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