prolapse

Question 1

anterior compartment prolapse

Answer 1

1. urethrocele - prolapse of the urethra into the vagina
   ( causes stress incontinence)
2. cystocele - prolapse of the bladder into the vagina

Question 2

middle compartment prolapse

Answer 2

1. uterine prolapse - descent of the uterus into the vagina

2. vaginal vault prolapse - descend of the vaginal wall post hysterectomy

Question 3

enterocele

Answer 3

herniation of the pouch of douglas into the vagina

Question 4

posterior compartment prolapse

Answer 4

prolapse of the rectum into the vagina

Question 5

most common type of prolapse

Answer 5

cystourethrocele

Question 6

pelvic organ prolapse quantification (POP-Q)

Answer 6

1. stage 1 - more than 1 cm above the hymen
2. within 1 cm to hymen
3. 1 cm below the hymen
4. complete eversion of the vagina

Question 7

classifying the degree of uterine descent

Answer 7

1. first degree - cervix is visible when perineum is depressed
2. second degree - cervic prolapsed through the introitus but fundus is in the pelvis
3. third degree - entire uterus is outside

Question 8

sx

Answer 8

1. sensation of pressure/heaviness and bulging
2. urinary symptoms
3. coital symptoms
4. bowel symptoms

Question 9

Mx - conservative

Answer 9

1. weight loss

2. pelvic muscle exercises

Question 10

Mx - methods to consider

Answer 10

1. conservative
2. pessary
3. surgery

Question 11

Mx - pessary

Answer 11

1. reduces prolapse symptoms and provides support
2. short term relief before surgry or long term relief if surgery is not indicated
3. SE - odour/vesicovaginal fistulas

Question 12

Mx - surgical - bladder/urethral prolapse

Answer 12

1. anterior colporrhaphy - suturing of the fibromuscular layer of the anterior vaginal wall
2. colposuspension

Question 13

Mx - surgical- uterine prolapse

Answer 13

1. Hysterectomy

2. Sacrohysteroplexy

Question 14

Mx- surgical - vault prolapse

Answer 14

1. sacrocolpopexy