Uterovaginal Prolapse

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UTEROVAGINAL PROLAPSE

DR.MAWAHIB ABD SALMAN HOD, OB/GYNE. DEPARTMENT GMC HOSPITAL,AJMAN

OBJECTIVES
At the end of the lecture the student should have the following knowledge
Definition of uterovaginal prolapse Degree and type of uterovaginal prolapse Anatomy of pelvic organs related to the uterine supports which prevent uterovaginal prolapse Anatomy of female pelvis related to the uterovaginal supports Causes, symptoms and treatment of utero vaginal prolapse

Definition
Uterovaginal prolapse means that the uterus will sag and downward into the vagina or the uterus has descended from its normal position in the pelvis farther down into the vagina.

Types of prolapse
Uterine prolapse Cysourethrocele Enterocele Rectocele Vaginal vault prolapse

Degree
First degree prolapse Second degree prolapse Complete or third degree prolapse Procidentia

Anatomy of Pelvic organs


Endopelvic Muscle Ligaments
Ligaments Uterosacral ligaments Pubo cervical ligaments

Symptoms and Clinical History


Uterine prolapse may have no obvious symptoms
A feeling or heaviness or pressure in the pelvis Feeling as if sitting on a small ball or as if something is falling out of the vagina Pain in the pelvis, abdomen or lower back Pain during intercourse A protrusion of tissue from the vagina Recurrent urinary tract infection Unusual or excessive discharge from the vagina Difficulty with urination including involuntary loss of urine , or urinary frequency or urgency Symptoms may be worsened by prolonged standing or walking (this is due to the added pressure placed on the pelvic muscle by gravity)

Causes
Pregnancy and child birth Large fibroids or tumors Ageing and menopause Obesity Chronic coughing, constipation or straining Heavy lifting Genetic conditions Previous pelvic surgery Spinal cord injury and other muscular atrophy conditions

Treatment
No treatment Conservative treatment
Ring Pessary Exercise Hormone replacement therapy Surgery

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