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Gynae > Vaginal Diseases > Flashcards

Vaginal Diseases Flashcards

1
Q

What is atrophic vaginitis?

A

Dryness and atrophy of the vaginal mucosa secondary to a decrease in circulating oestrogen levels.

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2
Q

Cause of atrophic vaginitis

A

The decrease in oestrogen levels following menopause leads to thinning of the lining of the vagina

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3
Q

Assocaited conditions with atrophic vaginitis

A

menopause
primary ovarian insufficiency
bilateral oophorectomy

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4
Q

Presentation of atrophic vaginitis

A

Dryness
Itching
Local bleeding
Dyspareunia

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5
Q

What may be seen on examination of atrophic vaginitis?

A

Thinning of epithelial lining of vagina
Vulvar or vaginal bleeding from fissures

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6
Q

Investigation for atrophic vaginitis

A

Clinical diagnosis

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7
Q

Management of atrophic vaginitis

A

Vaginal lubricants
Topical oestrogen
Hormone replacement therapy

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8
Q

What is urogenital prolapse? What causes it?

A

Protrusion of the pelvic organs into the vagina due to weakness of the muscles and ligaments supporting these organs.

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9
Q

Which muscles fail and cause a urogenital prolapse?

A

levator ani muscles (puborectalis, pubococcygeus and iliococcygeus) and the ligaments and fascia that support the pelvic organs.

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10
Q

Types of urogenital prolapse

A

Uterine Prolapse

Vault Prolapse
Prolapse of the top part of the vaginal into the vaginal canal

Rectocele
Prolapse of the rectum into the vagina through a defect in the posterior vaginal wall

Cystocele
Prolapse of the bladder into the vagina through a defect in the anterior vaginal wall

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11
Q

vault prolapse

A

Prolapse of the top part of the vaginal into the vaginal canal

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12
Q

Rectocele

A

Prolapse of the rectum into the vagina through a defect in the posterior vaginal wall

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13
Q

Cystocele

A

Prolapse of the bladder into the vagina through a defect in the anterior vaginal wall

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14
Q

RFs for urogenital prolapse

A

Multiparity (multiple vaginal deliveries)
Obesity
Instrumental delivery
Age
Chronic constipation
Chronic cough

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15
Q

Presentation of urogenital prolapse

A

Sensation of heaviness and dragging sensation within the vagina
Prolapse may be visible at the introitus or palpable within the vagina
Constipation
Urinary symptom
Sexual dysfunction (including dyspareunia)
Vaginal bleeding

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16
Q

sensation of heaviness and dragging sensation within vagina

A

urogenital prolapse

17
Q

WHere may urogenital prolapse be visible and palpable?

A

Prolapse may be visible at the introitus or palpable within the vagina

18
Q

Investigation for urogential prolapse

A

CLINICAL DIAGNOSIS

19
Q

How is severity of urogenital prolapse assessed?

A

Assess severity using POP-Q grading system

20
Q

Conservative management of prolapse

A

Maintain healthy weight
Stop smoking
Avoid heavy lifting

21
Q

Management of prolapse

A

Pelvic floor exercises
Oestrogens (can help provide symptomatic relief)
Vaginal pessary
Ring pessary is the most commonly used form (most appropraite for patients who are still sexually active)

Surgery
Pelvic Repair Surgery
Cystocele –> Anterior Colporrhaphy
Rectocele –> Posterior Colporrhaphy
Vault Prolapse –> Abdominal Sacrocolpopexy and Sacrospinous Fixation
Uterine Prolapse –> Vaginal Hysterectomy
Colpocleisis (closing of the vagina)

22
Q

1st line management for mild prolapse

A

pelvic floor exercises –> kegel

23
Q

What non-surgical management can help provide symptomatic relief in urogenital prolapse?

A

oestrogens

24
Q

What is the most appropriate non-surgical management for pateints with urogenital prolapse?

A

ring pessary

25
Q

Surgical management options for urogenital prolapse

A

Cystocele –> Anterior Colporrhaphy
Rectocele –> Posterior Colporrhaphy
Vault Prolapse –> Abdominal Sacrocolpopexy and Sacrospinous Fixation
Uterine Prolapse –> Vaginal Hysterectomy

26
Q

Surgical management option for cystocele

A

Cystocele –> Anterior Colporrhaphy

27
Q

Surgical management option for rectocele

A

Rectocele –> Posterior Colporrhaphy

28
Q

Surgical management option for vault prolapse

A

Vault Prolapse –> Abdominal Sacrocolpopexy and Sacrospinous Fixation

29
Q

Surgical management option for uterine prolapse

A

Uterine Prolapse –> Vaginal Hysterectomy

30
Q

Colpocleisis

A

closing of the vagina

Gynae (8 decks)

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