Urogynaecology Flashcards
What is prolapse?
Protrusion of uterus and/or vagina beyond normal anatomical confines
What is a cystocele?
Prolapse of anterior vaginal wall involving the bladder
What is a uterine prolapse?
Prolapse of uterus, cervix and upper vagina
What are some symptoms of prolapse?
Dragging sensation
Discomfort and heaviness around pelvis
Feeling of ‘lump coming down’
Painful sex
Discomfort
Backache
Constipation
What are the two treatment stages for prolapse?
Pelvic floor exercise
Intravaginal pessary
What is urge incontinence?
Overactivity of the detrusor muscle with sudden urges to pass urine without warning
What is stress incontinence?
Pelvic floor is weakened so urine can leak at times of increased pressure such as laughing or coughing
What is overflow incontinence?
Chronic urinary retention due to an obstruction to urine outflow
What are some management options for stress incontinence?
Avoid caffeine and diuretics
Weight loss
Pelvic floor muscle exercise
Duloxetine - SNRI
Sling surgery
What is the management of urge incontinence?
Bladder retraining for 6 weeks is 1st line
Oxybutynin
What are some side effects of oxybutynin?
Anticholinergic so causes dry mouth and eyes, urinary retention, constipation and postural hypotension
What can be a treatment for incontinence injected into the bladder wall?
Botox
What is acute cholecystitis?
Gallbladder inflammation from cystic duct blockage from gallstones
What is the presentation of acute cholecystitis?
Colicky, epigastric RUQ pain
Pruiritus
N+V
Murphys sign
Jaundice
Fever
Tachycardia
What is a vaginal fistula?
Abnormal opening between vagina and other nearby organs in the pelvic including bladder and rectum
