Pelvic Relaxation And Incontinence Flashcards
What is a cystocele?
Anterior wall of vagina prolapse
What is a rectocele?
Lower posterior vaginal prolapse
What is vaginal vault prolapse?
After hysterectomy, vagina sinks into vaginal canal.
What is a urethrocele?
Urethral prolapse and bladder prolapse
When we hear a patient say pelvic pressure and bulging cessation, what are we thinking?
Prolapse
4 treatment options for a cystocele?
Do nothing
Pelvic floor PT
Pessary
Surgical correction (anterior colporrhaphy)
What are we thinking if the patient comes in and says, “something is falling out” and I can feel something that is “out of me” when I wipe, what I am thinking?
Uterine prolapse
What is another symptom that can present with uterine prolapse?
Voids small amounts frequently and doesn’t empty bladder because uterus is kinking/compressing bladder ad urethra.
3 treatment options for uterine prolapse?
Pessary
Hysterectomy
Colpocleisis
What is a colpocleisis? What is important to know about this?
Shove the uterus back into the vaginal canal and sew it back there/close it up. These people can never use their vagina again?
Patient says she wets herself when she laughs, sneezes, coughs and wears pads/diapers, what are we thinking?
Stress incontinence
What are three extra tests we can do to confirm stress in continence?
Q tip
Urodynamics
Postvoid residual
What is the q tip test and what would be a result that tells you stress inconitnence?
Stick the q tip in the urethra and if the angle is greater than 30 degrees when she bears down, hyperactivity urethra.
What is the post void residual test?
Have the lady empty her bladder and then check the volume. If its less than 50 mls you know its not an overflow problem.
4 treatment options for stress incontience?
Topical estrogen
Pelvic floor PT
Pessary
Surgery - suburethral sling via vaginal approach or abdominal approach
Patient tells you she has to stick her fingers in her vagina and push on her posterior wall to poop, this is called splinting, what are we taking?
Rectocele
What is the best and only treatment option for a rectocele?
Surgery
Patient presents with urinary urgency and frequency, especially at night, what are we thinking?
Urge incontinence
What do you want to always check and do with urge incontience symptoms in a patent?
Urinalysis to check for UTI because UTIS present with frequency
2 treatment options for urge incontinence and overactive bladder?
Behavior modifications (need to gain control over bladder again) Antispasmodics
What are the two antispasmodics to give for overactive bladder?
Oxybutynin
Tolterodine
What two muscles make up the pelvic diaphragm?
Levator ani
Coccygeus
What two muscles make up the levator ani?
Pubococcygeus
Iliococcygeus
