DOCSLIB.ORG

A Woman's Guide To

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
A Woman's Guide To Women’s Institute A Woman’s Guide to Pelvic Health Conditions In women the pelvic floor is muscles, sexual abuse or pelvic fractures a group of muscles that form can result in a number of health problems a hammock-like support across the if not properly treated. opening of a woman’spelvis. These muscles, together with connective Women may experience: tissues, ligaments and nerves, keep all • Feeling a bulge and/or pressure of the pelvic organs, such as the bladder, of the uterus, bladder, vagina or rectum uterus, vagina and rectum, in place and • Loss of bladder control, leakage help these pelvic organs function. of urine, frequent urination • Sense of urgency to empty the bladder Sometimes the pelvic floor can be • The inability to hold a bowel movement compromised. Surgery, childbirth, • Pelvic pain scarring, chronic spasm of the pelvic 2 A Woman’s Guide to Pelvic Health Rectal prolapse: Rectal prolapse is differentiated from Pelvic organ rectocele in that with rectal prolapse the rectum actually protrudes out the anus rather than protruding into the vagina. prolapse (POP) Uterus or womb (uterine prolapse): When a group of ligaments (uterosacral and cardinal ligaments) at the top of the vagina Pelvic organ prolapse (POP) occurs weaken, causing the uterus to drop. when pelvic muscles and tissues become weakened, stretched or are injured. Some possible causes of injury include childbirth, chronically Stages of uterine prolapse: elevated intra-abdominal pressures (due to chronic cough, chronic constipation and obesity) or surgery. Stage 1 Stage 2 Stage 3 When the pelvic floor tissues which hold pelvic organs in place become weakened or stretched, it can cause the pelvic organs to bulge (or prolapse) into the vagina. In some cases, the pelvic organs may prolapse past the vaginal opening. The uterus descends The uterus descends The cervix, located at Pelvic organ prolapse is a common, treatable into the upper portion to the opening the opening of the uterus, medical condition which affects an estimated of the vagina. of the vagina. sags past the vaginal opening and may protrude one-third of all women – and half of all women outside the body. ages 55 and older. While pelvic organ prolapse can affect women of all ages, the risk of developing Stage 4: The uterus is completely out of the body. This condition also is called POP increases with age. Post-menopausal women complete prolapse (procidentia). are at the highest risk for developing POP. Pelvic organ prolapse may include one (or more) of Vaginal vault (apical vaginal prolapse): Vaginal vault prolapse the following conditions, including prolapse of the: may occure following a hysterectomy surgery (removal of the uterus). About 10 percent of women who undergo Bladder (cystocele): When the wall of the vagina overlying the a hysterectomy develop some degree of vaginal vault prolapse, bladder weakens and the bladder pushes against the vagina, where the top of the vagina drops toward the vaginal opening. producing a bulge. Pelvic pressure or protrusion are common Just like uterine prolapse, vaginal vault prolapse is staged syptoms. Urinary incontinence, inability to fully empty the according to the severity of the prolapse. bladder or recurrent bladder infections may also be a symptom. Rectocele: When the vaginal wall overlying the rectum weakens and the rectum pushes against the vagina, producing a bulge. Pelvic pressure, protrusion and difficulty with bowel movements may result. Summa Health 3 Visit summahealth.org/pelvic for more information and a list of our specialists and locations. Bladder Function • Medications, such as sedatives Fecal incontinence may be caused or muscle relaxants by a variety of factors, including: Women of all ages may have • Urinary tract infection • Diarrhea bladder control issues and • Constipation • Constipation may experience: • Muscle damage or weakness Persistent UI: of the anal sphincter muscles Bladder urgency and frequency: • Pregnancy • Nerve damage of the anal Frequent urination means needing • Childbirth injury sphincter muscles to urinate more often than usual. • Advanced age • Loss of elasticity (stretch) in the rectum Urgent urination is a sudden, strong • Menopause • Childbirth injury urge to urinate, along with discomfort • Hysterectomy • Hemorrhoids or rectal prolapse in your bladder. • Obstruction • Rectocele • Neurological disorders • Inactivity Painful bladder syndrome: Causes recurring discomfort or pain in the bladder and the surrounding pelvic region. Bowel Function Pelvic Pain Many people take normal Pelvic pain refers to pain Urinary incontinence (UI): bowel function for granted. in the lowest part of the torso, A loss of bladder control resulting in the However, this is a delicate in the area below the abdomen leakage of urine from the body. This system with the potential and between the hipbones, or includes stress incontinence, which for issues to arise, such as: pelvis. The pain may be sharp is urine loss while laughing, sneezing, or similar to cramps, and it can coughing, running or other physical Coccyx (tailbone) pain: be steady or come and go. Pelvic activity or urge incontinence, which A rare condition that causes persistent pain differs from abdominal pain, is leaking urine with a sense of urgency pain in the bottom of the spine. which occurs higher in the torso. while unable to reach a bathroom in time. Constipation: Conditions include: Urinary incontinence, both temporary Bowel movements that are infrequent • Pelvic muscle spasm and persistent, may be caused by: or hard to pass. • Endometriosis • Vulvodynia Temporary UI: Fecal incontinence: • Dyspareunia (pain with sexual • Alcohol Fecal incontinence is the involuntary intercourse) • Dietary habits, including consumption loss of stool or mucous from the rectum, • Pregnancy and post-partum related pain of carbonated drinks, artificial including the inability to hold a bowel • Vaginal atrophy (dryness and pain sweeteners, corn syrup, citrus fruits movement until reaching a toilet and associated with aging tissues) and others passing stool into one’s underwear without being aware of it happening. 4 A Woman’s Guide to Pelvic Health Treatments There are a wide range of both nonsurgical and surgical treatment options available to treat pelvic floor disorders. Nonsurgical Options Women of all ages may Pelvic Floor Physical Therapy beverages with caffeine, alcohol, have bladder control Patients learn techniques that help milk or carbonated beverages them regain pelvic floor control (fizzy) may help control urinary issues. Women may and function. urgency and incontinence. experience: Behavioral and/or Dietary Pessaries Medications Modifications A small silicone device, similar Several medications can improve • Bowel training helps patients to a diaphragm, is inserted into the bladder or bowel control by blocking develop a regular bowel movement vagina to relieve symptoms of uterine the signals from the nervous system pattern. Over time, the body or vaginal prolapse. which cause urgency. becomes accustomed to a regular bowel movement schedule, Biofeedback Pelvic Exercises thus reducing constipation Electronic monitoring of a normally Kegels consist of repeatedly and fecal incontinence. automatic bodily function in order to contracting and relaxing the muscles improve bladder and bowel control. of the pelvic floor. Strengthening • Changes to diet such as eating these muscles is beneficial for the right amount of fiber can help Botox Injections bladder and bowel control. with diarrhea and constipation. Botox can be injected into the Increasing fluid intake can help bladder muscle for treatment prevent constipation. Avoiding of urge incontinence. Summa Health 5 Pelvic Floor Physical Therapy Summa Health offers pelvic Bowel Function • Sacroiliac treatment and bracing floor physical therapy to help • Bowel disorders • Soft tissue and joint mobilization women regain pelvic floor • Coccyx (tailbone) pain • Therapeutic modalities such as control and function. • Constipation ultrasound or electrical stimulation • Fecal incontinence • Vaginal dilator training The importance of maintaining a healthy pelvic floor can easily be Pelvic Pain Educational: overlooked. Surgery, natural aging, • Pelvic muscle spasm • Patient and partner education childbirth, scarring, sexual abuse, • Endometriosis • Patient education on topics such as pelvic fractures or tailbone injuries • Dyspareunia (pain with pelvic floor anatomy, bowel and bladder can result in a number of pelvic sexual intercourse) retaining and pelvic muscle function floor problems if not properly • Pregnancy and post-partum related pain • Post-operative recovery education treated. These situations can • Pre-operative pelvic floor cause excessive muscle tightness Depending on the cause, muscle education or weakness that may lead to treatment may include both muscle spasm, pain, incontinence physical and educational or constipation. techniques. Summa has specially trained physical therapists who work Restoring muscle balance through Physical: one-on-one with patients in physical therapy leads to less pain, • Anal rectal balloon retraining a comfortable, private setting. resolved incontinence issues and • Biofeedback A physician’s referral is required. an improvement in your overall • Bladder and bowel retraining Most major insurance plans quality of life. Nonsurgical, pelvic • Customized exercise program are accepted, including floor physical therapy techniques to achieve muscle balance Medicare and Workers’ may be used to successfully
Load more

Recommended publications
  • Pelvic Inflammatory Disease -PID Examination and STI Screening
    How do I get tested for PID? What about my partner? a guide to PID is diagnosed by a medical assessment/ As PID can be caused by a sexually transmitted Pelvic Inflammatory Disease -PID examination and STI screening. There is no one infection it is important that all current partners simple test. are tested for STIs and are treated with antibiotics You can still have PID even if your STI screen is too (even if their STI tests are negative). negative. Sometimes ex partners will need to be tested too If your doctor suspects PID you will be advised - you will be advised about this. to have a course of antibiotics. This is because the consequences of leaving PID untreated or not When can I have sex again? treating promptly (see below) can be serious. It’s best you don’t have sex at all (not even with a We also need to make sure you are not pregnant condom and not even any oral sex) until you and – please tell your doctor if you think you could be your partner have finished your antibiotics. pregnant. What happens if my PID is left untreated? How is PID treated? Untreated PID can cause serious problems: It is important to get treated quickly to reduce the Persistent or recurrent bouts of pelvic pain risk of complications. Infertility PID is treated with a mixture of antibiotics to cover An ectopic pregnancy (this is a serious condition the most likely infections. requiring urgent surgery) The treatment course is usually for 2 weeks. Pelvic abscess The treatment is free and issued to you directly in Persistent or recurrent bouts of pelvic or the clinic.
    [Show full text]
  • What Is a Hysterectomy?
    Greenwich Hospital What is a Hysterectomy? PATIENT/FAMILY INFORMATION SHEET What is a Hysterectomy? A hysterectomy is the surgical removal of the uterus (womb). Sometimes the fallopian tubes, ovaries, and cervix are removed at the same time that the uterus is removed. When the ovaries and both tubes are removed, this is called a bilateral salpingo- oophorectomy. There are three types of hysterectomies: • A complete or total hysterectomy, which is removal of the uterus and cervix. • A partial or subtotal hysterectomy, which is removal of the upper portion of the uterus, leaving the cervix in place. • A radical hysterectomy, which is removal of the uterus, cervix, the upper part of the vagina, and supporting tissue. If you have not reached menopause yet, a hysterectomy will stop your monthly periods. You also will not be able to get pregnant. How is a hysterectomy performed? A hysterectomy can be performed in three ways: • Abdominal hysterectomy: The surgeon will make a cut, or incision, in your abdomen either vertically (up and down) in the middle of the abdomen below the umbilicus (belly button); or horizontally (side ways) in the pelvic area. The horizontal incision is sometimes referred to as a “bikini” incision and is usually hidden by undergarments. • Vaginal hysterectomy: The surgeon goes through the vagina and the incision is on the inside of the vagina, not on the outside of the body. • Laparoscopically assisted vaginal hysterectomy: This involves using a small, telescope-like device called a laparoscope, which is inserted into the abdomen through a small cut. This brings light into the abdomen so that the surgeon can see inside.
    [Show full text]
  • Dyspareunia: an Integrated Approach to Assessment and Diagnosis
    PROBLEMS IN FAMILY PRACTICE Dyspareunia: An Integrated Approach to Assessment and Diagnosis Genell Sandberg, PhD, and Randal P. Quevillon, PhD Seattle, Washington, and Vermillion, South Dakota Dyspareunia, or painful intercourse, is frequently referred to as the most common female sexual dysfunction. It can occur singly or be manifested in combination with other psychosexual disorders. Diagnosis of dyspareunia is appropriate in cases in which the experience of pain is persistent and severe. There has been little agreement concerning the origin of dyspareunia. Or­ ganic conditions and psychological variables have alternately been pre­ sented as major factors in causality. There is a presumed high incidence of physical disease associated with dyspareunia when compared with other female sexual dysfunctions. In the majority of cases, however, organic fac­ tors are thought to be rare in contrast with sexual issues and interpersonal or intrapsychic difficulties as a cause of continuing problems. The finding of an organic basis for dyspareunia does not rule out emotional or psychogenic causes. Thorough and extensive gynecologic and psycholog­ ical evaluation is essential in cases of dyspareunia. The etiology of dys­ pareunia should be viewed on a continuum from primarily physical to primar­ ily psychological with many women falling in the middle area. recurrent pattern of genital pain during or im­ Dyspareunia and vaginismus are undeniably linked, A mediately after coitus is the basis for the diagnosis and repeated dyspareunia is likely to result in vaginis­ of dyspareunia.1 The Diagnostic and Statistical Man­ mus, as vaginismus may be the causative factor in ual of Mental Disorders (DSM-III)2 has included dys­ dyspareunia.6-7 The difference between vaginismus pareunia under the classification of psychosexual dis­ and dyspareunia is that intromission is generally pain­ orders.
    [Show full text]
  • Pelvic Inflammatory Disease (PID) PELVIC INFLAMMATORY DISEASE (PID)
    Clinical Prevention Services Provincial STI Services 655 West 12th Avenue Vancouver, BC V5Z 4R4 Tel : 604.707.5600 Fax: 604.707.5604 www.bccdc.ca BCCDC Non-certified Practice Decision Support Tool Pelvic Inflammatory Disease (PID) PELVIC INFLAMMATORY DISEASE (PID) SCOPE RNs (including certified practice RNs) must refer to a physician (MD) or nurse practitioner (NP) for all clients who present with suspected PID as defined by pelvic tenderness and lower abdominal pain during the bimanual exam. ETIOLOGY Pelvic inflammatory disease (PID) is an infection of the upper genital tract that involves any combination of the uterus, endometrium, ovaries, fallopian tubes, pelvic peritoneum and adjacent tissues. PID consists of ascending infection from the lower-to-upper genital tract. Prompt diagnosis and treatment is essential to prevent long-term sequelae. Most cases of PID can be categorized as sexually transmitted and are associated with more than one organism or condition, including: Bacterial: Chlamydia trachomatis (CT) Neisseria gonorrhoeae (GC) Trichomonas vaginalis Mycoplasma genitalium bacterial vaginosis (BV)-related organisms (e.g., G. vaginalis) enteric bacteria (e.g., E. coli) (rare; more common in post-menopausal people) PID may be associated with no specific identifiable pathogen. EPIDEMIOLOGY PID is a significant public health problem. Up to 2/3 of cases go unrecognized, and under reporting is common. There are approximately 100,000 cases of symptomatic PID annually in Canada; however, PID is not a reportable infection so, exact
    [Show full text]
  • Different Influences of Endometriosis and Pelvic Inflammatory Disease On
    International Journal of Environmental Research and Public Health Article Different Influences of Endometriosis and Pelvic Inflammatory Disease on the Occurrence of Ovarian Cancer Jing-Yang Huang 1,2,†, Shun-Fa Yang 1,2 , Pei-Ju Wu 1,3,†, Chun-Hao Wang 4,†, Chih-Hsin Tang 5,6,7 and Po-Hui Wang 1,2,3,8,* 1 Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; cshe961@csh.org.tw (J.-Y.H.); ysf@csmu.edu.tw (S.-F.Y.); cshy1446@csh.org.tw (P.-J.W.) 2 Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan 3 Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 402, Taiwan 4 Department of Medicine, National Taiwan University, Taipei 106, Taiwan; cshy222@csh.org.tw 5 School of Medicine, China Medical University, Taichung 404, Taiwan; chtang@mail.cmu.edu.tw 6 Chinese Medicine Research Center, China Medical University, Taichung 404, Taiwan 7 Department of Medical Laboratory Science and Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan 8 School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan * Correspondence: wang0860@csmu.edu.tw † Equal contributions as first authors. Abstract: To compare the rate and risk of ovarian cancer in patients with endometriosis or pelvic inflammatory disease (PID). A nationwide population cohort research compared the risk of ovarian cancer in 135,236 age-matched comparison females, 114,726 PID patients, and 20,510 endometriosis patients out of 982,495 females between 1 January 2002 and 31 December 2014 and ended on the date Citation: Huang, J.-Y.; Yang, S.-F.; of confirmation of ovarian cancer, death, or 31 December 2014.
    [Show full text]
  • 3-Year Results of Transvaginal Cystocele Repair with Transobturator Four-Arm Mesh: a Prospective Study of 105 Patients
    Arab Journal of Urology (2014) 12, 275–284 Arab Journal of Urology (Official Journal of the Arab Association of Urology) www.sciencedirect.com ORIGINAL ARTICLE 3-year results of transvaginal cystocele repair with transobturator four-arm mesh: A prospective study of 105 patients Moez Kdous *, Fethi Zhioua Department of Obstetrics and Gynecology, Aziza Othmana Hospital, Tunis, Tunisia Received 27 January 2014, Received in revised form 1 May 2014, Accepted 24 September 2014 Available online 11 November 2014 KEYWORDS Abstract Objectives: To evaluate the long-term efficacy and safety of transobtura- tor four-arm mesh for treating cystoceles. Genital prolapse; Patients and methods: In this prospective study, 105 patients had a cystocele cor- Cystocele; rected between January 2004 and December 2008. All patients had a symptomatic Transvaginal mesh; cystocele of stage P2 according to the Baden–Walker halfway stratification. We Polypropylene mesh used only the transobturator four-arm mesh kit (SurgimeshÒ, Aspide Medical, France). All surgical procedures were carried out by the same experienced surgeon. ABBREVIATIONS The patients’ characteristics and surgical variables were recorded prospectively. The VAS, visual analogue anatomical outcome, as measured by a physical examination and postoperative scale; stratification of prolapse, and functional outcome, as assessed by a questionnaire TOT, transobturator derived from the French equivalents of the Pelvic Floor Distress Inventory, Pelvic tape; Floor Impact Questionnaire and the Pelvic Organ Prolapse–Urinary Incontinence- TVT, tension-free Sexual Questionnaire, were considered as the primary outcome measures. Peri- vaginal tape; and postoperative complications constituted the secondary outcome measures. TAPF, tendinous arch Results: At 36 months after surgery the anatomical success rate (stage 0 or 1) was of the pelvic fascia; 93%.
    [Show full text]
  • Studies of Human Physique and Sexual Attractiveness: Sexual Preferences of Men and Women in China
    AMERICAN JOURNAL OF HUMAN BIOLOGY 19:88–95 (2007) Original Research Article Studies of Human Physique and Sexual Attractiveness: Sexual Preferences of Men and Women in China 1 2 3 1 BARNABY J. DIXSON, ALAN F. DIXSON, * BAOGUO LI, AND M.J. ANDERSON 1Department of Conservation and Research for Endangered Species, Zoological Society of San Diego, San Diego, California 2School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand 3College of Life Sciences, and Key Laboratory Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, Xi’an, China ABSTRACT Men and women at Northwest University (n ¼ 631), Xi’an, China, were asked to rate the attractiveness of male or female figures manipulated to vary somatotype, waist-to- hip ratio (WHR), secondary sexual traits, and other features. In study 1, women rated the aver- age masculine somatotype as most attractive, followed by the mesomorphic (muscular), ecto- morphic (slim), and endomorphic (heavily built) somatotypes, in descending order of preference. In study 2, the amount and distribution of masculine trunk (chest and abdominal) hair were altered progressively in a series of front-posed figures. Women rated figures with no or little trunk hair as most attractive. Study 3 assessed the attractiveness of front-posed male figures which varied only in length of their nonerect penis. Numerical ratings for this trait were low, but moderate lengthening of the penis (22% or 33% above average) resulted in a significant increase in scores for attractiveness. In study 4, Chinese men rated the attractiveness of back- posed female images varying in waist-to-hip ratio (WHR from 0.5–1.0).
    [Show full text]
  • Perceived Gynecological Morbidity Among Young Ever-Married Women
    Perceived Gynecological Morbidity among Young ever-married Women living in squatter settlements of Karachi, Pakistan Pages with reference to book, From 92 To 97 Fatima Sajan,Fariyal F. Fikree ( Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan. ) Abstract Background: Community-based information on obstetric and gynecological morbidity in developing countries is meager and nearly non-existent in Pakistan. Objectives: To estimate the prevalence of specific gynecological morbidities and investigate the predictors of pelvic inflammatory disease Methods: Users and non-users of modem contraceptives were identified from eight squatter settlements of Karachi, Pakistan and detailed information on basic demographics, contraceptive use, female mobility, decision-making and gynecological morbidities were elicited. Results: The perceived prevalence of menstrual disorders were 45.3%, uterine prolapse 19.1%, pelvic inflammatory disease 12.8% and urinary tract infection 5.4%. The magnitude of gynecological morbidity was high with about 55% of women reporting at least one gynecological morbidity though fewer reported at least two gynecological morbidities. Significant predictors of pelvic inflammatory disease were intrauterine contraceptive device users (OR = 3.1; 95% CI 1.7- 5.6), age <20 years (OR = 2.3; 95% CI 1.1 - 4.8) and urban life style (OR = 2.1; 95% CI 1.0-4.6). Conclusion: There is an immense burden of reproductive ill-health and a significant association between eyer users of intrauterine contraceptive device and pelvic inflammatory disease. We therefore suggest improvement in the quality of reproductive health services generally, but specifically for family planning services (JPMA 49:92, 1999). Introduction Gynecological morbidity has been defined as structural and functional disorders of the genital tract which are not directly related to pregnancy, delivery and puerperium.
    [Show full text]
  • Chapter 14. Anthropometry and Biomechanics
    Table of contents 14 Anthropometry and biomechanics........................................................................................ 14-1 14.1 General application of anthropometric and biomechanic data .....................................14-2 14.1.1 User population......................................................................................................14-2 14.1.2 Using design limits ................................................................................................14-4 14.1.3 Avoiding pitfalls in applying anthropometric data ................................................14-6 14.1.4 Solving a complex sequence of design problems ..................................................14-7 14.1.5 Use of distribution and correlation data...............................................................14-11 14.2 Anthropometric variability factors..............................................................................14-13 14.3 Anthropometric and biomechanics data......................................................................14-13 14.3.1 Data usage............................................................................................................14-13 14.3.2 Static body characteristics....................................................................................14-14 14.3.3 Dynamic (mobile) body characteristics ...............................................................14-28 14.3.3.1 Range of whole body motion........................................................................14-28
    [Show full text]
  • Prevalence of Malignant Uterine Pathology in Utero-Vaginal Prolapse After Vaginal Hysterectomy
    Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology PelviperineologyORIGINAL Pelviperineology ARTICLE Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology Pelviperineology DOI: 10.34057/PPj.2020.39.04.006 Pelviperineology 2020;39(4):137-141 Prevalence of malignant uterine pathology in utero-vaginal prolapse after vaginal hysterectomy EDGARDO CASTILLO-PINO1, VALENTINA ACEVEDO1, NATALIA BENAVIDES1, VALERIA ALONSO1, WASHIGNTON LAURÍA2 1Department of Obstetrics and Gynaecology, Urogynaecology and Pelvic Floor Unit, School of Medicine, University of the Republic, Hospital de Clínicas “Dr. Manuel Quintela”, Montevideo, Uruguay 2Department of Obstetrics and Gynaecology, School of Medicine, University of the Republic, Hospital de Clínicas “Dr. Manuel Quintela”, Montevideo, Uruguay ABSTRACT Objective: The aim of this study was to establish the prevalence of malignant uterine pathology after vaginal
    [Show full text]
  • Complications of Incontinence and Prolapse Surgery: Evaluation, Intervention, and Resolution—A Review from Both Specialties W42, 16 October 2012 14:00 - 18:00
    Complications of Incontinence and Prolapse Surgery: Evaluation, Intervention, and Resolution—A Review from Both Specialties W42, 16 October 2012 14:00 - 18:00 Start End Topic Speakers 14:00 14:10 Introduction Howard Goldman 14:10 14:35 Complications of incontinence surgery (except Sandip Vasavada retention) 14:35 15:10 Retention/Voiding dysfunction after incontinence Roger Dmochowski surgery 15:10 15:30 Discussion All 15:30 16:00 Break None 16:00 16:35 Complications of prolapse surgery (except Howard Goldman dyspareunia) 16:35 17:00 Dyspareunia after pelvic floor surgery Tristi Muir 17:00 17:40 Discussion All 17:40 18:00 Questions All Aims of course/workshop This course will summarize both common and uncommon complications associated with standard and new technologies used for pelvic floor reconstruction and urinary incontinence therapy in women. The intent of this course is to present both the approach to evaluation and management of these complications from both the urologic and urogynecologic perspective of the combined faculty. The emphasis is on newer technologies and complications, both acute and chronic, which are associated with these various surgeries. The goal of this course will be to summarize, not only identification, but also evaluation and appropriate intervention, as well as patient counselling for these various complications. Educational Objectives This course will provide a detailed paradigm for avoiding, evaluating and managing complications of incontinence and prolapse surgery. Evidence continues to accrue in this area but it runs the spectrum from Level 1 to 5 with much being expert opinion. Unfortunately, very little cross comparison exists to support these differing interventions.
    [Show full text]
  • Management of Uterine Prolapse: Is Hysterectomy Necessary?
    DOI: 10.1111/tog.12220 2016;18:17–23 Review The Obstetrician & Gynaecologist http://onlinetog.org Management of uterine prolapse: is hysterectomy necessary? a b b, Helen Jefferis MRCOG, Simon Robert Jackson MD FRCOG, Natalia Price MD MRCOG * aSubspeciality Trainee in Urogynaecology, Department of Urogynaecology, Women’s Centre, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK bConsultant Urogynaecologist, Department of Urogynaecology, Women’s Centre, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK *Correspondence: Natalia Price. Email: Natalia.Price@ouh.nhs.uk Accepted on 1 June 2015 Key content Fertility preservation remains the one absolute indication for Management of uterine prolapse is currently heavily influenced by hysteropexy. Other potential advantages include stronger apical patient and surgeon preferences. support and reduced vaginal surgery. The traditional approach to uterine prolapse is vaginal Colpocleisis remains a valid option for a small cohort of patients. hysterectomy. However, this does not address the underlying Learning objectives deficiency in connective tissue pelvic floor support, and prolapse Options for the management of uterine prolapse. recurrence is common. How to help patients decide on a management plan. Uterine preservation surgery is increasing in popularity, both with surgeons and patients; there is currently little evidence to show Keywords: colpocleisis / hysteropexy / pelvic organ prolapse / superior outcome to hysterectomy. uterine preservation surgery / vaginal hysterectomy Please cite this paper as: Jefferis H, Jackson SR, Price N. Management of uterine prolapse: is hysterectomy necessary? The Obstetrician & Gynaecologist 2016;18: 17–23. DOI: 10.1111/tog.12220 Introduction significantly associated with regression of prolapse, leading the authors to suggest that the damage obesity causes to the When a woman presents with pelvic organ prolapse, the pelvic floor may be irreversible.
    [Show full text]