Encounter for other general counseling and advice on contraception -Contraceptive options discussed in detail. Patient advised to avoid pregnancy at least until cystocele improves. Progesterone only oral contraceptives, DEPO shot, and IUD discussed as options for birth control due to migraines. Patient would like to think contraceptive options over at home. Will call when she decides. Discussed starting Norethisterone 5mg tablets 1 tab once a day for 28 days, Depo shot every 3 months, or Mirena IUD insertion every 5 years. RTC in 2 weeks for encounter for contraceptive management or sooner if needed.
Cystocele- Patient advised to start pelvic floor therapy due to cystocele. Referred to pelvic floor therapy. Patient advised to avoid pregnancy at least until cystocele improves.
Malposition of Uterus-Start pelvic floor therapy. Referral sent to pelvic floor therapist.