Uterine Prolapse

[alophysio]

Hi.

Firstly, are you male or female because the following will probably only be possible if you are a female - for some reason, they don't mind male gynaes but any other male professional, the patient gets uncomfortable with it.

A uterine prolapse situation is usually where the uterus falls through the cervix into the vagina and even can come out - there are many people in the world who will tell you that when they cough and sneeze, they go to the toilet to "push it back in".

You may have to determine why she is prolapsing. Is it because of pelvic floor dysfunction? Or is there increased intraabdominal pressure? Or is there physical injury to the pelvic floor etc.

The best thing to do - and what i always do - is refer her to a pelvic floor physio for an assessment. If the cause is weak pelvic floor, i would often work in conjunction with the other physio. If the pelvic floor seems to be working ok, then i can fix the excessive intraabdominal pressure thing - it is usually bracing of the obliques inappropriately. If there is injury, then it is off to the doctor for her.

Of course, she may be trialling a course of conservative treatment before heading off to surgery.

A few other points...a contraceptive device in the uterus is usually called an IUD (intra-uterine device - imaginative name that!). She obviously hadn't had a hysterectomy then because that often makes these things worse.

The other pains are difficult to assess from here. However, the symptoms may be consistent with excessive IA pressure - she is nervous, tender down one side, c/o tightness. Does she have incontience? If she doesn't, i am willing to bet that her pelvic floor is ok and she is using her obliques.

Does she have a crease across her abdomen above the belly button? If so, you can bet that it will be an external oblique compression.

All the best and let us know what is going on.

[junior_physiotherapist]

Hi.

Firstly, are you male or female because the following will probably on>>

She obviously hadn't had a hysterectomy then because that often makes these things worse.

The other pains are difficult to assess from here. However, the symptoms may be consistent with excessive IA pressure - she is nervous, tender down one side, c/o tightness. Does she have incontience? If she doesn't, i am willing to bet that her pelvic floor is ok and she is using her obliques.

Does she have a crease across her abdomen above the belly button? If so, you can bet that it will be an external oblique compression.

All the best and let us know what is going on.

Thanks ..sir

Regarding ur questions: i'm a female physiotherapist .
sorry i didn't get what did u have advice me as
-how i can make assessment for her pelvic floor muscles
-u said she oboviously hadn't hyserectomy this bad ,So why!!!
-being use her obliques,,,and being have a creases across her abdomine above her belly line!!! actully i didn't get ur meanings??sorry
-she had her last 3 deliveries by ciseria, she is multipara,so there is lines marks across her lower part of her abdomine..
-about her incontinence i'll ask her :

once again many thanks sir