Abstract
The complete management of incontinence and prolapse is not just a surgical exercise! You need to think about the patient’s medical problems as they relate to their pelvic floor problem. Collaboration with physicians and other surgeons may be needed. From a medical point of view, referral to a respiratory physician, endocrinologist (for hypothyroid-related obesity, diabetes), dietician, or neurologist may be required. If the patient has truncal obesity and cannot lose weight, order tests for serum insulin levels at 0, 1, and 2 h after 75 g glucose load; if she has insulin resistance, metformin therapy is likely to help her lose weight. From a surgical point of view, referral to an ENT surgeon, thyroid surgeon, or colorectal surgeon may be needed. The urogynecologist should treat constipation and atrophic vaginal symptoms.
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© 2013 Springer-Verlag London
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Moore, K.H. (2013). How to Manage the Patient After History and Examination. In: Urogynecology: Evidence-Based Clinical Practice. Springer, London. https://doi.org/10.1007/978-1-4471-4291-1_3
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DOI: https://doi.org/10.1007/978-1-4471-4291-1_3
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