Pelvic organ prolapse Flashcards
what type of prolapse occurs if it is anterior?
cystocele
what type of prolapse occurs if it is posterior?
rectocele
what type of prolapse occurs if it is apical?
enterocoele
what are the components of the pelvic floor?
endopelvic fascia pelvic diaphragm urogenital diaphragm (perineum)
what are the different endopelvic fascia?
uterosacral ligament
pubocervical fascia
rectovaginal fascia
what type of tissue is the endopelvic fascia?
fibre-muscular connective tissue
what endopelvic fascia is fibrous-muscular elastic tissue?
rectovaginal fascia
where does the uterosacral fascia commonly tear?
medially around the cervix
where does the pubocervical fascia commonly tear?
there are 3 attachments so can tear at any of these
- laterally or in front of the cervix
where does the rectovaginal fascia commonly tear?
centrally
upper: enterocele
lower: rectocele and perineal body decent
what are the symptoms of a prolapse?
vaginal:
- seeing or feeling of something coming down
- pressure, heaviness
- sensation of bulging or protrusion
- difficulty inserting tampons
urinary:
- incontience
- urgency/frequency
- straining, difficulty urinating/maintaining stream
bowel:
- incontinence with flatus, faeces
- incomplete emptying/straining
- urgency
what is the gold standard investigation for a prolapse?
pelvic organ prolapse quantification score
what is the first line treatment for stage I and II POP?
pelvic floor muscle training
what are the treatment options for POP?
pelvic floor muscle training
pessaries
surgery
what are the risk factors for POP?
pregnancy labour - long second stage - large babies - forceps advancing age previous pelvic surgery i.e. continence procedures obesity hormonal high intensity aerobic exercise / weight lifting
