Muhamad Na'im B Ab Razak (jacknaim) is a fresh graduate Muslim Doctor from Universiti Sains Malaysia and waiting for the enrollment into the housemanship program. Ambitious in pursuing master program in emergency and traumatology medicine and loves to spent his free time joining humanitarian missions, writing and speaks as an amateur public speaker in motivation and comparative religion. [HOME]

OSCE pro III series 12


Answer


1) Uterovaginal prolapsed grade III


2)Clinical presentation

-Non specific clinical presentation (lump, local discomfort, bachache, bleeding/infection, dyspareunia)

-Specific; cystourethrocele- urinary frequency and urgency, voiding difficulty, UTI, stress incontinence.

-Rectocele; incomplete bowel emptying, digitations, splinting.
-Worsening protrusion through the vaginal opening over time


3)Ring Pessary (Silicon-rubber based or Shelf pessary)



4)Two complication
-Vaginal erosions and ulcers
-Vaginal tract Infection
-Urinary tract infection
-bleeding
-irritative symptoms
-Stress urinary incontinence
-interfere with sexual intercourse
-difficulty with bowel movement


5)Definitive treatment
Vaginal hysterectomy with colporrhaphy


Notes:
Grading is done while patient is straining and prolapsed is described as lowest or most dependent portion

Grade 1: descent within vagina
Grade 2: Descent into introitus
Grade 3: Descent outside introitus