Functional: Pelvic Organ Prolapse: Difference between revisions
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==== History ==== | ==== History ==== | ||
* Whether the patient is aware of any prolapse and what, if any, symptomatology and bother the prolapse may be causing. | * '''Signs and Symptoms''' | ||
** '''Sensation of a vaginal bulge remains the only symptom that is strongly associated with prolapse''' at or below the hymenal ring | **Whether the patient is aware of any prolapse and what, if any, symptomatology and bother the prolapse may be causing. | ||
*** '''Other symptoms, including UI and fecal incontinence, voiding and defecation difficulty, and sexual dysfunction, frequently coexist with | *** '''Sensation of a vaginal bulge remains the only symptom that is strongly associated with prolapse''' at or below the hymenal ring | ||
**** Disorders of defecation, including fecal incontinence and urgency, should be carefully evaluated before considering POP surgery. | **** '''Other symptoms, including UI and fecal incontinence, voiding and defecation difficulty, and sexual dysfunction, frequently coexist with pelvic organ prolapse''', but they correlate weakly with the severity or site of pelvic organ prolapse. | ||
** | ***** Disorders of defecation, including fecal incontinence and urgency, should be carefully evaluated before considering POP surgery. | ||
* Gynecologic and obstetric history, including gravity, parity, and hormonal status. | * '''Risk factors''' | ||
* Determination of whether the patient is premenopausal, perimenopausal, or post-menopausal and whether she has used any exogenous hormones such as oral contraceptives or local or systemic hormone replacement therapy | **Gynecologic and obstetric history, including gravity, parity, and hormonal status. | ||
* Treatment expectations and an understanding of the balance between benefits and risks/burden of available treatment options. | ** Determination of whether the patient is premenopausal, perimenopausal, or post-menopausal and whether she has used any exogenous hormones such as oral contraceptives or local or systemic hormone replacement therapy | ||
* '''Treatment expectations''' and an understanding of the balance between benefits and risks/burden of available treatment options. | |||
**Treatment of POP may ameliorate symptoms of sexual dysfunction. Still, dyspareunia has been associated with some types of POP repair, and, as such, changes in sexual function are an important aspect of preoperative counseling. | |||
==== '''Physical examination''' ==== | ==== '''Physical examination''' ==== | ||