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  • Approach To The Case

    Încărcat de

    mr.kcbrent
    33 vizualizări18 pagini
    A patient presented with complete procidentia, stage 3 cystourethrocele, and rectocele. She also had hypertension, diabetes mellitus type 2, and known cardiac disease. Her initial management involved a diabetic diet, increased fiber, monitoring of vital signs and intake/output, medications for her conditions, and potential placement of a pessary. If deemed fit for surgery after evaluation, estrogen therapy would begin preoperatively to prepare tissues followed by colpocleisis or colpectomy to repair the pelvic organ prolapse while managing her cardiovascular comorbidities.

    Descriere originală:

    PROCIDENTIA

    Titlu original

    POP Gyne Presentation

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    A patient presented with complete procidentia, stage 3 cystourethrocele, and rectocele. She also had hypertension, diabetes mellitus type 2, and known cardiac disease. Her initial management involved a diabetic diet, increased fiber, monitoring of vital signs and intake/output, medications for her conditions, and potential placement of a pessary. If deemed fit for surgery after evaluation, estrogen therapy would begin preoperatively to prepare tissues followed by colpocleisis or colpectomy to repair the pelvic organ prolapse while managing her cardiovascular comorbidities.

    Drepturi de autor:

    © All Rights Reserved
    Descărcați ca PPTX, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    33 vizualizări18 pagini

    Approach To The Case

    Încărcat de

    mr.kcbrent
    A patient presented with complete procidentia, stage 3 cystourethrocele, and rectocele. She also had hypertension, diabetes mellitus type 2, and known cardiac disease. Her initial management involved a diabetic diet, increased fiber, monitoring of vital signs and intake/output, medications for her conditions, and potential placement of a pessary. If deemed fit for surgery after evaluation, estrogen therapy would begin preoperatively to prepare tissues followed by colpocleisis or colpectomy to repair the pelvic organ prolapse while managing her cardiovascular comorbidities.

    Drepturi de autor:

    © All Rights Reserved
    Descărcați ca PPTX, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    din 18

    Approach to the case

    Pelvic
    Pelvic Organ
    Organ
    Prolapse
    Prolapse

    Physical examination revealed complete


    procidentia, stage 3 cystourethrocele,
    rectocele
    Management
    of a patient
    with
    Complete
    Procidentia,
    cystourethro
    cele,
    rectocele
    with Hypertension, DM type
    II & known cardiac disease
    List of problems
    Known comorbidities:
    Hypertensive
    Type II Diabetes mellitus
    Cardiac disease
    Signs and symptoms
    Urinary urgency
    Difficulty initiating urinary stream
    Urinary incontinence
    Complete procidentia, stage 3 cystourethrocele,
    rectocele
    Residual volume of 300ml after catheterization
    Initial management
    DIET: Diabetic Diet, increase in fiber intake
    Monitor VS q 4 hrs
    Monitor Intake and Output
    Check FBC for patency and record and monitor
    urine volume
    Medications: Maintenance for HPN: ACE/ ARBS,
    Antidiabetic medications, medications for the
    known Cardiac Disease
    Non surgical treatment
    Traditionally
    pessaries have
    been reserved for
    women either
    unfit or unwilling
    to undergo
    surgery.
    Gehrung with knob
    Gellhorn
    Placement
    Surgical management
    Start estrogen therapy 1 mo before surgery
    Stringent preoperative evaluation
    Secure CP Clearance
    Provided patient has no estrogen related cancers
    Evaluate post operative voiding
    Surgical management
    Colpocleisis or colpectomy (narrowing or closure
    of the vaginal tissue and introitus)

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