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

3. 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 .

4. First degree prolapse

5. Second degree prolapse

6. Third degree prolapse

7. S tretching 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

8. 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

9. 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

10. 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.)

11. 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

12. Thanks You!

13. 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?AuthParam=1348826780_3c1d68b448bc8c2e320c4a720ab8fce3&GroupName=JSC&FilePath=/ ESD6/JSCDL/jdk/7u7-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. Reference