Nokea
A 58-year-old postmenopausal woman presents with a sensation of pelvic heaviness and states she feels like something is sitting in her vagina. On examination, the provider notes a visible protrusion of the bladder into the anterior vaginal wall. What structural disorder of the female reproductive system is consistent with these findings?
Correct Answer: A
Rationale: The correct answer is A: pelvic floor prolapse. This condition is characterized by weakening of the pelvic floor muscles and ligaments, leading to descent of pelvic organs such as the bladder into the vagina. The patient's symptoms of pelvic heaviness and sensation of something in her vagina are classic signs of pelvic floor prolapse. Examination findings of visible protrusion of the bladder into the anterior vaginal wall further support this diagnosis.
Explanation of incorrect choices:
B: DES exposure - This is not a structural disorder of the female reproductive system. DES exposure is associated with adverse effects on reproductive health but does not present with visible bladder protrusion.
C: Vaginal septum - This is a congenital anomaly where the vagina is divided by a septum. It does not typically present with bladder protrusion.
D: Bladder fistula - This is an abnormal connection between the bladder and another structure. While it can cause urinary symptoms, it does not typically present with visible bladder protrusion into the vagina.