Cystocele, Rectocele, and Vaginal Prolapse Essay

Cystocele, Rectocele, and Vaginal Prolapse - Essay Example Vaginal prolapse on the other hand resembles a hernia for there is protrusion of part of the abdominal or pelvic contents through an aperture in the supporting structures. Protrusion takes place between the two levatores ani and, in more severe cases, through the orifice of the vagina when vaginal prolapse occurs (Hamilton-Fairley, D., 2004). Signs and Symptoms: The commonest complaints are feeling of fullness of the vagina, a lump coming down, a dragging sensation or bearing down in the back or lower abdomen, vaginal discharge due to congestion of the cervix, an ulcer of the ectocervix or cervical ectropion, and a bloodstained discharge may occur if there is ulceration. Difficulty with coitus may be experienced if the cervix protrudes or is greatly elongated. Urinary symptoms include frequency of micturition. This is common and is often daytime only. Nocturnal frequency may be present if there is added cystitis. Some patients may have urgency of micturition due to weakness of the bladder sphincter mechanism and urge incontinence may occur in some cases. There may be difficulty in emptying the bladder completely and the woman may find she has to push the prolapse up with a finger to complete the act of micturition. Complete retention of urine may follow urethral overstretch. This may be associated with stress incontinenc e. Many women with prolapse complain of constipation, and this may be due to difficulty in emptying the rectum completely because it bulges into the vagina. Others notice discomfort on sitting on a firm surface; the vaginal wall over the rectocoele can bulge down between the labia. With age, the labia become atrophic and less protective and the prolapsed vagina is exposed to trauma when sitting on hard surfaces (Hamilton-Fairley, D., 2004). A cystourethrocoele is usually obvious and the distance from the introitus to the bulge can be measured using a special ruler. The woman is asked to cough and any leakage of urine and/or descent of the cervix is noted. As the speculum is withdrawn any posterior vaginal wall prolapse can be noted. Where there is a complaint of stress incontinence, examination is best made with some urine in the bladder; the urethra and bladder neck may then be supported with two fingers to demonstrate that this maneuver controls the incontinence (Hamilton-Fairley, D., 2004). Diagnostic and Therapeutic Procedures: Stress incontinence must be distinguished from other causes of incontinence of urine such as urge incontinence and incontinence due to neurological disease. General examination should include fitness for surgery. Abdominal examination should be performed to exclude an intra-abdominal mass. Manual pelvic examination or ultrasound should exclude a pelvic mass and delineate the size of the uterus and ovaries if present. If prolapse is not evident, even with a Valsalva manoeuvre, the patient should be examined in the upright position. It is important to reproduce the symptoms and signs with which the patient presents. If a woman has significant urinary symptoms, urodynamics may help define the cause of the symptoms, which will enable the gynaecologist to give some prognosis for treatment. Hence, if urodynamics

Criminal Law - newspaper articles Assignment Example | Topics and Well Written Essays - 2000 words

Criminal Law - newspaper articles - Assignment Example The overall purpose is to reach a conclusion on the accuracy of press reports that touch on legal matters while pointing out various reasons for inaccuracies that occur. Under the UK rules, fraud by false representation refers to a situation where a person makes a false representation either by intent or being dishonest in the process for personal gains. A representation is defined as being false if the person making it knows that it is true and misleading. In other case, fraud may be by a person failing to disclose information by intent through dishonest means for personal gains. The other part is fraud by abuse of position in which the person involved misuses his position for his personal gain. In the article, James Stevenson has pleaded guilty of an account of fraud in the IT firm where he worked by adding nectar points to his card which he later used to purchase things and access services. The judge also refers to him as having used his office to represent himself falsely. In the case that is presented in the article, James Stevens is guilty of one account of fraud namely fraud by abuse of position. Stevens used his position where he had access to all the activities that involve the use of cards, which was run by a third party, to benefit from services that were being offered by use of the card. This is evidenced by the amount of items that he purchased using the card despite his denial of the figures that have been presented in court. The reporting was not accurately done because in the article, an impression is created that Stevens was sent to jail because of having just added the amount of nectar points to his card. This scenario points out the inaccuracies in the reporting of legal affairs. PC Jamie Hillman who stole over  £70,000 from banks in loans to fund an extra marital affair walked out of court freely as the judge declared him of being emotionally fragile. The Bristol court