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.
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.
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).
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.
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)