UTERINE PROLAPSE

Uterine Prolapse - 3rd Year GNM, Midwifery and Gynecological Nursing (Definition, Causes, Stages, Sign and Symptoms, Diagnosis,Treatment and Prevention)

UTERINE PROLAPSE

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Definition:

Uterine prolapse is a condition where the uterus slips from its normal position and pelvic cavity into the vagina. It happens when your tissue or muscle of the uterus becomes weak.

Complete uterine prolapse in which the uterus protrudes through the vaginal hymen is known as procidentia.

Uterine Prolapse

Etiology/Cause:

1. Pregnancy / childbirth with normal or complicated vaginal delivery
2. Weakness in the pelvic muscle due to age
3. Weakening tissue tone due menopause

Risk Factor:

• Chronic obstructive Pulmonary Disorder (COPD)
• Obesity
• Chronic cough
• Pelvic tumors
• Straining due to Constipation
• Heavy lifting

Using tobacco and smoking makes your lungs condition bad and due to chronic cough you may leads to uterine prolapse.

Stages:

⇨First degree: The cervix drops into the vagina.

⇨Second degree: The cervix drops to the level just inside the opening of the vagina.

⇨Third degree: The cervix is outside the vagina.

⇨Fourth degree: The entire uterus is outside the vagina. This condition is also called procidentia.

Sign and Symptoms/ Clinical Manifestation:

Most of the people with uterine prolapse have not experience any sign or symptoms but some uterine prolapse symptoms are listed below:

• A feeling of fullness or pressure in the pelvis.
• Pain in pelvis or in the lower back. 
• Pain during sex or intercourse.
• Urination problems, Pee incontinence.
• Constipation

If the situation goes to the level of procidentia then symptoms may include- bleeding, vaginal discharge, ulceration.

Diagnostic Evaluations:

• History collection
• Physical examination
• Vaginal examination often with a speculum
• Pelvic exam
• Urine culture
• Ultrasound
• MRI

Management:

⇒NON-SURGICAL MANAGEMENT:-

1. Exercise: Pelvic Floor Muscle Training (PFMT) or Kegel exercises can help strengthen your pelvic floor muscles. This may be the only treatment needed in mild cases of uterine prolapse.
2. Vaginal pessary: A pessary is a rubber or plastic doughnut-shaped device that fits around or under the lower part of your uterus. This device helps prop up your uterus and hold it in place.
3. Diet and Lifestyle: Drink plenty of fluids and eat high-fiber foods, such as fruits, vegetables, beans and whole-grains to avoid constipation and avoid too much heavy lifting or do that correctly.
4. Estrogen cream helps in restoring strength of vaginal tissue some time doctor may prescribe this cream to heal uterine prolapse.

SURGICAL MANAGEMENT :-

1. Hysterectomy - surgical removal of uterus
2. Prolapse repair without hysterectomy

Prevention:

• Exercise regularly 
• Avoid becoming constipation
• Take healthy diet
• Maintain healthy weight