Pelvic Relaxation And Incontinence

Question 1

What is a cystocele?

Answer 1

Anterior wall of vagina prolapse

Question 2

What is a rectocele?

Answer 2

Lower posterior vaginal prolapse

Question 3

What is vaginal vault prolapse?

Answer 3

After hysterectomy, vagina sinks into vaginal canal.

Question 4

What is a urethrocele?

Answer 4

Urethral prolapse and bladder prolapse

Question 5

When we hear a patient say pelvic pressure and bulging cessation, what are we thinking?

Answer 5

Prolapse

Question 6

4 treatment options for a cystocele?

Answer 6

Do nothing
Pelvic floor PT
Pessary
Surgical correction (anterior colporrhaphy)

Question 7

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?

Answer 7

Uterine prolapse

Question 8

What is another symptom that can present with uterine prolapse?

Answer 8

Voids small amounts frequently and doesn’t empty bladder because uterus is kinking/compressing bladder ad urethra.

Question 9

3 treatment options for uterine prolapse?

Answer 9

Pessary
Hysterectomy
Colpocleisis

Question 10

What is a colpocleisis? What is important to know about this?

Answer 10

Shove the uterus back into the vaginal canal and sew it back there/close it up. These people can never use their vagina again?

Question 11

Patient says she wets herself when she laughs, sneezes, coughs and wears pads/diapers, what are we thinking?

Answer 11

Stress incontinence

Question 12

What are three extra tests we can do to confirm stress in continence?

Answer 12

Q tip
Urodynamics
Postvoid residual

Question 13

What is the q tip test and what would be a result that tells you stress inconitnence?

Answer 13

Stick the q tip in the urethra and if the angle is greater than 30 degrees when she bears down, hyperactivity urethra.

Question 14

What is the post void residual test?

Answer 14

Have the lady empty her bladder and then check the volume. If its less than 50 mls you know its not an overflow problem.

Question 15

4 treatment options for stress incontience?

Answer 15

Topical estrogen
Pelvic floor PT
Pessary
Surgery - suburethral sling via vaginal approach or abdominal approach

Question 16

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?

Answer 16

Rectocele

Question 17

What is the best and only treatment option for a rectocele?

Answer 17

Surgery

Question 18

Patient presents with urinary urgency and frequency, especially at night, what are we thinking?

Answer 18

Urge incontinence

Question 19

What do you want to always check and do with urge incontience symptoms in a patent?

Answer 19

Urinalysis to check for UTI because UTIS present with frequency

Question 20

2 treatment options for urge incontinence and overactive bladder?

Answer 20

Behavior modifications (need to gain control over bladder again)
Antispasmodics

Question 21

What are the two antispasmodics to give for overactive bladder?

Answer 21

Oxybutynin

Tolterodine

Question 22

What two muscles make up the pelvic diaphragm?

Answer 22

Levator ani

Coccygeus

Question 23

What two muscles make up the levator ani?

Answer 23

Pubococcygeus

Iliococcygeus