2 week postoperative exam after vaginal hysterectomy with pe | Figure 1

obgyndoc

Obstetrics & Gynecology

2 week postoperative exam after vaginal hysterectomy with pelvic floor repair and suburethral sling for complete uterovaginal prolapse. Patient is now continent and has a functional vagina.

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35 year old female with hx of continues incontinence after she was suffering from severe bleeding at delivery of her first child stopped by hysterectomy ..
MRI with contrast was negative
cystoscopy revealed the pictures above !
whats your DDx !
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Uterine prolapse to be operated Repair planned](https://app.figure1.com/case-detail/2528dc41-3e6e-4761-a625-3b08bdfb0356)


Cochrane Review; 19 trials (2717 women).
Key results
Surgery to treat women with POP and stress urinary incontinence:
In two studies of moderate quality, women with stress incontinence benefited from an additional continence procedure (mid‐urethral sling) at the time of vaginal prolapse repair for the outcome of postoperative stress urinary incontinence (SUI). The continence procedure might also be postponed for three months after prolapse surgery with similar success rates. In this situation, some women might avoid an additional continence operation.
It is unclear whether abdominal prolapse repair (sacrocolpopexy or sacrohysteropexy) with an additional abdominal continence procedure (Burch colposuspension) improves urinary leakage after surgery.
Surgery to treat women with POP and occult stress urinary incontinence:
Five moderate‐quality studies of women with prolapse and observed urinary leakage during vaginal examination with a reduced prolapse reported benefit from an additional continence procedure (mid‐urethral sling) when undergoing vaginal prolapse surgery.
Surgery to treat continent women with POP:
Evidence from one moderate‐quality study was inconclusive as to any benefit of an additional continence procedure (mid‐urethral sling) when women underwent vaginal prolapse surgery.


uterine prolapse in a 60-year-old #Schizophrenic patient suffering with #Incontinence](https://app.figure1.com/case-detail/458aa8fb-007b-440a-a8aa-1e89723f1bff)


A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.
He had a history of hypertension, long-term smoking, and a sedentary lifestyle.
On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.](https://app.figure1.com/case-detail/ae0fe999-6875-4474-94f0-ad823dbb9b3a)


A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets.
Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.](https://app.figure1.com/case-detail/c271070f-2bc7-4052-9895-635277e1a7d5)


A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.](https://app.figure1.com/case-detail/48f41642-b9db-4089-b120-a94ee52328de)


patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?](https://app.figure1.com/case-detail/2af390e1-ace8-40ed-ba1c-98fb2d72f4c5)