uterine prolapse

1. Uterine Prolapse
Prepared by: Cheng Chan Mara

2. 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.
Definition

4. Usually, prolapse is rated by degrees:
• First-degree prolapse: the cervix rests in the lower 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. • 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).
Etiology

11. • Feeling like you are sitting on a small ball
• 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
Clinical Manifestation

12. • 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.
Treatment

14. • 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)
Treatment (cont.)

15. • 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:
Collaborative Care

16. Thanks You!

17. • http://www.davincihysterectomy.com/assets/images/uterus
_prolapse_after_220x201.jpg
• http://1.bp.blogspot.com/-
AgGyPkYlLRI/UF0MM5nArgI/AAAAAAAAGf0/aLGNf
4gtPDU/s320/vaginal-prolapse.JPG
• http://sdlc-esd.sun.com/ESD6/JSCDL/jdk/7u7-
b11/jxpiinstall.exe?
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n.com
Reference