Professor B T Haylen
Obstetrician in North Sydney

A full history of the main symptoms is taken as well as other symptoms that may be present but are not recognized as important. Maximum women presenting for assessment will have more than one symptom. Stress Incontinence: Involuntary loss of urine with coughing, running, jumping, sneezing and other exercise activities. Encourage incontinence: Involuntary loss of urine associated with a compelling desire to void which is hard to defer (urgency). Urgency: A compelling desire to void which is hard to defer. Pelvic pressure: A dragging, heaviness feeling or fullness in the lower abdomen generally concentrated overhead the pubic bone. Vaginal lump: If the prolapse is more advanced, women will feel a bulge or a lump sitting at the entrance to the vagina or even outside the vaginal entrance. sacra backache: A period like sacra (lower) backache may indicate prolapse due to the stretching of the supports of the uterus and upper vagina (uterosacral ligaments) which are attached there. If there is say uterine prolapse, the below segment (the cervix) may be impinged upon with intercourse, causing discomfort. Strain to void: The need to push or strain to attain passage of urine. There may be a relation to intercourse, lengthy distance travel (dehydration) or before surgery though quite often none of these relations exist. Preceding surgery: Any operations for general gynecological problems, especially hysterectomy, or past bladder surgery are generally maximum suitable Preceding or donate medical illnesses: It is imperative to understand any or all former and inter stylish illnesses as some of these might be relevant to management. The usual age for women presenting for assessment is 56 years. Often they are then postmenopausal and issues related to this might coexist. Medications: Research on those medications that might affect the bladder is relatively small. A entire list of medications is urgent in planning any treatment necessary.

Urogynaecology is the area of gynecology and Female Urology that involves the assessment and treatment of below urinary tract (bladder and urethra) and pelvic floor problems including uterine and vaginal prolapse. These are imperative studies to measure true pressure in the bladder during bladder filling and emptying. Bladder conditions such as urinary incontinence or voiding dysfunction cannot be effectively treated without prolapse surgery. A triumphant overall prolapse repair is unlikely unless this area of weakness (if present) is repaired. Symptoms of voiding dysfunction what do they really mean? Urine flow rates in women with symptoms of below urinary tract dysfunction. The cervix of the retroverted uterus is anteriorly placed in the vagina close to the bladder or urethra as opposed to the position of the cervix of the anteverted uterus lying in the posterior for nix and directed inferoposteriorly. It was noted that with 6 women 16, the uterus was anteverted with a full bladder and retroverted with an unoccupied bladder (a retroverted uterus never became anteverted). Women presenting with cyclical symptoms of below urinary tract dysfunction are more liable to have a retroverted uterus. As a further observation, the symptom of stress incontinence tends to be different in women with a retroverted uterus. Due to the anteriorly placed cervix, the anterior vaginal wall of women with a retroverted uterus can be observed to be functionally if not actually shorter than those with an anteverted uterus. Surgery in the posterior vaginal compartment generally is the last piece of multicompartment vaginal pelvic organ prolapse (POP) surgery. Some of these can only really be assessed accurately and all are best measured at the time of surgery for posterior vaginal prolapse. This examine suggests a conceivable role for the PG, PVVD, MVP (undisplaced), ROFL as key (anatomical surgical) indicators (AI) to quantify specific defects in at different levels of posterior vaginal compartment surgery (PR), namely the perineum, posterior vaginal vault, vaginal mucosa and recto vaginal space respectively. We have previously suggested 20 that the vaginal vault should be considered as an area rather than an apex, the former with anterior, posterior and lateral aspects. Three Levels of defects are pertinent to the majority of PCs compared with perhaps only one Smooth (II) flaw anteriorly, provided the vault component of any anterior fault is resolved by the posterior vault fix (e.g. Not only do the component surgeries identified in this study address the defects of the posterior vagina and posterior vaginal vault, they may have an impact, if performed effectively, in providing ongoing urge for the anterior vaginal wall and assisting in preventing recurrences. (ii) Relevant surgery: Including and especially before hysterectomy, prolapse ardor continence surgery. (iv) Medications: Including those with obvious or possible effects on the under urinary tract. All examinations for pelvic organ prolapse should