2010-5-6 Definition 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. www.freelivedoctor.com
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7 Degrees of uterine prolapse
First degree:cervix still inside vagina
2010-5-6 8 Degrees of uterine prolapse
Second degree:the cervix appears outside the vulva. The cervical lips may become congested and ulcerated
2010-5-6 Degrees of uterine prolapse
Third degree:completeprolapse.In the picture the uterus is retroflexed,and the outline of bladder can be seen.This is sometimes called complete procidentia.
The stretching of muscle and fibrous
Increased intra-abdominal pressure
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.
2010-5-6 12 Symptoms Something coming down Backache Increased frequency of micturition A ‘bearing down’ sensation Stress incontinence Coital problems Difficulty in voiding urine www.freelivedoctor.com
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17 Treatment Pessary treatment Indications Patient prefers a pessary. Pelvic surgery risks Prolapse amenable to pessary The patient is not fit for surgery Patient wishes to delay operation www.freelivedoctor.com