Introduction
The symptoms manifested in Mrs. Meriwether include an uncontrollable urge to urinate, right renal colic, dehydration, and electrolyte and acid-base imbalances. On the other hand, signs reported by the patient include voiding in her underwear, something protruding through her vagina, whitish and cottage cheese-like vaginal discharge, profuse vomiting, and diarrhea. The remarkable details that can help diagnose the patient’s condition are vaginal deliveries complicated by shoulder dystocia, episodes of right renal colic-produced renal lithiasis, and gastroenteritis. The results expected from the ordered tests are the presence of urinary tract infections, normal or elevated blood count, the presence of a tumor in the reproductive system, and urethra and bladder abnormalities. Possible future complications the patient is likely to develop due to her conditions are urinary tract infections and kidney damage.
The Relationship between Urinary Incontinence and the Cystocele and Dystocic Deliveries
There is a significant relationship between urinary incontinence and cystocele and dystocic deliveries. According to Zhu et al. (2018), childbirths play a considerable role in the development and occurrence of pelvic organ prolapse such as cystocele. Dystocic deliveries cause a lot of pressure on the bladder and the muscles between the organ and the vagina. The pressure can contribute to genital and pelvic floor trauma during delivery. As a result, the bladder may sag into the vaginal. Although pregnancies and childbirths cause urinary incontinence, dystocic deliveries may double the risks for the condition (Ahlund et al., 2019). Women who have ever had dystocia deliveries can have problems controlling their bladder due to damaged nerves that control the organ. Additionally, the complications when giving birth can rapture the pelvic floor muscle and move the bladder as well as the urethral, leading to urinary incontinence.
Cystocele Is a Cause of Urinary Tract Infections
Cystocele can cause urinary tract infections even though it does not cause the latter directly. Frequent urinary infections are some of the symptoms related to cystocele (Mayo Clinic, 2020). The latter sags into the former when weakened muscles between the vaginal and the organ lead to a fallen bladder occur. These factors increase urine retention in the bladder after someone urinates or is post-void residual. The large volume of post-void residual raises the risks for recurrent urinary tract infections. Therefore, pelvic organ prolapses such as cystoceles can be considered a contributing factor for urinary tract infections.
The Cause of the Whitish and Cottage Cheese-Like Vaginal Discharge
The occurrence of virginal discharge is common among women, especially during pregnancies. However, an abnormal discharge, like in the case of Mrs. Meriwether, is an indicator of a health problem. Yeast infections may have caused the whitish and cottage cheese-like vaginal discharge the patient had in her last pregnancy. Yeast infection produces whitish and cottage cheese-like discharge, accompanied by itching and burning sensations (Waikhom et al., 2020). Although the existence of yeast in the vagina is not abnormal, it can grow and multiply uncontrollably in certain situations, such as during pregnancies due to disruption of vaginal pH balance caused by hormone changes. Pregnancies raise the amount of estrogen in the body, increasing the vaginal pH. As a result, the vagina becomes less acidic, creating a favorable environment for the yeast to multiply faster and cause infections.
Prognosis of Mrs. Meriwether’s Cystocele
Mrs. Meriwether’s vaginal deliveries complicated by shoulder dystocia contributed to the cystocele. While the condition is not life-threatening, it can harm the patient’s quality of life. Mrs. Meriwether’s cystocele can be managed by avoiding lifting healthy weights or straining, and Kegel exercises strengthen her vaginal and urethra openings (Mayo Clinic, 2020). However, if the cystocele remains untreated, it can worsen, making the patient unable to urinate. The inability to urinate can cause complications such as kidney infections and damage. Urinary obstruction can be caused by other factors such as infections, blood clots, enlarged uterus, kidney, and bladder, as well as ureter stones. Urinary obstruction can also be caused by Tumors inside or outside the urinary tract and trauma with pelvic fracture. Abnormal congenital structures and a weak bladder can further contribute to the condition.
Female Reproductive System Tumors
Something protruding through Mrs. Meriwether’s vagina made her worried about having a tutor. However, medical investigation diagnosed her with stress urinary incontinence, cystocele, and certain female reproductive system tumor that have to be ruled out. In Mrs. Meriwether’s case, the tumors that the doctor must rule out include vulvar, vagina, and cervix cancers. Although other types of cancers affect the female reproductive system, the three mentioned tumors are the ones the patient could have noticed easily from the outside. Complete blood count (CBC) and pelvic ultrasound are tests that helped the doctors confirm that the patient had no tumor.
Renal Colic Produced By a Renal Lithiasis
Renal lithiasis is a health condition caused by stones inside the urinary tract or the kidney. In the case of Mrs. Meriwether, the stones were in the urinary tract, manifested by symptoms such as renal colic. According to Alelign and Petros (2018), renal colic is a pain associated with the blockage of a part of the urinary tract by calculus (stones). These stones form when uric acid and calcium in the urine crystalize. The urinary tract blockage causes pain that comes in waves, as described by the patient. Renal lithiasis can cause urinary tract infections and kidney damage if it remains untreated. The condition reported by the patient is related to chronic kidney disease because the stones in the urinary tract can cause kidney stones. Uribarri (2020) indicates that a history of kidney stones increases the risks for chronic kidney disease and its progression. Therefore, effective treatment of renal lithiasis can lower the possibility of contracting chronic kidney disease.
References
Ahlund, S., Rothstein, E., Rådestad, I., Zwedberg, S., & Lindgren, H. (2019). Urinary incontinence after uncomplicated spontaneous vaginal birth in primiparous women during the first year after birth.International Urogynecology Journal, 31(7), 1409-1416. Web.
Alelign, T., & Petros, B. (2018). Kidney stone disease: An update on current Concepts.Advances in Urology, 2018, 1-12. Web.
Mayo Clinic. (2020). Anterior prolapse (cystocele) – Symptoms and causes. Mayo Clinic. Web.
Uribarri, J. (2020). Chronic kidney disease and kidney stones. Current Opinion in Nephrology and Hypertension, 29(2), 237-242. Web.
Waikhom, S., Afeke, I., Kwawu, G., Mbroh, H., Osei, G., Louis, B. Deku. J, Kasu, E., Mensah, P., Agede, C., Dodoo, C., Asiamah, E., Tampuori, J., Korbuvi, J., & Opintan, J. (2020). Prevalence of vulvovaginal candidiasis among pregnant women in the Ho municipality, Ghana: species identification and antifungal susceptibility of Candida isolates. BMC Pregnancy and Childbirth, 20(1), 1-14. Web.
Zhu, Y., Deng, S., Jiang, Q., & Zhang, Y. (2018). Correlation between delivery mode and pelvic organ prolapse evaluated by four-dimensional pelvic floor ultrasonography.Medical Science Monitor, 24, 7891-7897. Web.