Prolapse Flashcards
prolapse
protrusion of an organ or structure beyond its normal anatomical confines
female POP (pelvic organ prolapse)
descent of pelvic organs towards or through the vagina
what are the 3 distinct layers of the pelvic floor?
endo-pelvic fascia
pelvic diaphragm
urogential diaphragm
what are the risk factors for POP?
forceps birth
large baby
prolonged second stage of labour
previous pelvic surgery
constipation
hormonal factors
occupation with heavy lifting
exercise (weight lifting)
urethrocele
prolapse of the lower anterior wall involving the urethra only
cystocele
prolapse of the upper anterior vaginal wall involving the bladder
uterovaginal prolapse
prolapse of uterus, cervix, upper vagina
enterocele
prolapse of upper posterior wall of the vagina usually containing loops of small bowel
rectocele
prolapse of lower posterior wall of the vagina involving the rectum bulging forwards the vagina
typical symptoms in women with POP
heaviness
pressure
sensation of bulge or protrusion
seeing or feeling a bulge or protrusion
difficulty in inserting tampons
incontinence
frequency/urgency
straining
how do you assess POP?
QoL?
look for a pelvic mass
POPQ is the gold standard!
investigations of POP
USS/ MRI
urodynamics
IVU or renal USS
how do you treat POP?
pelvic floor muscle training
perineometer
biofeedback
vaginal cones
electrical stimulation
vaginal pessaries!!!
surgery!
what are vaginal pessaries?
device inserted into a vagina to hold a prolapsed womb
