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cce_gynecology_pelvic organ prolapse (physical examination (bimanual…
cce_gynecology_pelvic organ prolapse
history
investigations
rule out UDS (urodynamic study)
rule out UTI (mid-stream urine)
rule out DM (fasting glucose)
physical examination
bimanual
(uterus, adnexal mass, vaginal ring pessary: pubic symphysis to posterior fornix)
Sims speculum
which compartment
speculum
(
degree of prolapse
, bleeding, discharge) (cough, Valsalva)
rectovaginal
integrity of rectovaginal septum, strength of perineal body
BMI
kg/m/m
surgery
uterine prolapse
vaginal hysterectomy
compartment
anterior
anterior colporrhaphy
anterior vaginal mesh
middle
(young) sacrocolpoplexy
(3rd4th) sacrospinous ligament fixation
psoterior
posterior colporrhaphy
fragile, unfit, need surgery
colpoclesis
vaginal ring pessary
change every 6 months
lifestyle modification
weight reduction
x medical disease e.g. cough/smoking
x prolonged standing/walking, x heavy lifting
pelvic floor exercise
3 times every day