1. Prepared by: Cheng Chan Mara

2. Definition

Uterine Prolapse is the downward displacement
of the uterus into the vaginal canal or a gradually
descends of the uterus in the axis of the vagina taking
the vaginal wall with it.

3. 

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. First degree prolapse


6. Second degree prolapse


7. Third degree prolapse


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).

9. 

10. 

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. Treatment
 Vaginal pessary:

This device fits inside your vagina and holds your
uterus in place. Used as temporary or permanent treatment,
vaginal pessaries come in many shapes and sizes.

13. 

14. Treatment (cont.)

 Surgery:
Several different types of surgery can be used to
treat a severe genital prolapse. These procedures
include:
• 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. 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. 
Thanks You!

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.