Continence & Women's Health Pre Module

Conservative Treatment options

Antatomy

Types of Incontinence

Prolapse

Surgery

Genitourinary Symptoms of Menopause

Vaginal Support Pessary

Continence management - incontinence pads, contiform, skin & pressure area care

Causes/ Risk Factors for Pelvic Floor Dysfx

Urinary

Faecal

Stress

Urge

Mixed

Insensible loss

Causes of Faecal incontinence

Anterior/ Posterior Repair

Sphincter Repair (post OASIS)

OASI (Obstectric Anal Sphincter Injuries)

Family Hx

Vaginal Births + instrumental delivery (forceps, Ventouse) + levator avulsion

OASI (Obstetic Anal Sphincter Injury (3A,B,C + 4)

Smoking, respiratory conditions + cough

Age

Vaginal weights

Bowel resection/ loss of bowel = decr transit time

Rectal prolapse

Pelvic Floor

Urge

Insensible loss

Hysterectomy

Colpocleisis

Urethral sling

Lifestyle factors

Low oestrogen

Non-hormonal vaginal moisterisers

Systemic Menopause Hormone Therapy

Topical oestrogen

Oestrogen pessary

Pelvic floor muscle training

High BMI

Smoking

Exercise & physical activity

Nutrition/ gut health/ constipation

Colporrhaphy

E-stim

Constipation management

General exercise

Pessary

Bladder training/ bladder diary

Urge suppression strategies

Trauma informed care

Assessment - POP Stix, POP-Q system

Urethral Sphincter

Intrinsic Sphincter Deficiency

Skeletal & Smooth Muscle

Superficial & deep (Levator Ani) muscles

Rectum, Anus & Anal sphincter

Internal & External Anal sphincters (IAS - extension of bowel, multi-nervous system control (autonomic, enteric, somatic), smooth muscle. EAS - skeletal muscle

Bladder

Cervix

Uterus

Nerves

Stage 1-4

Overflow

Care w sexual assault, CSA, DV

Consent++, especially for Vaginal Exams

Anterior Wall, Posterior Wall, Uterine

Pelvic Pain Syndromes

Endometriosis, Adenomyosis, Sexual pain (Dyspareunia), Overactive PF

Birth trauma

Ethnicity & genetics

Menopause

Surgery (Hysterectomy), Cancer Rx (Radiation => vaginal stenosis), Hormone treatments i.e Tamoxifen, Aromatase Inhibitors

Subjective Ax - symptoms, previous Rx, Obstetric Hx, PMHx, Medications, surgery, activity, questions relating to behaviour of symptoms i.e. frequency, urgency, volume loss, post void dribble, sexual symptoms, bowel habits, bristol stool chart, fluid intake, diet

Objective Ax - BMI, PFM exam (tone, strength, PERFECT system, scars, skin condition, perineal lift, cough Ax, bladder diary, pad test