UteroVaginal Prolapse

Question 1

Definition

Answer 1

Protrusion of organ or structure beyond its normal confines is called prolapse.

Question 2

Genital prolapse :

Answer 2

descent of one or more of the genital organ (urethra, bladder, uterus, rectum or Douglas pouch or rectouterine pouch”) through the fasciomuscular pelvic foor below their normal level.

Question 3

Vaginal prolapse

Answer 3

can occur without uterine prolapse but the uterus cannot descent without carrying the vagina with it.

Question 4

The uterus is normally

Answer 4

anteverted,antefexed

Question 5

Version

Answer 5

angle between the longitudinal axis of cervix, and that of the vagina.

Question 6

Flexion

Answer 6

angle between the longitudinal axis of the uterus, and that of the cervix.

Question 7

Anteverted uterus.

Answer 7

The uterus is approximately at right angles to the vagina and has a slight forward curve

Question 8

Retroposition

Answer 8

The uterus is displaced backwards, but the direction of its axis remains the same.

Question 9

Retroversion

Answer 9

The long axis of the uterus is directed backward.

Question 10

What’s the vaginal prolapse? 3

Answer 10

1) Anterior vaginal wall prolapse
2) Posterior vaginal wall prolapse
3) Vault prolapse

Question 11

What’s the type of the anterior vaginal wall prolapse

Answer 11

1. cystocele : Prolapse of the upper part ( inside part ) of the anterior vaginal wall with the base of the bladder.
2. urethrocele : Prolapse of the lower part of the anterior vaginal wall
   with the urethra
3. cysto-urethrocele.: Complete anterior vaginal wall prolapse

Question 12

What’s the type of Posterior vaginal wall prolapse ?

Answer 12

1. rectocele: anterior wall of the rectum + middle third of the posterior vaginal wall.
2. entrocele : (( hernia of the pouch of Douglas )) : if the upper
   third of the posterior vaginal wall descends lined by the peritoneum of
   the Douglas pouch and containing loops of the intestne

Question 13

Vault prolapse ?

Answer 13

descent of the vaginal vault, where the top of the vagina descends )or
inversion of the vagina) after hysterectomy.
Subtotal hysterectomy > total hysterectomy.

Question 14

If the patient has history of hysterectomy, what is type of the prolapse you can see?

Answer 14

Vault prolapse.

Question 15

The pelvic foor muscles form a sling around the…

Answer 15

lower pelvic outlet

Question 16

rectum is stopped from bulging forward into the vagina by

Answer 16

rectovaginal fascia

Question 17

rectum bulging forward into the vagina) have defects in

Answer 17

rectovaginal fascia

rectoceles

Question 18

The bladder and urethra are separated from the vagina by

Answer 18

pubocervical fascia

Question 19

The mid-vagina rest on the……is separated from the bladder and urethra by ……. If there is defect in this fascia what will happen?

Answer 19

rectovaginal fascia

anterior vaginal wall fascia (pubocervical)

cystoceles

Question 20

The cervix is supported to the lateral pelvic side-wall by the strong….

Answer 20

cardinal ligaments

Question 21

Women with upper vaginal prolapse (uterine prolapse, vault prolapse or enteroceles) have defects in

Answer 21

uterosacral and / or cardinal ligaments

Question 22

The degree of uterine prolapse
مع شرح كل وحده

Answer 22

First degree:cervix stll inside vagina

• if she is coughing still on the vagina
• she feel something but she can’t see it.
• Uterus gradually descent in the axis of the vagina taking the vagina wall with it present clinically at any level.

•bladder
•rectum
•uretur
• complication: stenosis of ureter > hydronephrosis> and Anuria