Pelvic Floor Dysfunction Flashcards Preview

ESA 4 - Reproductive System > Pelvic Floor Dysfunction > Flashcards

Flashcards in Pelvic Floor Dysfunction Deck (36):
1

When can the pelvic floor be damaged? 

During childbirth 

2

When is the anal sphincter endangered in childbirth? 

If there is a midline tear or episiotomy 

3

When is the anal sphincter protected in childbirth? 

If there is a mediolateral tear or episiotomy 

4

When are episiotomies performed? 

If there is a clinical need, such as intrumental birth, or a suspected fetal compromise

5

What are perineal tears classified into? 

Four degree

6

What is a first degree perineal tear? 

Where the fourchette and vaginal mucosa are damaged, and the underlying muscles are exposed, but not torn 

7

What is a second-degree perineal tear? 

Tears to posterior vaginal walls and perennial muscles, but the anal sphincter is intact 

8

What is a third-degree perineal tear? 

Extends to the anal sphincter that is torn, but the rectal mucosa is intact 

9

What is a fourth-degree perineal tear? 

When the anal canal is opened, and the tear may spread to the rectum

10

How is a episiotomy performed? 

Use a mediolateral technique; 45-60 degrees to the right side, originating from the vaginal fourchette, and use tested, effective analgesia

11

Other than tears, what other damage can childbirth cause? 

  • Stretch of the pudendal nerve
  • Stretch and damage of the pelvic floor and perineal muscles
  • Stretch/rupture of ligaments supporting muscles 

 

12

What does a stretch of the pudendal nerve cause? 

  • Neuropraxia
  • Muscle weakness

 

13

What does stretching and damage to the pelvic floor and perineal muscles cause?

Muscle weakness

14

What does stretching/rupture of ligaments supporting muscles cause? 

Ineffective muscle action 

15

What happens if ligaments supporting muscles in the perineal area get stretched overtime? 

They remodel and get longer

16

Does a caeserean avoid the damage caused by childbirth? 

No, appears that the damage can occur due to just having the child in the pelvis area

17

What factors contribute to pelvic floor dysfunction? 

  • Age 
  • Menopause
  • Obesity
  • Chronic cough
  • Intrinsic connective tissue laxity

 

18

Why does menopause predispose to pelvic floor dysfunction? 

Atrophy of tissues after oestrogen withdrawal

19

What can cause intrinsic connective tissue laxity leading to prolapse?

Defined conditions or constitutional

20

What are the types of prolapse? 

  • 1st degree
  • 2nd degree
  • 3rd degree

 

21

What is a first degree prolapse? 

Uterus falls into vagina, but doesn't fall out of the body 

22

What happens in a 2nd degree prolapse? 

Uterus reaches vaginal opening (cervix peeks out near the labia)

 

23

What happens in a 3rd degree prolapse? 

Uterus partially or completely falls externally, and the vagina is turned inside out 

24

When does a 3rd degree prolapse most commonly occur? 

Post-hysterectomy 

25

What % of women over 50 will have urinary incontience problems? 

50%

26

What % of prolapses reoccur after corrective surgery in women? 

10-15%

27

How can prolapse and urinary incontinence be treated?

  • Pelvic floor muscle
  • Surgery

 

28

What is the advantage of pelvic floor muscle exercise in treatment of prolapse and urinary incontinence? 

  • Easy
  • Safe 
  • Effective 

29

How effective are pelvic floor muscle exercises in treating incontinence?

Cure of incontinence occurs in 50-75% of patients 

30

What is the effect of pelvic floor muscle exercises in prolapse management? 

Will prevent or delay worsening of prolapse

31

What do surgical continence procedures do? 

Increase support to the sphincter mechanism and prevent descent of the bladder neck

32

Give two examples of surgical continence procedures

  • Colposuspension 
  • Tension-free vaginal tape

 

33

How effective are surgical continence procedures? 

Cure rate 85-90%

34

What are the disadvantages of surgical continence procedures?

  • Voiding difficulty/retention
  • Overactive bladder disease (obstruction)

 

35

Give 3 surgical prolapse procedures

  • Removed prolapsed organs
  • Restoring connective tissue supports
  • Maintaing functions

 

36

What are the side effects of surgical prolapse procedures?

  • Recurrence
  • New incontinence
  • Dyspareunia (painful intercourse)