Vaginal Prolapse

Question 1

Vaginal Prolapse RF

Answer 1

Age
Multip
Obesity
Menopause
Smoking
Heavy lifting
Constipation
Connective tissue dx

Question 2

Grading systems for vaginal prolapse

Answer 2

POP-Q (anatomical landmarks wrt hymen)

Shaw’s (more common looks at descent of prolapse)

Question 3

Treat vaginal prolapse?

Answer 3

If troublesome

Question 4

Lifestyle advice for vaginal prolapse

Answer 4

Healthy weight
Stop smoking
Avoid lifting

Question 5

Medical Management of vaginal prolapse

Answer 5

Pelvic floor exercise
Oestrogens (pill, patch, cream)
Vaginal pessary changed every 6mo
- SE: unpleasant discharge, irritation, UTI, interference with sex

Question 6

Surgical Mx of Vaginal Prolapse

Answer 6

Sacrocolpoplexy, colporrhaphy
Hysterectomy
Colpocleisis (only if advanced and not intending to have sex)

Question 7

PACES counselling of Vaginal Prolapse

Answer 7

RF: Multip., age, obesity, prolonged 2nd stage labour
Explain mechanics of dx (internal vagina exits pelvis)
Explain lifestyle modifications (weight, smoking, lifting)
Explain cons/med. mx (oestrogen)
Ring pessary or surgery