special pop gynecology pelvic relaxation

what is the most common indicatoin for a hysterectomy in women over 55

pelvic floor relaxation

what percent of women have risk of having surgery for incontinence or prolapse by age 80

11%

what is the pathophysiology of pelvic floor relaxation

menopause

childbirth

damage to pelvic floor causing loss of support

pelvic prolapse causing symptoms of pressure, fullness, urinary and/or fecal incontinence

what are the types of pelvic floor relaxation

cystocele and urethrocele

rectocele

enterocele

uterine prolapse or procidentia

what is cystocele

herniation of the bladder into the anterior wall of the vaginal canal

what is urethrocele

prolapse of urethra into anterior vaginal wall

what are the symptoms of cystocele and urethrocele symptoms

pelvic or vaginal pressure

dyspareunia

urinary stress incontinence

difficulty emptying the bladder

frequent UTI

what can we do for cystocele to help repair tissues

breather exercises

kegels

what is rectocele

herniation of lower rectum through the posterior wall of the vaginal wall

what are the symptoms of rectocele

vaginal pressure or discomfort

protrusion from posterior wall

constipation

difficulty evacuating rectum

dyspareunia

what is enterocele

prolapse of small intestine through teh posterior aspect of the vagina cul de sac of douglas

what is procidentia

prolapse of the uterus into the vaginal canal

describe the first degree of procidentia

half way into vaginal canal

describe the second degree of procidentia

cervix is out of the vaginal canal

describe the third degree of procidentia

complete prolapse

uterus outside the body

what is the etiology of procidentia

childbirth

trauma

what are the s/s of procidentia

pelvic pressure

painless

dyspareunia

what are non surgical treatments for pelvic relaxation

kegels

pessaries (supportive, vaginal or systemic strogen with post menopause)

hysterectomy

what do pessaries do

silicone “donuts” that press against vaginal walls