Urogynecology and Pelvic Floor Dysfunctions

Gynecology and Obstetrics · Clinical Specialties

How it begins

El suelo pélvico es un sistema de suspensión biomecánico que sostiene la vejiga, el útero/cúpula vaginal y el recto contra la gravedad y la presión intraabdominal. Su falla —estructural, neurológica o funcional— produce el espectro de incontinencia urinaria, prolapso de órganos pélvicos, disfunción anorrectal y dolor pélvico crónico.

What it covers

1. Introduction, Definitions and Epidemiology
2. · 1.1 Standardized Terminology (ICS/IUGA)
3. · 1.2 Epidemiology and Disease Burden
4. · 1.3 Impact on Quality of Life
5. Functional Anatomy of the Pelvic Floor
6. · 2.1 The Levator Ani Muscular Complex
7. · 2.2 DeLancey's Three Levels of Vaginal Support
8. · 2.3 Pelvic Floor Innervation
9. Physiology of Urinary and Fecal Continence
10. · 3.1 The Normal Urination Cycle
11. · 3.2 Urethral Closure Mechanisms (Passive Continence)
12. · 3.3 Physiology of Fecal Continence
13. Pathophysiology and Risk Factors
14. · 4.1 Vaginal Birth as the Main Causal Factor
15. · 4.2 Non-Obstetric Risk Factors
16. Urogynecological History
17. · 5.1 Characterization of Urinary Symptoms
18. · 5.2 Urination Diary (Bladder Diary)
19. · 5.3 Validated Questionnaires
20. · 5.4 Complementary Directed Story
21. Physical Examination and the POP-Q System
22. · 6.1 Preparation and Sequence of the Exam
23. · 6.2 The POP-Q System (Pelvic Organ Prolapse Quantification)
24. · 6.3 POP-Q staging
25. · 6.4 Muscle and Functional Evaluation
26. Urodynamic Studies and Complementary Tests
27. · 7.1 Components of the Multichannel Urodynamic Study
28. · 7.2 Indications for Preoperative Urodynamic Study
29. · 7.3 Other Complementary Tests
30. Stress Urinary Incontinence (SUI)
31. · 8.1 Pathophysiological Mechanisms
32. · 8.2 Diagnostic Criteria and Severity
33. Overactive Bladder and Urge Incontinence
34. · 9.1 Pathophysiology
35. · 9.2 Clinical Presentation and Differential Diagnosis
36. · 9.3 Mixed Incontinence: the Challenge of Predominance
37. Overflow Incontinence and Neurogenic Bladder
38. · 10.1 Overflow Incontinence
39. · 10.2 Neurogenic Bladder: Topographic Correlation
40. · 10.3 Functional Incontinence
41. Pelvic Organ Prolapse (POP)
42. · 11.1 Classification by Compartment
43. · 11.2 Cardinal Symptoms of Prolapse
44. · 11.3 Differential Diagnosis of Vaginal Lump
45. Anorectal Dysfunction
46. · 12.1 Classification of Fecal Incontinence
47. · 12.2 Obstetric Anal Sphincter Injury (OASIS)
48. · 12.3 Obstructive Defecation Syndrome
49. Chronic Pelvic Pain and Hypertonic Pelvic Floor
50. · 13.1 Pelvic Myofascial Pain Syndrome
51. · 13.2 Nantes Criteria for Pudendal Neuralgia
52. Conservative Treatment and Rehabilitation
53. · 14.1 Pelvic Floor Muscle Training (PFMT)
54. · 14.2 Vaginal Pessaries
55. · 14.3 Hypertonic Pelvic Floor Rehabilitation
56. Pharmacological Treatment
57. · 15.1 Pharmacology of the Overactive Bladder
58. · 15.2 Local Vaginal Estrogen Therapy
59. · 15.3 Duloxetine in SUI
60. Surgical Treatment
61. · 16.1 Surgery for Stress Urinary Incontinence
62. · 16.2 Compartment Prolapse Surgery
63. · 16.3 Surgical Complications to Monitor
64. Special Situations and Long-Term Monitoring
65. · 17.1 Perinatal Prevention and Management
66. · 17.2 Considerations in the Frail Geriatric Patient
67. · 17.3 Athletes and High Impact Activity
68. · 17.4 Long-Term Monitoring and Measurement of Results