Uterine prolapse


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Uterine prolapse

  1. 1. Prepared by: Cheng Chan Mara
  2. 2. Definition  Uterine Prolapse is the downward displacementof the uterus into the vaginal canal or a graduallydescends of the uterus in the axis of the vagina takingthe vaginal wall with it.
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  4. 4. Usually, prolapse is rated by degrees:  rests in the lower First-degree prolapse: the cervix part of the vagina. Second-degree prolapse: the cervix is at the vaginal opening. Third-degrees prolapse: the uterus protrudes through the introitus.
  5. 5. First degree prolapse 
  6. 6. Second degree prolapse 
  7. 7. Third degree prolapse 
  8. 8. Etiology  Stretching of muscle and fibrous tissue. eg. Pregnancy and childbirth. Increased intra-abdominal pressure as a result of chronic coughing, lifting of heavy objects and obesity, place pressure on the pelvic floor. A constitutional predisposition to stretching of the ligaments as a response presumably to years in the erect position. Menopause and ageing increase the risk of prolapse. (The female hormone estrogen plays an important role in maintaining the strength of the pelvic floor).
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  11. 11. Clinical Manifestation  on a small ball Feeling like you are sitting Difficult or painful sexual intercourse Frequent urination or a sudden urge to empty the bladder Low backache Uterus and cervix that stick out through the vaginal opening Repeated bladder infections Feeling of heaviness or pulling in the pelvis Vaginal bleeding Increased vaginal discharge
  12. 12. Treatment Vaginal pessary:  This device fits inside your vagina and holds youruterus in place. Used as temporary or permanent treatment,vaginal pessaries come in many shapes and sizes.
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  14. 14. Treatment (cont.)  Surgery: Several different types of surgery can be used totreat a severe genital prolapse. These proceduresinclude: • surgery to repair the tissue that supports the prolapsed organ • surgery to repair the tissue around the vagina • surgery to close the opening of the vagina • surgery to remove the womb (hysterectomy)
  15. 15. Collaborative Care  preventive measures:  Early visits to HC provider = early detection  Teach Kegel’s exercises during PP period preoperative nursing care:  Thorough explanation of procedure, expectation and effect on future sexual f(x)  Laxative and cleansing edema (rectocele) – independently, at home a day prior procedure  Perineal shave prescribed also  Lithotomy position for surgery postop nursing care:  Pt. is to void few hours after surgery; catheter if unable (after 6 hrs)
  16. 16. Thanks You!
  17. 17. Reference  http://www.davincihysterectomy.com/assets/images/uterus_pr olapse_after_220x201.jpg http://1.bp.blogspot.com/- AgGyPkYlLRI/UF0MM5nArgI/AAAAAAAAGf0/aLGNf4gtPDU /s320/vaginal-prolapse.JPG http://sdlc-esd.sun.com/ESD6/JSCDL/jdk/7u7- b11/jxpiinstall.exe?AuthParam=1348826780_3c1d68b448bc8c2e320 c4a720ab8fce3&GroupName=JSC&FilePath=/ESD6/JSCDL/jdk/7 u7-b11/jxpiinstall.exe&File=jxpiinstall.exe&BHost=javadl.sun.com http://www.nhs.uk/conditions/prolapse-of-the- uterus/pages/treatment.aspx http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002477/ http://www.mayoclinic.com/health/uterine- prolapse/DS00700/DSECTION=symptoms http://www.mayoclinic.com/health/uterine- prolapse/DS00700/DSECTION=treatments-and-drugs Medical Surgical Nursing (Volume 2) by Lewis, Heitkemper, Dirksen, O’Brien, Bucher.