MBchB study guide

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GENITAL PROLAPSE Learning Objectives:At the end of this course, the learner should be able to:1. List the supporting structures of the pelvis2. Discuss the causes of pelvic relaxation3. Describe the various types of genital prolapse4. Discuss the management of genital prolapse; diagnosis, treatment including surgical correction and prevention of the various uro-gynaecological problemsDefinitionDamage or weakness of the structures which support the pelvic organs, resulting in their descent from the normal position and herniation through the vaginal wall.Supporting structures1. Perineal body; the superficial group of perineal muscules and the deep trasverse perineal muscles also contribute to the support.2. Pelvic floor made of the muscular floor, levator ani muscle (Pubovaginalis, puborectalis, Pubococcygeus and ileococcygeaus). 3. Pelvic fascia; Transverse cervical ligaments(Cardinal ligaments), Uterosacral ligaments, pubo-cervical fascia4. The broad ligament and round ligaments have little or no supporting function.Causes of pelvic relaxation1. Obstetric factorsa. Prolonged labourb. Large fetusc. Forceps on cervixd. Perineal injuries and tearse. Malpositio

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