Genitourinary Prolapse Flashcards Preview

Gynaecology > Genitourinary Prolapse > Flashcards

Flashcards in Genitourinary Prolapse Deck (82)
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61

What does the choice of surgical procedure for pelvic organ prolapse depend upon?

- If woman is sexually active
- If family is complete
- General fitness
- Whether has had a hysterectomy
- Nature of prolapse

62

What is a controversial surgery for pelvic organ prolapse?

Mesh repair

63

Why is mesh repair for pelvic organ prolapse a topic of controversy?

Concerns of long-term health problems

64

What are the long-term complications of mesh repair for pelvic organ prolapse?

- Extrusion
- Erosion
- Bleeding
- Pain
- Dyspareunia
- Bladder/bowel dysfunction

65

What are the surgical options for bladder/urethral prolapse?

- Anterior colporrhaphy
- Colposuspension

66

What happens in an anterior colporrhaphy?

Folds the fibromuscular layer of the anterior vaginal wall

67

What are the intraoperative complications of anterior colporrhaphy?

- Haemorrhage
- Haematoma
- Cystotomy

68

When can a colposuspension be considered for treatment of pelvic organ prolapse?

For urethral sphincter incontinence associated with cystourethrocele

69

How is a colposuspension performed?

Paravaginal fascia on either side of the bladder neck and base of the bladder are approximated to pelvic side wall by sutures through ipsilateral iliopectineal ligament

70

What are the surgical options for a uterine prolapse?

- Hysterectomy
- Sacrocolpoplexy
- Sacrospinus fixation

71

What is a sacrocolpoplexy?

The uterus is attached to the longitudinal ligament over the sacrum

72

What are the ways a sacrocolpoplexy can be performed?

- Laparoscopic
- Open

73

What is an advantage of a sacrocolpoplexy for uterine prolapse?

Woman can retain her uterus

74

What is a sacrospinus fixation of uterine prolapse?

Unilateral or bilateral fixation of the uterus to the sacrospinus ligamnet

75

What are the risks of sacrospinus fixation for uterine prolapse?

Injury to the pudendal nerve and vessels and the sciatic nerve

76

What are the surgical options for a vault prolapse?

- Sacrospinus fixation
- Sacrocolpoplexy

77

What is the surgical option for a recto/enterocele?

Posterior colporrhaphy

78

What is obliterative surgery for pelvic organ prolapse?

The prolapse is corrected by moving the pelvic viscera back into the pelvis and closing off the vaginal canal

79

What are the advantages of obliterative surgery for pelvic organ prolapse?

- Almost 100% effective
- Reduced peri-operative morbidity
- Safe for those who are frail

80

What is the main disadvantage of obliterative surgery for pelvic organ prolapse?

Vaginal intercourse is no longer possible

81

What are the potential complications of pelvic organ prolapse?

- Ulceration and infection of prolapsed organs outside introitus
- Urinary tract complications
- Bowel dysfunction

82

What are the urinary complications that can occur with pelvic organ prolapse?

- Stress incontinence
- Chronic retention and overflow incontinence
- Recurrent UTIs