Precancerous and Malignant Vulvar Lesions. Pelvic Floor Disorders. Stress Urinary Incontinence.

pyometra

uterine infection, pus can’t be evacuated (from atrophic changes in older women)

large uterus, abd pain

can be associated w/ endometrial or cervical canceer

lichen sclerosus

pruritus of vulva, thin epidermis, edematous dermis, dissapearance papillary ridges

ttt lichen sclerosus

topical steroids

picture vulvar squamous hyerplasia

red skin, folds, liquefied white plaques

biopsy shows thick epithelium, elongated papilalary ridges

ttt vuvlar intraepithelial neoplasia

local excision

__________ of the vulva is a rare intraepithelial adenocarcinoma that presents as chronic vulvar irritation or eczema-like lesions

paget disease

ttt paget disease

wide excision

vulvar carcinoma presentation

hard nodule or ulcer (moist base, raised edges)

vaginal pruritis

vulvar carcinoma ttt

vulvectomy + inguino-femoral node diseection

what is considered an abnormal uterine position

retroversion

enterocele

herniation of the small intestine into the upper posterior vaginal wall, often occurring after hysterectomy or in women with pelvic floor weakness

cystocele

prolapse of the bladder into the anterior vaginal wall, due to weakening of the supportive tissue between the bladder and vagina

rectocele

prolapse of the rectum into the posterior vaginal wall, caused by weakened rectovaginal septum support

genital prolapse picture

cervix or vaginal wall protruding thru vagina

urinary and defecation problems, dyspareunia

ttt genital prolapse

perineal exercises, pessary

colorrhpahy

types urinary incontinence

• stress (increase intrabd p)

• urge (leakage)

• mixed (stress and urge)

• fxnal

major cause of __________ is urethral hypermobility due to impaired support from pelvic floor

stress incontinence

in patient with urinary stress incontinence, evidence of atrophy (pallor and thin tissue) may indicate

estrogen deficiency

urinary stress incontinence - if cough stress test is +, what test may determine if urine loss is from urethral hypermobility

marshal bonney test

urinary stress incontinence ttt

a adrenergic agonists, pelvic floor training, acupuncture, electrical stimuluation/biofeedback

surgery (sling, bladder neck suspension)