Pelvic relaxation

Question 1

what is an enterocele?

Answer 1

herniation of small bowel into vagina

Question 2

CP of pelvic relaxation:

Answer 2

pelvic P & pain
urinary incontinence
dyspareunia
bowel & bladder dysfct

Question 3

when is pelvic relaxation most problematic?

Answer 3

postmenopausal women

Question 4

RFs for pelvic relaxation:

Answer 4

pts w/chronically increased ab’l P - chronic cough, straining, ascites, ob, large pelvic tumors
traumatic delivery
aging, menopause

Question 5

first-degree vs. second-degree vs. third-degree pelvic relaxation:

Answer 5

first-degree = prolapsing struc is in upper 2/3 of vagina
second degree = prolapsing struc descends to introitus
third degree = structure protrudes outside vagina

Question 6

tx of pelvic relaxation:

Answer 6

hrm'l therapy - ES if postmenopausal
Kegel
pessary
ant and/or post colporrhaphy
hysterectomy if really severe

Question 7

who should use pessaries?

Answer 7

pts in whom surgery is CI’d but sx’s are severe

pg or postpartum pts