Urogynaecology

1. A fit and very active 62 year old woman presents with a 12 month history of noticing a “lump coming down below”. She has no past medical history of note and has previously had 4 vaginal deliveries. On vaginal examination, she has a complete procidentia. What is the definitive management for her?

2. A 65 year old woman is referred to the outpatient clinic with a history of urinary frequency and difficulty emptying her bladder completely. She is known to be a poorly controlled hypertensive and suffers from diabetes. She has a BMI of 38. She is sexually active. On speculum examination she has a large cystocoele and significant uterine descents ( grade 3 on popq). What is the single most best management for her?

3. Mrs Briganza, 58 year old, sexually active, complains of a “ballooning” of tissue through the vaginal opening when she stands for long periods of time. She had a vaginal hysterectomy 15 years previously for dysfunctional uterine bleeding. She is sexually active and she complains of mild Dysparuenia. On examination, she has a vault prolapse. What is the best definitive management for her?

4. Mrs. X a fit and very active 65 year old woman presents with a 12 month history of noticing a “lump coming down below”. She has no past medical history of note and has previously had 6 vaginal deliveries. She had undergone vaginal hysterectomy 6years back for grade 3prolpase. On vaginal examination popq is enclosed in grid form. What’s popq classification of Mrs.X?

5. Mrs. Bx, 55year old woman presents with a 10 months history of noticing a “lump coming down below”. She has no past medical history of note and has previously had 3 vaginal deliveries. She had undergone vaginal hysterectomy 3years back for grade 2 prolpase.
Complains of incomplete emptying of bladder, urgency.
On vaginal examination popq is enclosed in grid form. What’s popq classification of Mrs.Bx?

6. Mrs. CD, 55year old woman presents with a 12months history of noticing a “lump coming down below”. She has no past medical history of note and has previously had 3 vaginal deliveries.
She had undergone vaginal hysterectomy 3years back for grade 3 prolpase.
Complains of incomplete emptying of bladder, urgency, Frequency.
On vaginal examination popq is enclosed in grid form. What’s popq classification of Mrs.Bx?

7. Mrs. ZN, 55year old woman presents with a 10 months history of noticing a “lump coming down below”. She has no past medical history of note and has previously had 4 vaginal deliveries.
She had undergone vaginal hysterectomy 2 years back for grade 4prolpase.
Complains of incomplete emptying of bladder, urgency and incomplete evacuation of bowel and constipation.
On vaginal examination popq is enclosed in grid form. What’s popq classification of Mrs.ZN?