30.01.2020 Urogynecology case

This was my first urogynecology patient. She has a total uterine prolapse grade IV. I was able to reposition it and then prodeeded with the usual urogynecology exam. From the anamnesis I understood that the urin loss was occasional from time to time (the prolapse probably helping to reduce this). The stress test was positiv. Urin examination surprisingly showed no signs of infection. This patient is 65 years old! And pretty short. For clarification, Dr. Lovatina standing next to her looks tall in this photo but she is about my height (160 cm). I know at home we would have the ability to offer both a surgical option and a conservative option. Here I can do neither, at least not at the moment. A pessary inserted into the vagina could keep the uterus repositioned. Right now we are trying to find out if something like this can be found here. I suspect not. It would however be a good solution for this very fit and mobile patient.