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uterovaginal prolapse

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               Uterovaginal prolapse
Meaning:Downward descent of the uterus and orthe vagina towards or through the introitus.
Often times , the bladder , urethra, bowel and the rectum may be secondarily involved. There are three degrees of prolapse:
1. Descent of cervix to the introitus
2. Cervix and part of the uterus through the introitus
3. Cervix and the whole uterus through the introitus . The third degree is called procidentia.
Causes:
1. imperfect development of the suporting tissues of the uterus
2. stretching the supporting tissues. by childbirth
3. Chronic increase in intra abdominal pressure such as obesity, chronic cough and tumors.
4. post menopausal atrophy of supporting tissues of the uterus due to oestrogen withdrawal.
The clinical features include :
1. Feeling of a bearing down sensation in labour. It may occur suddenly or gradually.
2. Difficulty with micturition and defecation.
3. Severe pain
4. Fullness of the Vagina

How to avoid utero vagina prolapse:
1.avoid pushing before cervix is fully dilated.
2. Avoid obesity, cigarette and treat chronic cough
3. Appropriate hormone replacement therapy in some post menopausal women.
Treatment: It is held with ring pessaries. If this fails, surgery is done. (Colporrhaphy)

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