Vaginal_Prolapse_Flashcards
What factors should be considered for the management of vaginal prolapse?
Factors to consider for the management of vaginal prolapse include the woman’s preferences, site of prolapse, lifestyle factors, comorbidities, age, desire for childbearing, previous abdominal or pelvic floor surgery, and the benefits and risks of individual procedures.
What general lifestyle advice should be given for managing vaginal prolapse?
General lifestyle advice for managing vaginal prolapse includes losing weight if BMI >30kg/m2, avoiding heavy lifting, and preventing/treating constipation.
What are the medical management options for vaginal prolapse?
Medical management options for vaginal prolapse include pelvic floor exercises (16-week course), oestrogens (pill, patch, cream, or implant), and a vaginal ring pessary (changed every 6 months).
What are the side effects of using a vaginal ring pessary?
Side effects of using a vaginal ring pessary include unpleasant discharge, irritation, UTI, and interference with sex (sex is not possible with a shelf pessary).
What are the surgical options if there is no preference regarding the preservation of the uterus?
Surgical options if there is no preference regarding the preservation of the uterus include vaginal hysterectomy ± vaginal sacrospinous fixation, vaginal sacrospinous hysteropexy, Manchester repair, and sacro-hysteropexy with mesh.
What are the surgical options if there is a preference for preserving the uterus?
Surgical options if there is a preference for preserving the uterus include vaginal sacrospinous hysteropexy and Manchester repair (unless the woman wishes to have children in the future).
What are the surgical options for vault prolapse?
Surgical options for vault prolapse include vaginal sacrospinous fixation and sacrocolpopexy (mesh used to attach the vagina to sacral vertebra).
What is colpocleisis and when is it offered?
Colpocleisis is a procedure involving closure of the vagina and is only offered if the woman does not intend to have penetrative sex or they are at high surgical risk.
What are the risk factors for vaginal prolapse?
Risk factors for vaginal prolapse include multiparity, age, obesity, prolonged second stage of labour, and heavy lifting.
What should be explained to the patient regarding the diagnosis of vaginal prolapse?
Patients should be explained the diagnosis of vaginal prolapse.
What lifestyle modifications should be explained to the patient for managing vaginal prolapse?
Lifestyle modifications that should be explained to the patient for managing vaginal prolapse include losing weight, maintaining a healthy diet, and stopping smoking.
What conservative management options should be explained to the patient for vaginal prolapse?
Conservative management options that should be explained to the patient for vaginal prolapse include pelvic floor exercises and the use of oestrogens.
What should be explained to the patient about the use of a ring pessary or surgery for vaginal prolapse?
Patients should be explained the use of a ring pessary or the surgical options available for managing vaginal prolapse.
