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Genital Prolapse

This document discusses genital prolapse, which refers to the descent or falling down of female pelvic organs from their normal positions. It describes the different types of genital prolapse including uterine prolapse, anterior vaginal wall prolapse (cystocele), and posterior vaginal wall prolapse (rectocele). Predisposing factors, symptoms, and findings of genital prolapse are outlined. Both conservative treatments like pessaries and surgical treatments are mentioned.

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craniophage95
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171 views

Genital Prolapse

This document discusses genital prolapse, which refers to the descent or falling down of female pelvic organs from their normal positions. It describes the different types of genital prolapse including uterine prolapse, anterior vaginal wall prolapse (cystocele), and posterior vaginal wall prolapse (rectocele). Predisposing factors, symptoms, and findings of genital prolapse are outlined. Both conservative treatments like pessaries and surgical treatments are mentioned.

Uploaded by

craniophage95
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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Genital prolapse anatomical

Uterine prolapse Anterior vaginal wall prolapse


cystocele cystourethrocele

Posterior vaginal wall prolapse

Genital prolapse
5th Year Medical Students 2005

rectocele enterocele

Other associated conditions urethral caruncle; rectal prolapse; vaginal vault prolpase

Uterovaginal prolapse

Cystocele

Rectocele

First degree uterine prolapse

Second degree uterine prolapse

Third degree uterine prolapse

Predisposing factors
Congenital pelvic floor weakness collagen, race, anatomy Difficult or traumatic labour - denervation Multiparity - trauma Chronic disorders chronic obstructive airway, constipations, straining Abdominal tumours Obesity, smoking, heavy lifting Steroids, menopause, pelvic surgery

Symptoms
Pressure symptoms weight dragging down Mass at introitus Low backache Urinary symptoms incomplete emptying of bladder, retention of urine, recurrent UTI Bladder symptoms constipation, mass protruding at defaecation Others bleeding, discharges, stress incontinence, discomfort

Findings
Uterine prolapse first, second or third degree (complete procidentia) Anterior vaginal wall prolapse bladder prolapse, urinary incontinence
midline defects loss of rugae para-vaginal defects rugae OK

Cystocele paravaginal defect & midline defect

Posterior vaginal wall prolapse rectal prolapse, loaded faecal matter Urethral caruncle red inflamed tumour

Uterine prolapse
Conservative treatment
observation or pessary treatment pelvic floor exercise (young, women wanting pregnancy, pregnancy, against surgical intervention, pessary test)

Vaginal prolapse
Cystocele, urethrocele
Anterior vaginal wall repair, mesh repair

Rectocele
Posterior vaginal wall repair, posterior perineorrhaphy Enterocele repair

Surgical treatment - uterus conserved Manchester repair,


uterosacroplexy, ischiospinous colposuspension, sacrocolpopexy - uterus removed vaginal hysterectomy

Genuine stress incontinence


Tensionless vaginal tape procedure, other sling procedures, laparoscopic colposuspension, Burch colposuspension

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