pelvic organ prolapse

Question 1

whats a enterocele

Answer 1

loops of intestine bulge into vagina

Question 2

presentation of pelvic organ prolapse

Answer 2

• Vaginal Symptoms (Heaviness, Dragging, Pressure)
• Urinary Symptoms (Incontinence, Recurrent UTIs, Frequency)
• Bowel Symptoms (Difficulty defecating, Incomplete emptying)
• Sexual dysfunction (Inability, Pain, Discomfort)

Question 3

risk factors of pelvic organ prolapse

Answer 3

• Parity
• Vaginal birth
• Forceps delivery
• Large baby (>4 kg)
• Age
• Obesity
• Heavy lifting
• Chronic Constipation
• Previous pelvic surgery

Question 4

types of pelvic organ prolapse

Answer 4

apical (uterovaginal)
anterior vaginal wall (cystocele, urethrocele)
posterior vaginal wall (enterocele, rectocele)

Question 5

investigation of pelvic organ prolapse

Answer 5

examination
POPQ score (gold standard)
baden walker halfway grading

US or MRI
urodynamics
Intravenous urogram or renal US if suspicious of ureteric obrustiction

Question 6

management of POP

Answer 6

pelvic floor muscle training
usage of vaginal oestrogen (protects vaginal and bladder wall from irritation)
usage of vaginal pessaries (with optimal fitting and teaching to avoid problems)

• Repair operations (anterior or posterior colporrhaphy)
• Colpo-vaginal suspension
• Hysterectomy (vaginal or abdominal)