Uterine prolapse is the downward displacement of the uterus into the vaginal canal. It is usually rated by degree depending on how far the uterus has descended. Risk factors include pregnancy, childbirth, obesity, chronic coughing, and menopause. Symptoms include pressure or heaviness in the pelvis, urinary problems, and painful sex. Treatment options include the use of a vaginal pessary or various surgical procedures to repair tissues. Nursing care focuses on preventive measures like Kegel exercises and helping patients before and after surgery.

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.