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that may or may not involve the placement of mesh, and obliterative surgery (Iglessia & Smithling, 2017). Recurrent UTI. A UTI is a symptomatic bacterial infection that occurs within the urinary tract. The pathogens associated with a UTI include E. Coli, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis, and S. saprophyticus (Flore, Walker, Caparon, & Hultgren, 2015). If a woman presents with one or more of the following symptoms, a UTI should be suspected, these symptoms are dysuria, frequency, back pain, and pelvic pressure or pain (Flore, Walker, Caparon, & Hultgren, 2015). The combination of positive nitrate and leukocytes in a urine specimen indicates a UTI and a sample should be sent to the lab for culture and sensitivity (Flore, Walker, Caparon, & Hultgren, 2015). Until the culture results return, the patient should be treated empirically (Flore, Walker, Caparon, & Hultgren, 2015). For recurrent UTIs, a urinalysis with a culture and
sensitivity is a must in order to identify the causative organism and prescribeto proper antibiotic treatment (Flore, Walker, Caparon, & Hultgren, 2015).Endometriosis. Risk factors for endometriosis include early menarche, family history, late menopause, low body mass index, Mullerian anomalies, prolonged menstruation, nullparity, short lactation intervals, short menstrual cycles, difficulty with defication, cyclic nausea, and being Caucasian (Schrager, Falleroni, & Edgoose, 2013). A patient will likely presents with symptoms such as dysmenorrhea, abdominal or pelvic pain, painful sex, postcoital bleeding, and nonspecific symptoms such as lower back pain or abdominal pain (Schrager et al., 2013). Some women will also present with diffuse tenderness during their pelvic exam (Schrager et al., 2013). A pregnancy test should be obtained to rule out ectopic pregnancy (Schrager etal., 2013). A transvaginal ultrasound can be used to visualize abnormalities and laparoscopy is the diagnostic tool of choice to visualize “powder burns”,adhesions, and “chocolate cysts” on the ovarian and peritoneal surfaces (Schrager et al., 2013). The treatment of choice is NSAIDs, followed by oralcontraceptives for hormone therapy (Schrager et al., 2013).ReferencesFlore, A., Walker, J., Caparon, M., & Hultgren, S. (2015). Urinary tract infections: Epidemiology, mechanisms of infection, and treatment options. Nat Rev Microbiol 13(5), 269-284. Retrieved from Iglesia, C. & Smithling, K. (2017). Pelvic organ prolapse. American Family Physician, 96(3), 179-185. Retrieved from Schrager, S., Falleroni, J., & Edgoose, J. (2013). Evaluation and treatment ofendometriosis. American Family Physician, 87(2), 107-113. Retrieved from Tarney, C. & Han, J. (2014). Postcoital bleeding: A review on etiology, diagnosis, and management. Obstetrics and Gynecology International, 2014.Doi: 10.1155/2014/192087
Week 7 SummaryI forgot to include J.A’s obstetric history in my original post. J.A. has never been pregnant. She has had yearly visits with her gynecologist since she was20. All of her pap smears have been normal. She reports her menstrual cycle is regular and that it generally occurs for 4 to 6 days. She reports her LMP was 2 weeks ago.