Uterine prolapse

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Uterine prolapse

  1. 1. 1<br />Uterine prolapse<br />www.freelivedoctor.com<br />
  2. 2. 2010-5-6<br />Definition<br />The uterus gradually descends in the axis of the vagina taking the vaginal wall with it. It may present clinically at any level, but is usually classified as one of three degrees.<br />www.freelivedoctor.com<br />
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  5. 5. 2010-5-6<br />5<br />www.freelivedoctor.com<br />
  6. 6. 2010-5-6<br />www.freelivedoctor.com<br />
  7. 7. 7<br />Degrees of uterine prolapse<br /><ul><li>First degree:cervix still inside vagina</li></li></ul><li>2010-5-6<br />8<br />Degrees of uterine prolapse<br /><ul><li>Second degree:the cervix appears outside the vulva. The cervical lips may become congested and ulcerated</li></ul>www.freelivedoctor.com<br />
  8. 8. 2010-5-6<br />Degrees of uterine prolapse<br /><ul><li>Third degree:completeprolapse.In the picture the uterus is retroflexed,and the outline of bladder can be seen.This is sometimes called complete procidentia.</li></ul>www.freelivedoctor.com<br />
  9. 9. 10<br />Causes<br /><ul><li>The stretching of muscle and fibrous </li></ul> tissue<br /><ul><li>Increased intra-abdominal pressure</li></ul>www.freelivedoctor.com<br />
  10. 10. 2010-5-6<br />11<br /><ul><li>In recent years,the incidence of prolapse is greatly reduced .The more liberal use of caesarean section and the elimination of labours are probably the two most important factors.</li></ul>www.freelivedoctor.com<br />
  11. 11. 2010-5-6<br />12<br />Symptoms<br />Something coming down<br />Backache<br />Increased frequency of micturition<br />A ‘bearing down’ sensation<br />Stress incontinence<br />Coital problems<br />Difficulty in voiding urine<br />www.freelivedoctor.com<br />
  12. 12. 2010-5-6<br />13<br />www.freelivedoctor.com<br />
  13. 13. 2010-5-6<br />14<br />www.freelivedoctor.com<br />
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  15. 15. 2010-5-6<br />16<br />www.freelivedoctor.com<br />
  16. 16. 17<br />Treatment<br />Pessary treatment<br />Indications<br />Patient prefers a pessary.<br /> Pelvic surgery risks<br /> Prolapse amenable to pessary<br /> The patient is not fit for surgery<br /> Patient wishes to delay operation<br />www.freelivedoctor.com<br />
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  20. 20. www.freelivedoctor.com<br />
  21. 21. Surgery<br /><ul><li>Anterior colporrhaphy</li></ul> (and repair of cystocele)<br /><ul><li> Posterior colpoperineorrhaphy</li></ul> (including repair of rectocele)<br /><ul><li> Manchester repair
  22. 22. Vaginal hysterectomy</li></ul>www.freelivedoctor.com<br />

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