A 62 years old woman complains of low back
pain and perineal pressure for 1 and half years. She
has been prescribed a pessary which she is reluctant
to wear. On pelvic examination a 2nd degree uterine
prolapse with cystocele and rectocele is observed.
“Is the condition of the uterus collapsing, falling
down, or downward displacement of the uterus with
relation to the vagina. It is also defined as the bulging of
the uterus into the vagina.’’
“ Is characterized by a portion of the
vaginal canal protruding from the opening of the vagina.”
In the pelvic floor, pelvic diaphragm is divided into
anterior triangle and posterior triangle.
Anterior triangle consist of urethra and vagina.
Posterior triangle consist of rectum.
SUPPORTS OF THE UTERUS:
1. Cardinal ligament(mackenrodt’s, transcervical,lateral
2. Uterosacral ligament
3. Pubocervical fascia
SUPPORTS OF VAGINA:
1. Cardinal ligament
2. Pubo cervical ligament
3. Pelvic floor muscles
4. Perineal body
First recorded in about 2000 BC.
First ever successful vaginal hysterectomy for prolapse
was done by a peasent woman on her own. She cut
down her uterus,but end up with urinary incontinence.
Degrees of prolapse of uterus:
There is usual a Right angle Relationship between
uterus and vagina.
How the uterus changes into the same plane as the
As the uterus gets start descending, the uterus
starts moving down and down and down until
Outside of the body.
When it almost outside the body is called
procidentia: marked prolapse
Grade I: cervix is not in vagina.
Grade II: cervix is now in vaginal opening.
Grade III: (procidentia)
The uterus is hanging outside and here it
is wrapped by anterior and posterior wall of
ETIOLOGY of Pelvic Relaxation
It is most commonly related to
When you push a nine pounds baby through a pelvic floor,
injury is not uncommon.
a-non specific symptoms
c-also ask about
MODE OF DELIVERIES