Pelvic Organ PRolapse Flashcards
Level 1 pelvic support fails? What falls?
Cervix and uterus will drag bladder later on
Level 2 pelvic support failure?
Get cytocele
Level 3 pelvic support failure?
Rectocele, lax perineal body
“Need to push my perineum to defecate”
Cystocele is what?
Anterior vaginal wall
What is Rectocele
Posterior vaginal wall is descending
Anterocele is?
Level 1 defect allowing small bowel to prolapse down into pouch of Douglas
Levator ani does what?
Reinforced endopelvic fascia.
Doesn’t cause prolapse itself
Aetiology of prolapse?
Parity multi vaginal
Age
Menopause
Previous Sx
Main reason for prolapse?
Pelvic muscle weakness
Endofascial support failure
Constipation
chronic Cough
Causes of Nullipara us prolapse?
Tumour Deinnervation Heavy weight lifting Ehler-danlos, Marfan's Chronic cough, obesity, smoking, DM Constipation
Chronic steroids
Risk factors in childbirth that lead to prolapse
Any baby more than 10 pounds
More than 4 children
Mid pelvis instruments
More than 2 hours of pushing
Does prolapse cause incontinence
Sometimes, but normally not, usually the weakening of the endofascial supports causes prolapse
Most common presentation of cystocele else?
Lump/bulge Pain/stretch Bladder symptoms Incomplete voiding Dyspareunia
Rectocele causes?
Incomplete defecation
Life threatening prolapse?
Bladder and urethral obstruction due to a huge prolapse
Pulling of ureters
