Vaginal lumps- rapid differentials

Cystocele-Anterior vaginal prolapse- there is an underlying failure of the investing fascia and the bladder also descends -this is called cystocele or bladder prolapse

Severity of vaginal wall prolapse can be graded by the Baden-Walker system- based on level of protrusion Grade 0 No prolapse Grade 1 halfway to hymen Grade 2 to the hymen Grade 3 halfway past the hymen Grade 4 maximal possible

frequency and dysuria pelvic or vaginal fullness bulging upper front wall of vagina some times patient may find it impossible to urinate except by pushing up the cystocele with her finger.

diagnosis can be via examination - apply a single bladed speculum against the posterior vaginal wall while patients are in lithotomy position cystogram treatment○ observe- mild prolapse○ lifestyle changes e.g weight reduction , avoiding constipation○ pelvic floor exercises○ pessary○ surgery

Urethrocele -Urethral prolapse is circumferential protrusion of the distal urethra through the external urethral meatus ( an uncommon condition ).Two variants PrepubertalPost menopausal Presentation would be different based on age.

Prepubertal urethral prolapse is generally asymptomatic Post menopausal prolapse often symptomatic with vaginal bleeding associated with voiding symptoms. Intravenous pyelograms and voiding cystourethrogramps Summarisation of treatment is difficult but is divided into○ medical management○...