A cystocele is when the wall between the bladder and the vagina weakens.Uterine Prolapse<unk>  can be assessed with a strong clinical history and physical exam, though imaging is often needed for diagnosis. As part of the clinical history, a healthcare provider may ask about obstetric history, including how many pregnancies and deliveries, what mode of delivery and if there were any complications during delivery. Providers will also ask about presence and severity of symptoms such as pelvic pain or pressure, problems with urination or defecation, painful sex, or sexual<unk> . The physical exam may include both examination with a speculum to visualize the cervix and check for inflammation, as well as manual examination with the provider's fingers to assess for pain and strength of pelvic<unk>  muscle contraction. Imaging provides a more complete picture of the type and severity of<unk>  than history and physical exam alone. Historically,<unk> oscopy with defecography and cystography were used. More recently, MRI has been used to complement and sometimes replace<unk> oscopic assessment of the disorder. This technique is less invasive, and allows for less radiation exposure and increased patient comfort, though an enema is required the evening before the procedure. Both<unk> oscopy and MRI assess the pelvic<unk>  at rest and during maximum strain using coronal and sagittal views. When grading individual organ prolapse for severity, the rectum, bladder and uterus are individually assessed. Prolapse of the rectum is referred to as a rectocele, bladder prolapse through the anterior vaginal wall is called a cystocele, and prolapse of the small bowel is an enterocele. To assess the degree of<unk> , three measurements are taken into account. First, an anatomic landmark known as the pubococcygeal line must be determined, which is a straight line connecting the inferior margin of the pubic symphysis at the midline with the junction of the first and second coccygeal elements on a sagittal image. After this, the location of the puborectalis muscle sling is assessed, and a perpendicular line between the pubococcygeal line and muscle sling is drawn. This line provides a reference point for the measurement of pelvic<unk>  descent. Descent greater than 2 cm below this line is considered mild and descent greater than 6 cm is considered severe. Lastly, a line from the pubic symphysis to the puborectalis muscle sling is drawn, which is a measurement of the pelvic<unk>  hiatus. Measurements greater than 6 cm are considered mild, and greater than 10 cm severe. The degree of organ prolapse is assessed relative to the hiatus. The grading for organ prolapse relative to the hiatus is more strict. Any descent below the hiatus is considered abnormal, and descent greater than 4 cm is considered severe. Ultrasound can also be used to diagnose<unk> . Transabdominal, transvaginal, transperineal and endoanal ultrasound (EUS) are important tools for diagnosing<unk> . For EUS, an ultrasound probe is inserted into the anal canal and can be used to visualize and assess the anatomy and function the pelvic<unk> . Ultrasound is easily accessible and noninvasive, however it may compress certain structures, does not produce high quality images and cannot be used to visualize the entire pelvic<unk> .
Pelvic floor dysfunction
Delayed ejaculation
Premature ejaculation
Pelvic girdle pain
Pelvic pain
Dyspareunia
Pelvic organ prolapse
Coital incontinence