Pelvic Organ Prolapse

Question 1

Risk factors of Pelvic Organ Prolapse

Answer 1

Increased Age
Increases Parity
Obesity
Congenital Weakness to Pelvic Floor
Menopause
Previous Pelvic Surgery

Question 2

Levels of support

Answer 2

Level 1 ( Transverse Cervical Ligament, Utereosacral Ligament)

Level 2 ( Pubocervical Fascia, Rectovaginal Fascia, Levator Ani)

Level 3 ( Perineal Body)

Question 3

Clinical Presentations of POP

Answer 3

Something coming down’ or a feeling of a mass/lump in the vagina which worsens with progression of the day, and relieved by lying down

Dragging discomfort in vagina

Vaginal discharge

Urinary symptoms such as incomplete bladder emptying despite straining. The patient may digitally reduce the bulge in order to pass urine

Frequency and recurrent UTI

Hydroureters and hydronephrosis due to kinking of ureters are rare

Rectocele may present with difficulty with defecation and she may resort to splinting before moving bowels

Question 4

Indications of Pessary

Answer 4

1. Prolapse within 6 months of Delivery
2. Patients not fit for surgery
3. Patients that don’t want surgery
4. Promote healing before surgery

Question 5

Complications of POP

Answer 5

Obstruction of Urinary Tract
Hypertrophy of Cervis
Edema of Cervix
Hydronephrosis