Pelvic Organ Prolapse and Urinary Incontinence Flashcards
Bladder falls into the vagina
Cystocele
Small bowel falls into the vagina
Enterocele
Rectum falls into the vagina
Rectocele
Uterus falls into the vagina
Uterine prolapse
Upper portion of the vagina (the apex) descends into the vaginal canal.
Vagina vault prolapse
refers to complete prolapse
Procidentia
Clinically Useful Grading Scale:
0- none
1- mild defect, not visible without speculum
(descent halfway to hymen)
2- prolapse to hymen
3- prolapse beyond hymen (halfway past)
4- complete prolapseClinically Useful Grading Scale:
0- none
1- mild defect, not visible without speculum
(descent halfway to hymen)
2- prolapse to hymen
3- prolapse beyond hymen (halfway past)
4- complete prolapseConservative Therapies for POP
Strengthening the pelvic floor
- Kegel Exercises
- Vaginal Cone Weights
Supporting the pelvic floor
- Pessaries
Surgical therapies for POp
Surgical Repair
Mesh
When to treat?
Symptoms reach a bother scale to patient
Prolapse has led to tissue trauma or other ill effects
Associated urinary incontinence
Experiencing the overwhelming need to urinate, even if you just went and/or being unable to hold it long enough to reach a bathroom
Urge incontinence / “Overactive Bladder”
Urine loss during episodes of increased intra-abdominal pressure, such as exercise, coughing, sneezing, laughing, or any body movement which puts pressure on the bladder
Stress incontinence
Combination of both urge and stress
Mixed incontinence
incontinence occurring without urgency or stress
Unconscious or Overflow incontinence
Pathology of Urge incontinence
Idiopathic detrusor instability (DI)
Neuropathic detrusor hyperreflexia
