Pelvic Organ Prolapse Flashcards
What is pelvic organ prolapse
Refers to the descent of the pelvic organs into the vagina
Cause of pelvic organ prolapse
Weakness and lengthening of the ligaments and muscles surrounding the uterus, rectum and bladder
What is a uterine prolapse
Uterus descends into vagina
What is a vault prolapse
Top of the vagina descends into the vagina - women who no longer have uterus
What is a rectocele
Posterior vaginal wall defect - rectum prolapses into the vagina
What is a rectocele associated with
Constipation, faecal loading, urinary retention and palpable lump in vagina
What is a cystocele
Anterior vaginal wall defect - bladder prolapses backwards into the vagina
What is a urethrocele
Prolapse of urethra into vagina
What is a cystourethrocele
Prolapse of bladder and uterus
Risk factors for pelvic organ prolapse
Weak and stretched muscles and ligaments, multiple vaginal deliveries, advanced age and postmenopausal state, instrumental or traumatic delivery, obesity, smoking, chronic respiratory disease or chronic constipation, hysterectomies
Symptoms of pelvic organ prolapse
Something coming down in the vagina, dragging or heavy sensation in the pelvis, urinary symptoms such as incontinence, urgency, frequency, weak strea, and retention.
Bowel symptoms, sexual dysfunction, recurrent UTIs, backache
Diagnosis of pelvic organ prolapse
Vaginal exam
Dorsal or left lateral position
Patients asked to cough
Exclude pelvic mass or rectal mass
Pelvic floor muscle contraction assessed
Grading system for pelvic organ prolapse
POPQ score used which grades 0-4 base on position to hymen plane
What is uterine procidentia
Prolapse extending beyond the introitus
Management of grade 1 prolapse
Watch and wait, pelvic physiotherapy, weight loss, lifestyle changes, treatment related symptoms, vaginal oestrogen cream
