Management Of Genital Prolapse

Posted by e-Medical PPT
Prolapse/Procidentia is downward decent of uterus &/or vagina (Procidentia is from Latin procidere - to fall)
It is a state of pelvic relaxation due to a disorder of pelvic support structures that is, the endopelvic fascia
It is not a disease but a disabling condition

WEAKNESS OF THE SUPPORTS OF THE UTERUS & VAGINA
Precipitating / Exaggerating / Unmasking Causes -
INCREASED INTRA ABDOMINAL PRESSURE
 Chronic cough
 Chronic Constipation
 Heavy Wt.Lifting / domestic Work
 Obesity, Ascitis
WEAKNESS OF THE SUPPORTS & MUSCLES
 Chronic ill health, malnutrition dysentery, anemia
 Inadequate rest during pureperium
 Menopause

TYPES OF PROLAPSE
Vaginal
Anterior –cystocele & urethrocele
Posterior - Enterocele & Rectocele
Vault Prolapse - a special term applied to the prolapse of upper vagina

Uterine/Utero-vaginal- Acquired or Congenital.
First degree.
Second degree &.
Third degree-(total Prolapse / complete procidentia).
However Procidentia is often used only to denote third degree uterine prolapse.

HOW TO TREAT ?
NON-SURGICAL Methods: -Limited Role
PELVIC FLOOR REHABILITATION (pelvic muscle exercises, galvanic stimulation, physiotherapy, rest in the purperium).
HORMONE REPLACEMENT, both systemic and local.
PESSARY TREATMENT for temporary relief
 During Pregnancy, Pureperium & Lactation
 When Operation is Unsafe due to Extreme Senility/Debility and Diseases
 Preoperatively
 For therapeutic test
SURGICAL TREATMENT: -RECONSTRUCTIVE SURGERY is invariably needed and has to be a COMBINATION OF PROCEDURES to correct the multiple defects.

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