POP – Pelvic Organ Prolapse

1. POP – Pelvic Organ Prolapse General The vagina is a virtual space only. The vaginal axis is 45 degrees posterior, toward the rectum. The Uro-Genital Diaphragm extends from the pubic symphysis anteriorly to the coccyx posteriorly. The uretero-vesicle angle is usually 90 degrees at the baseof the bladder. The levator muscles are at the vaginal introitus. Specifically Urethrocele Cystocele Cystourethrocele Enterocele Rectocele Urinary Incontinence Stress Urgency Mixed

2. POP/Bladder Clinical Cases Case #1 23 yo comes in with 5 day history of frequent urination that burns when she voids. Case #2 35 yo comes in with SEVERE cramps when she pees and she also has low-grade constant pain if she pushes into her lower abdomen just above her pubic bone. Urine analysis is negative for WBC or bacteria. Case #3 45 yo comes in with 7 bladder infections, one after the other, frequently progressing to blood in the urine. Case #4 55 yo comes in with progressive irritation of the bladder and frequent voiding of small amounts of urine. UAs x3 have been negative. Case #5 45 yo has 5 children and loses 10 drops of urine every time she coughs. Case #6 45 yo has 5 children and wets her pants, losing 4 ounces of urine every time she leaks. Case #7 45 yo sometimes wets her pants and sometimes loses urine just when she exercises. Diagnosis Options Bladder infection Interstitial cystitis Bladder cancer Atrophic bladder mucosa Stress Urinary Incontinence Urgency Incontinence Mixed Incontinence Treatment Options Antibiotics Cystoscopy Bladder biopsy Double void x 3 days 2-minute void x 3 days Pessary Support surgery