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Pelvic organ prolapse occurs when one or more pelvic organs, such as the bladder, uterus, or rectum, descend from their normal positions due to weakness or damage in the muscles and tissues that support these organs. The document discusses the anatomy of pelvic floor support, factors that can contribute to prolapse, and how different types of prolapse such as cystocele, rectocele, and enterocele are evaluated and treated. Conservative treatments focus on lifestyle changes while surgical repairs aim to reconstruct the weakened pelvic floor tissues and fascia.
This document discusses the evaluation and management of genital prolapse. It begins by describing normal uterine and vaginal support structures. It then discusses the pathophysiology of pelvic organ prolapse, including neuromuscular dysfunction and weakness of supporting ligaments. Evaluation involves history, physical exam including staging systems, and sometimes additional tests. Treatment options include conservative approaches like pessaries or intravaginal devices, as well as surgical options.
Complications of mesh and should we use it ? - www.jinekoklojivegebelik.comjinekolojivegebelik.com
The document discusses the use of mesh in pelvic organ prolapse (POP) surgery, comparing synthetic and biological meshes. It summarizes various studies that have found complication rates ranging from 0-39% for synthetic meshes and 0-64% for biological meshes. While mesh may be preferable for recurrent or complex cases, there is no strong evidence currently to support its routine use in POP surgery. Further research through RCTs and pooled audits is still needed.
The document discusses several potential postpartum complications including postpartum hemorrhage, infection, urinary incontinence, prolapse, and mental health issues. Postpartum hemorrhage is the leading cause of maternal mortality and can be life-threatening, with causes such as uterine atony, lacerations, and retained placenta. Other complications include infection, urinary incontinence, structural issues like prolapse, and mental health issues such as postpartum depression. Prevention, early assessment, and treatment are emphasized to manage complications.
This document provides an overview of abdominal anatomy terminology and structures. It discusses the internal coverings of the abdomen including the peritoneum and mesenteries. It then covers the blood supply and innervation of the foregut, midgut, and hindgut. Finally, it discusses some common congenital abnormalities that can occur in embryonic development of the gastrointestinal tract.
Gebelik Kolestazı -Cholestasis of Pregnancy - www.jinekolojivegebelik.comjinekolojivegebelik.com
1. Intrahepatic cholestasis of pregnancy is characterized by pruritus and jaundice in the last trimester of pregnancy, and can recur in subsequent pregnancies.
2. Laboratory findings include elevated serum bile acids and liver enzymes. The condition can cause complications like preterm birth and fetal distress.
3. Treatment focuses on relieving pruritus through medications like cholestyramine, antihistamines, phenobarbital, and ursodeoxycholic acid. Delivery may be indicated if symptoms are severe or fetal well-being is compromised.
PCOS is a common hormonal disorder characterized by oligomenorrhea and hyperandrogenism. It can cause long term health risks like diabetes, cardiovascular disease, and endometrial cancer. Management involves lifestyle changes like weight loss through diet and exercise to improve symptoms. Medications may be used to treat irregular periods, hirsutism, and help with ovulation induction and fertility. Screening for metabolic complications is recommended due to increased risk.
PCOS was first described in 1935 and affects 5-10% of women of reproductive age, making it the most common endocrine disorder. It is characterized by hyperandrogenism, chronic anovulation, and polycystic ovaries. Patients often see multiple medical practitioners before receiving a correct diagnosis of PCOS due to its variable signs and symptoms. Women with PCOS are also at higher risk of developing diabetes, cardiovascular disease, and other metabolic complications. Lifestyle interventions including diet and exercise can help manage symptoms and reduce health risks associated with PCOS.
Case 1 involves a 17-year-old female with primary amenorrhea who has normal development and health history. Her physical exam and labs are normal except she is underweight. She likely has hypothalamic amenorrhea due to inadequate calorie and fat intake and should be evaluated for an eating disorder.
Case 2 is a 24-year-old woman with secondary amenorrhea and irregular periods. She is overweight with signs of PCOS like acne and hirsutism. Her labs show elevated testosterone and cystic ovaries on ultrasound consistent with a diagnosis of PCOS.
Case 3 is a 29-year-old with secondary amenorrhea and a history of spontaneous abortion and D&