowel prolapse. Upper posterior vaginal wall weakened.
What is a rectocoele?
Rectal prolapse. Lower posterior vaginal wall weakened.
What are the vaginal symptoms of POP?
Feeling/seeing a lump/bulge
Pressure
Heaviness
Difficulty inserting tampons
What are the urinary symptoms of POP?
Urinary incontinence
Frequency/urgency
Weak/prolonged urinary stream
Having to manually reduce prolapse to empty bladder
What are the bowel symptoms of POP?
Frequency/incontinence of flatus or stool
Incomplete emptying
Having to manually manipulate prolapse to empty bowels
What is the investigation for POP?
Bimanual or speculum examination
USS/MRI
Urodynamic studies
IVU or Renal imaging
What is the prevention for POP?
Avoid constipation
Smaller family size
More education - e.g. pelvic floor exercises
What is the treatment of POP?
Pelvic floor exercises - no role in advanced disease
Education - perinometer, biofeedback, vaginal cones, electric stimulation
Pessary - silicone, just as effective as surgery
Surgery - relieve symptoms and maintain function
