Uterine Prolapse

Prepared by: Cheng Chan Mara

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

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.

First degree prolapse

Second degree prolapse

Third degree prolapse

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

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

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

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.)

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)

Collaborative Care

Thanks You!

http://www.davincihysterectomy.com/assets/images/

uterus_prolapse_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?

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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.

Reference