vaginal prolapse

Question 1

Urtherocoele

Answer 1

prolapse of lower anterior vaginal wall, involving the urethra only

Question 2

Cystocoele

Answer 2

Prolapse of upper anterior vaginal wall, involving bladder

Associated prolapse of urethra = cystourethrocele

Question 3

Apical

Answer 3

Prolapse of uterus, cervix and upper vagina

If uterus has been removed, the vault can prolapse

Question 4

Enterocele

Answer 4

Prolapse of upper posterior wall of vagina

Pouch usually contains small loops of bowel

Question 5

Rectocele

Answer 5

Prolapse of lower posterior wall of vagina, involving anterior wall of the rectum

Fingers enter prolapse on DRE

Question 6

Grading of prolapse

Answer 6

0
No descent of pelvic organs during straining

1
Leading surface of prolapse does not descend below 1cm above the hymenal ring

2
Leading edge of prolapse extends from 1cm above, to 1cm below the hymenal ring

3
Prolapse extends 1cm below the hymenal ring, but without vaginal eversion

4
Vagina completely everted

Question 7

None surgical treatment

Answer 7

Ring pessary

Shelf pessary

Question 8

Surgical treatment

Answer 8

Uterine prolapse = hysteroplexy

Vaginal vault prolapse = sacrospinus fixation/sacrocolpoplexy

Vaginal wall prolapse = anterior/posterior repair