Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction Y3 > Pelvic organ prolapse > Flashcards

Pelvic organ prolapse Flashcards

1
Q

What is a pelvic organ prolapse?

A

Refers to the descent of pelvic organs into the vagina.

Prolapse is the result of weakness and lengthening of the ligaments and muscles surrounding the uterus, rectum and bladder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a uterine prolapse?

A

Uterine prolapse is where the uterus itself descends into the vagina.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a vault prolapse?

A

Vault prolapse occurs in women that have had a hysterectomy, and no longer have a uterus.

The top of the vagina (the vault) descends into the vagina.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a rectocele and what is it commonly associated with?

A

Rectoceles are caused by a defect in the posterior vaginal wall, allowing the rectum to prolapse forwards into the vagina.

Rectoceles are particularly associated with constipation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What complication can occur due to rectocele?

A

Women can develop faecal loading in the part of the rectum that has prolapsed into the vagina.

Loading of faeces results in significant constipation, urinary retention (due to compression on the urethra) and a palpable lump in the vagina.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Can a rectocele be corrected?

A

Yes

Women may use their fingers to press the lump backwards, correcting the anatomical position of the rectum, and allowing them to open their bowels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Symptoms of a rectocele?

A
  • bulging
  • pressure
  • “mass”
  • difficulty in defecation
  • incomplete defecation
  • splinting vaginal wall or perineum
  • difficulty inserting tampon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 3 compartments that a prolapse can occur in?

A

Anterior

Middle or Apical

Posterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a cystocele?

A

Cystoceles are caused by a defect in the anterior vaginal wall, allowing the bladder to prolapse backwards into the vagina.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Symptoms of a cystocele?

A
  • bulging
  • pressure
  • “mass”
  • difficulty voiding
  • incomplete emptying
  • splinting vaginal wall
  • difficulty inserting tampon
  • pain with intercourse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Prolapse of urethra is called a urethrocele, what is the term for combined prolapse of the urethra and bladder?

A

Cystourethrocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is an enterocele?

A

Also known as a small bowel prolapse occurs when the small intestine (small bowel) descends into the lower pelvic cavity and pushes at the top part of the vagina, creating a bulge.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Symptoms of a vault prolapse and enterocele?

A
  • bulging
  • pressure
  • “mass”
  • difficulty voiding
  • incomplete emptying
  • splinting vaginal wall
  • difficulty inserting tampon
  • pain with intercourse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Different prolapse types and their compartments?

A

Anterior - cystocele

Middle/apical - vault (vaginal) prolapse/enterocele

Posterior - rectocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the risk factors for a pelvic organ prolapse?

A

Sex: Women are more likely than men to have pelvic organ prolapse –pregnancy, childbirth, giving birth to a large baby and menopause.

Age: As you get older, the muscles lose some of their strength.

Obesity: Being overweight increases the pressure on the pelvic floor.

Smoking: A chronic cough can cause episodes of high pressure in the abdomen or aggravate prolapse that has other causes.

Other problems: heavy lifting, constipation , COPD, hereditary causes-Family history of weakness in connective tissue ( Marfan’s Syndrome, Ehrlers -Danlos Syndrome) .

Being Hispanic, Indian or white.

Prior pelvic surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Main presenting symptoms of pelvic organ prolapse?

A

A feeling of “something coming down” in the vagina

A dragging or heavy sensation in the pelvis

Urinary symptoms, such as incontinence, urgency, frequency, weak stream and retention

Bowel symptoms, such as constipation, incontinence and urgency

Sexual dysfunction, such as pain, altered sensation and reduced enjoyment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Symptoms of pelvic organ prolapse are less bothersome in the morning and often get worse as the day progresses. True/false?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Women may notice relief of pain on straining or bearing down. True/false?

A

False

They may notice the prolapse will become worse on straining or bearing down.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When examining for pelvic organ prolapse, various positions may be attempted, including what 2 positions?

A

The dorsal and left lateral position

20
Q

What is the vaginal interiotus?

A

The vaginal opening

21
Q

How many grades of uterine prolapse (descent)?

A

4 grades (grade 1-grade 4)

22
Q

What is Grade 0 uterine prolapse?

A

Grade 0 = normal.

Above grade 1 up to grade 4 is abnormal.

23
Q

Grade 1 uterine prolapse?

A

In vagina

24
Q

Grade 2 uterine prolapse?

A

At interiotus (opening of the vagina)

25
Q

Grade 3 uterine prolapse?

A

Outside of the vagina

26
Q

Grade 4 uterine prolapse?

A

Entirely outside the vagina.

Also known as procidentia

27
Q

What are other names for a grade 4 uterine prolapse?

A

Occurs when prolapse is fully out of vagina.

Also known as procidentia or complete prolapse.

28
Q

What is the hymen of the vagina?

A

A thin piece of tissue located at the opening of the vagina.

The hymen needs to be open to allow menstrual blood and normal secretions to exit the vagina.

29
Q

What is the Baden-Walker halfway system?

A

Designed to measure the most distal portion of the prolapse site in relation to the hymen.

30
Q

Grading for the Baden-Walker halfway system?

A

Grade 0 = no prolapse
Grade 1 = Halfway to hymen
Grade 2 = To hymen
Grade 3 = Halfway past hymen
Grade 4 = Maximum descent

31
Q

What is POP-Q and how may it be carried out?

A

Pelvic organ prolapse quantification system. Typically carried out by a simple pelvic exam as part of a complete physical exam.

Speculum to examine the different parts of the vagina to determine which part of the vagina is prolapsing and to what extent.

Patient straining, 6 specific sites are evaluated, at rest 3 sites measured.

32
Q

For POP-Q, when the patient is strained 3 sites are evaluated and whilst at rest, 6 sites are measured. True/false?

A

False

At rest - 6 specific sites are evaluated

Straining - 3 sites are measured

33
Q

What is the zero point of reference in POP-Q?

A

Hymenal ring represents the “fixed” point of reference.

If a site is above the hymen, assigned a negative number.

If site prolapses below the hymen, the measurement is positive.

34
Q

If a site sits below the hymen, it is given a negative number. True/false?

A

False

If site prolapses below the hymen, the measurement is positive.

If a site is above the hymen, assigned a negative number.

35
Q

3 main management options for prolapse?

A

Conservative management

Vaginal pessary

Surgery

36
Q

Who is conservative management mainly aimed at?

A

Is appropriate for women that are able to cope with mild symptoms, do not tolerate pessaries or are not suitable for surgery.

37
Q

Examples of conservative management options?

A

Physiotherapy (pelvic floor exercises)

Weight loss

Lifestyle changes for associated stress incontinence, such as reduced caffeine intake and incontinence pads

Treatment of related symptoms, such as treating stress incontinence with anticholinergic mediations

Vaginal oestrogen cream

38
Q

What are vaginal pesseries?

A

Inserted into the vagina to provide extra support to the pelvic organs.

They can create a significant improvement in symptoms and can easily be removed and replaced if they cause any problems.

39
Q

What are the types of vaginal pesseries?

A

Ring pessaries are a ring shape, and sit around the cervix holding the uterus up

Shelf and Gellhorn pessaries consist of a flat disc with a stem, that sits below the uterus with the stem pointing downwards

Cube pessaries are a cube shape

Donut pessaries consist of a thick ring, similar to a doughnut

Hodge pessaries are almost rectangular. One side is hooked around the posterior aspect of the cervix and the other extends into the vagina.

40
Q

Roughly how often should vaginal pesseries be taken out and cleaned?

A

Around every 4 months

41
Q

What is a side-effect of using vaginal pesseries?

A

Can cause vaginal irritation and erosion over time.

42
Q

What can help to protect the vaginal wall against irritation when using pesseries?

A

Oestrogen cream

43
Q

What is the definitive option for treating pelvic organ prolapse?

A

Surgery can include vaginal hysterectomy.

44
Q

What are possible complications of pelvic organ prolapse surgery?

A
  • Pain, bleeding, infection, DVT and risk of anaesthetic
  • Damage to the bladder or bowel
  • Recurrence of the prolapse
  • Altered experience of sex
45
Q

What are mesh repairs?

A

Mesh repairs involve inserting a plastic mesh to support the pelvic organs.

46
Q

Potential complications associated with mesh repairs?

A
  • Chronic pain
  • Altered sensation
  • Dyspareunia (painful sex) for the women or her partner
  • Abnormal bleeding
  • Urinary or bowel problems

Reproduction Y3 (78 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions