Pelvic Relaxation

What percentage of surgery do women have for incontinence or prolapse symptoms by age 80?

11%

What are some symptoms of pelvic prolapse (relaxation)?

Pressure, fullness, urinary and/or fecal incontinence

What is the hormonal etiology?

Menopause, atrophy and atony of tissue

What is the trauma etiology?

Childbirth

What is cystocele?

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

What is urethrocele?

Prolapse of the urethra into the anterior vagina wall

What are symptoms of cystocele and urethrocele?

Pelvic or vaginal pressure, dyspareuia, urinary stress incontinence, difficulty emptying the bladder, frequent UTI

What is rectocele?

Herniation of lower rectum through the posterior wall of the vagina wall

What are symptoms of rectocele?

Vaginal pressure or discomfort, protrusion coming from the posterior wall, constipation, difficulty evacuating rectum, dyspareunia

What are symptoms of enterocele?

Prolapse of the small intestine through the posterior aspect of the vaginal cul de sac of douglas

What is procidentia?

Prolapse of the uterus into the vaginal canal

What is 1st degree procidentia?

Half way into the vaginal canal

What is 2nd degree procidentia?

Cervix is out of the vaginal canal

What is 3rd degree procidentia?

Complete prolapse, the uterus is outside the body

What is the etiology of procidentia?

Childbirth/trauma

What are the signs and symptoms of procidentia?

Pelvic pressure, painless, dyspareunia

What is a non-surgical treatment?

Kegels

How can pessaries be used?

Supportive, used with vaginal or systemic estrogen with postmenopausal women, should be removed and cleaned at least every 2-4 months by patient or clinician