Pelvic Organ Prolapse
The most common compartment of prolapse
Anterior (cystocele)
Another name for leakage with cough/sneeze
Stress urinary incontinence
Common symptoms aside from urgency that present with overactive bladder
Nocturia and frequency
Most common complication of sling surgery
Bladder perforation
Specialized test to measure bladder capacity and compliance
Urodynamics
POP-Q point measuring the cervix or vaginal cuff
Point C
First line treatment for Stress Urinary Incontinence
Pelvic floor muscle training
First line therapy for overactive bladder
behavioral therapy, bladder training
You perform a MUS and the nurse calls postoperatively. What study must be performed before discharging the patient?
Postvoid residual
A patient voids 900cc with a postvoid residual of 250cc.
What is a normal PVR
A 42 year old present for her annual exam and the provider notices the cervix at the introitus. She has no symptoms. What is the first line managment?
Expectant management
Gold standard surgical treatment for SUI
Midurethral sling
Anticholinergic
A patient presents to clinic after a LSC hysterectomy with a thin, watery vaginal discharge. What testing in clinic should be done
Double dye test
Most common cause of vesicovaginal fistulas worldwide
Childbirth
Risk factor most strongly associated with POP
Vaginal Delivery
Simple way to diagnose stress incontinence
Cough stress test
Advanced treatment for OAB includes which three therapies?
Botox, PTNS and Sacroneuromodulation
What testing is indicated in a patient taking oxybutinin who states that their incontinence is acutely worse?
Postvoid residual
Scale to describe stool consistency
Bristol stool Index
Surgical procedure suspending vaginal apex to sacrum
Sacrocolpopexy
Two data points necessary before performing a stress incontinence surgery in a low risk patient
Observation of leakage with increase in abdominal pressure and a PVR
Alternative medications to oxybutinin with different risk profiles
Mirabegron or veribegron (B3 Agonist)
Nerve at risk in sacrospinous ligament fixation
Pudendal nerve
A patient has a fourth degree laceration that is repaired. What is her risk of another 4th degree laceration with a subsequent vaginal birth?
7 times more likely to have another 4th degree laceration - baseline risk 1-2% x 7 = 7%