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6 Cards in this Set
- Front
- Back
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What are the main possible types of gynaecological prolapses?
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1 - Uterine
2- Anterior vaginal wall: bladder (cystocoele) and/or urethra (urethrocoele) 3. Posterior wall: rectum (rectocoele) and/or pouch of Douglas (enterocoele) 4. Vaginal valt |
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What are the causes of gynaecological prolapse?
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- childbirth
- Oestrogen deficiency - Obesity and chronic cough - Congenital weakness - Pelvic masses |
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What are the clinical features of gynaecological prolapse? Inlcuding cystocoele and rectocoele.
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- often asymptomatic
- dragging sensation or the sensation of a lump - worse at the end of the day or when standing up - severe prolapse = intercourse problems, ulseration, bleeding and discharge. - cystocoele = urinary frequency, incomplete bladder emptying, stress incontinence - rectocoele = no symptons or difficult in defaecating. |
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How do you investigate gynaecological prolapse?
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- pelvic USS - ?mass
- Cystometry - ?incontinence - fitness for surgery: ECG, CXR, FBC, U + E |
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How is gyanecology prolapses managed?
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- General - do notthing / lose weight / treat chest problems inc. smoking
- Physiotherapy - Pessaries e.g. shelf, ring. Change 9-12 monthly - Surgery- vaginal histerectomy for uterine prolapse, anterior repair for cystocoele, posterior repair for rectocoele. sacrohysteropexy for vault prolapse. Consider surgery for genuine stress incontinence. |
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How do you investigate gynaecological prolapse?
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- pelvic USS - ?mass
- Cystometry - ?incontinence - fitness for surgery: ECG, CXR, FBC, U + E |
