Prolapse Flashcards
1
Q
Definition of enterocele
A
Herniation of the peritoneum with or without small bowel between the rectum and uterus at the apex of the vagina
2
Q
Normal support structures of the uterus
A
- transverse cervical ligaments
- uterosacral ligaments
(broad and round ligaments dont offer support)
3
Q
Fascia surrounding uterus
A
- pubo-cervical (Ant)
- rectovaginal (post)
4
Q
Baden-Walker grading system
A
1: halfway down the vagina
2: to the hymenal ring
3: beyond the hymenal ring
4: maximal descent
5
Q
Causes of prolpase
A
- parity
- genetic (poor collagen)
- oestrogen def
- increased abdo pressure
- neurological (spina bifida)
6
Q
Symptoms of anterior prolapse
A
- stress incontinence
- urgency
- urge incontinence
- post mic dribbling
- poor stream
- double voiding
- incomplete empyting
- manual replacement to void
- recurrent UTI
7
Q
Symptoms of posterior prolapse
A
- pelvic pressure
- constipation
- incomplete emptying
- faecal incompetence
- digital splinting/ aiding
8
Q
Surgical treatment of prolapse
A
- anterior colporraphy (ant)
- posterior colpo-perineorrphy (post)
- vaginal hysterectomy and vault suspension
- sacrospinous fixation (vault)
- sacrocolpopexy (vault)
- vaignal mesh procedures
9
Q
Complications of surgery for prolapse
A
- vault abscess
- dyspareunia
- difficulty urinating
- fistula formation
- bowel dysfunction
- stress incontinence
- mesh complications (infection)
10
Q
Post-op care for prolapse
A
- off work for 4-6 weeks
- avoid intercourse for 6 weeks
- avoid increased abdo pressure
- avoid straining exercise
