Urogenital prolapse

Question 1

Define cystocoele/cystourethrocoele.

Answer 1

Prolapse of the anterior vaginal wall including the bladder, or prolapse of the bladder and urethra, respectively

Question 2

Define rectocoele.

Answer 2

Prolapse of the lower posterior wall of the vagina including the anterior wall of the rectum

Question 3

Define enterocoele.

Answer 3

Prolapse of the upper posterior wall of the vagina (Pouch of Douglas)

Question 4

Define uterovaginal prolapse.

Answer 4

Prolapse of the uterus, cervix, and upper vagina

Question 5

What is the conservative/medical management of urogenital prolapse?

Answer 5

• Physiotherapy - pelvic floor exercises

- Pessaries - change 6 monthly

Question 6

What is the most appropriate surgery for cystourethrocoele?

Answer 6

• Anterior colporrhaphy/repair

- Colposuspension

Question 7

What is the most appropriate surgery for rectocoele?

Answer 7

Posterior colpoperineorrhaphy/repair

Question 8

What are the most appropriate surgeries for vaginal vault prolapse?

Answer 8

• Sacrospinous ligament fixation

- Sacrocolpoplexy

Question 9

What are the most appropriate surgeries for uterine prolapse?

Answer 9

• Hysterectomy

- Sacrohysteropexy

Question 10

What are the risk factors for urogenital prolapse?

Answer 10

• Increasing age
• Multiple vaginal deliveries
• Obesity
• Spina bifida