Tuesday, July 1, 2014

Structural Abnormalites

Structural Abnormalities-

-Cystocele-



-Cystocele is a hernia of the anterior vaginal wall that is associated with decent of the bladder

-Risk factors for cystocele include parity, advancing age, and obesity

-Hysterectomy may be associated with an increase risk of cystocele

-Chronic constipation can increase the risk for cystocele

-Clinical symptoms may include:  bulge, vaginal pressure, sexual dysfunction, and urinary and defecation problems

-Treatment is indicated for women with symptoms of prolapse.  Asymptomatic cystocele is not an indication for treatment


-Surgical correction is definitive therapy



-Uterine Prolapse-



-Apical prolapse is descent to the cervix, uterus or vaginal vault

-Apical vaginal prolapse is descent of the vaginal cuff scar or cervix, below a point which is 2 cm less than the total vaginal length about the plane of the hymen.

-Risk factors for development include:  parity, obesity, chronic constipation, hysterectomy, and advancing age

-Indications for surgical correction are those who are symptomatic and can tolerate surgical repair


-Rectocele-




-Rectocele is anterior protrusion of the rectum, usually into the vagina.

-The diagnosis of this is make of pelvic examination

-Risk factors for rectocele include:  vaginal childbirth, advancing age, and increasing body mass index

-Treatment is surgical correction definitively

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