The content is prepared specially for Health Teaching Or Clinical teaching purpose for the subject of Reproductive Health & Gynecological Nursing. It's a short summarization form of Uterovaginal Prolapse. For more details please go through the references which I have mentioned. Thank you

1. UTEROVAGINAL PROLAPSE
Presented by: Sweta Koirala
B.Sc Nursing 14th Batch
KUSMS, Dhulikhel 18/31/2020

2. UTEROVAGINAL PROLAPSE
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3. COURSE CONTENT
• Normal anatomy of the uterus
• Introduction
• Causes
• Symptoms
• Management
• Prevention
• Complications
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4. Normal anatomy of Uterus
• The uterus is a thick muscular organ capable of
expansion to accommodate a growing fetus
• It usually lies immediately postero superior to
the bladder and anterior to the rectum
• The exact anatomical location of the uterus
varies with the degree of distension of bladder
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6. INTRODUCTION
• Uterine prolapse refers to collapse or descend
or change in the position of uterus in relation
to surrounding structure in pelvis
• It happens when the pelvic floor muscle and
ligaments become weak and are no longer able
to support the uterus
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7. STAGES OF UV PROLAPSE
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8. STAGES
• STAGE 0- External OS is at level of ischial spine,
no prolapse
• STAGE I- Uterus descends down but external OS is
above introitus
• STAGE II- External OS lies outside vaginal introitus
but uterus is inside the vagina
• Stage III- Uterus lies outside the introitus
• Stage IV- Complete prolapse wit eversion of entire
vagina
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9. CAUSES???
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10. OBESITY/ OVERWEIGHT
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11. PREGNANCY
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12. PROLONG LABOR
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13. MACROSOMIC BABY
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14. DECREASED ESTROGEN LEVEL
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15. CONSTIPATION
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16. CHRONIC COUGH
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17. HEAVY EXERCISES/ WEIGHT
LIFTING
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18. MULTIPAROUS WOMEN
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19. ABDOMINAL OR PELVIC TUMORS
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20. CONGENITAL DISEASE
CONDITIONS
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21. SIGNS AND SYMPTOMS ???
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22. SIGNS AND SYMPTOMS
• Feeling of something
coming down per
vaginam, especially
while moving about
• Discomfort during
walking if mass
comes outside the
introitus
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23. SIGNS AND SYMPTOMS CONTD…
• Backache or dragging
pain in the pelvis
• Dyspareunia
• Excessive whitish or
bloody discharge per
vagina
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24. URINARY SYMPTOMS :
Difficulty passing urine , incomplete emptying
of bladder
Urgency or frequency
Urinary retention
Painful micturition
Stress incontinence
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25. BOWEL SYMPTOMS:
Difficulty in passing stool
Fecal incontinence
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26. MANAGEMENT??
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27. MANAGEMENT
Conservative management :
• Estrogen replacement therapy
• Pelvic floor exercises i.e. Kegel exercise
• Pessary treatment
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28. INDICATIONS OF PESSARY USE
Early pregnancy
Puerperium
Patients unfit for surgery
Patients unwillingness for operation
While waiting for operation
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29. TREATMENT CONTD…
Surgical management:
• Vaginal hysterectomy with pelvic floor repair
(PFR)
• Anterior and posterior colporraphy
• Total abdominal hysterectomy
• Fothergill’s operation
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30. Prevention ?
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31. GENERAL MEASURES
Maintenance of birth spacing
Avoidance of:
 strenuous activities
 chronic cough
 constipation
 heavy weight lifting
 too many contraceptive devices
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32. PREVENTION
During pregnancy:
• Pelvic floor exercise
During labor:
• Avoid bearing down effect before the cervix is
not fully dilated
After delivery:
• Prevention of constipation
• Continuation of pelvic floor exercises
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33. PREVENTION CONTD…
After menopause:
• Hormonal replacement therapy
• Avoid prolong standing
• Avoid heavy lifting and chronic cough
• Continuation of pelvic floor exercise
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34. COMPLICATIONS
• Urinary tract infection (UTI)
• Urinary incontinence
• Fecal incontinence
• Dyspareunia
• Decubitus ulcer
• Hypertrophy of cervix
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35. SUMMARIZATION
1) What is Uterovaginal Prolapse ?
2) What are any 3 causes of UV prolapse ?
3) What are any 3 signs & symptoms of UV
prolapse ?
4) What are any 4 preventive measures of UV
prolapse ?
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36. THANK YOU
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37. REFERENCES
• Dutta D.C, Konar H. DC Dutta’s Textbook of
Gynaecology, 7th Ed,India: Jaypee Brothers
Medical Publishers(P) Ltd; 2008
• Prasai DG, Bhattarai S G. Gynaecology
Nursing, 1st Ed,Kathmandu: Medhavi
publication; 2012
• Sharma Muna. Nursing Concepts and
Principles, 2nd Ed, Kathmandu: Medhavi
Publication; 2016
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