DOC I HAVE UTERINE PROLAPSE
Uterine prolapse occurs when the ligaments and muscles holding the uterus in place has weakened to allow it to drop out of the vagina especially in a squatting position.
Causes of Uterine Prolapse:
1.Pregnancy and childbirth -the physical trauma of child birth can strain the pelvic muscles and ligaments to the extent that they are not as strong as before childbirth
2.large fibroids or pelvic tumors can cause pressure on the pelvic muscles downward by gravity
3.age and menopause can weaken the pelvic muscles and the elasticity of the ligaments
4.Heavy lifting as in manual work can also strain and damage pelvic muscles
5.overweight women are more prone to prolapse
6.Pelvic or spinal surgery may damage nerves and pelvic muscles increasing the risk of prolapse.
7.Genetic conditions or muscle dystrophy conditions may be responsible for weak muscles
8.Chronic coughing from smoking or the straining due to constipation, increases the risk of prolapse
Symptoms and signs of uterine prolapse are:
1.Heaviness or protrusion out of the vagina
2.Some thing dropping out of the vaginal area
3.Discomfort or pain in pelvis, abdomen or back
4.Vaginal discharge is excessive or unusual
5.Frequency of urination or urine infection
6.Loss of control of urination(incontinence)
Symptoms may be worse in the evening after prolonged standing or walking
Signs of Uterine prolapse are:
1.Physical examination may show a protrusion of the uterus on squatting.
2.Vaginal examination show the degree of uterine prolapse especially in the standing position:
Stage I Descent of the uterus to any point in the vagina above the level of the hymen
Stage II Descent to the level of the hymen
Stage III – Descent beyond the hymen
Stage IV – Total prolapse
3.Ultrasound of the pelvis may exclude other conditions than uterine prolapse
Treatment of Uterine Prolapse :
Conservative usually for mild cases of uterine prolapse:
1.Kegel exercises help to strengthen the pelvic floor muscles.
The patient is asked to tighten the pelvic muscles by tightening the anus for a few seconds and then release many times a day.
2.Vaginal pessary is a rubber or plastic device which is placed around or under the cervix to support the uterus and hold it in position.
Regular removal and cleaning is important to prevent infection.
It is a temporary measure.
Surgery:
This is the more permanent method of treatment.
1.Colpocleisis involves the removal of a part of anterior and posterior vaginal wall and closing of the margins of the two walls resulting in a small vaginal canal.
The uterus is thus unable to drop out of the smaller vaginal canal.
Success is 90-100%.
2.Sacrospinous fixation is a procedure where the uterosacral ligaments bilaterally is sutured to the sacrospinous ligaments preventing the prolapse.
3.Sacrohysteropexy make use of a strip of synthetic mesh to hold the uterus in place in an operation done through a 15-cm incision or laparoscopy. One end of the mesh is attached to the cervix and top of the vagina and the other to the sacrum thus supporting the uterus.
4.Vaginal hysterectomy -the uterus is removed through the vagina and the uterosacral and cardinal ligaments are sutured together.
5.Abdominal hysterectomy is done when there is pelvic inflammatory disease or previous intra-abdominal operation when a vaginal hysterectomy is not advisable. The uterus is removed followed by a vaginal anterior and posterior colporrhaphy.
Prognosis of uterine prolapse indicates the treatment in most cases will relieve the symptoms and discomfort.
Prevention of uterine prolapse :
1.Avoid constipation by taking a healthy diet
2.Pelvic muscle exercise (Kegel exercises) should be done regularly
3.Avoid straing of pelvic muscle by using correct lifting techniques
4.Avoid smoking to prevent a chronic cough
About kenkee481
Dr Kenneth Kee is still working as a family doctor at the age of 67.
However he has reduced his consultation hours to 3 hours in the morning and 2 hours in
the afternoon.
He first started writing free blogs on medical conditions seen in the clinic in 2007 on http://kennethkee.blogspot.com.
His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com
This autobiolographical account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Conditions” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.
From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.
He apologized for typos and spelling mistakes in his earlier books.
He will endeavor to improve the writing in futures.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical conditions.
He has published 700 kindle Books on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.
The purpose of these simple guides is to educate patient on health conditions and not meant as textbooks.
He does not do any night duty since 2000 ever since Dr Tan had his second stroke.
His clinic is now relocated to the Buona Vista Community Centre.
The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.
He is now doing some blogging and internet surfing (bulletin boards since the 1980's) starting
with the Apple computer and going to PC.
The entire PC is upgraded by himself from XT to the present Pentium duo core.
The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.
He is also into DIY changing his own toilet cistern and other electric appliance.
His hunger for knowledge has not abated and he is a lifelong learner.
The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.
This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.
Dr Kee is the author of:
"A Family Doctor's Tale"
"Life Lessons Learned From The Study And Practice Of Medicine"
"Case Notes From A Family Doctor"
“The Amazing Story of the Cold Sore Virus”
“Of Bed Bugs, Lice And Scabies! Skin Infections”
“A Simple Guide to Sexual Health”
“A Simple Guide To Cancer”
“A Simple Guide to Skin Polyp and Other Polyps”
“A Simple Guide to Sexually Transmitted Diseases”
“A Simple Guide To Stroke”
“A Simple Guide to Women's Health”
“A Simple Guide to Men's Health”
“A Simple Guide to AutoImmune Diseases”
“A Simple Guide to Alternative Therapy”
“A Simple Guide to Alzheimer's Disease and Dementia”
“A Simple Guide to Hypertension and Heart Diseases”
“A Simple Guide To Liver Diseases”
“A Simple Guide to Diabetes Mellitus and Diabetes Insipidus”
“A Simple Guide to Skin Fungal Infections”
“A Simple Guide to Hemorrhoids and Anal Diseases”
“A Simple Guide to Genetic Diseases”
“A Simple Guide to Vitamins, Minerals and Health”
“A Simple Guide to Kidney Stones and Kidney Diseases”
“A Simple Guide to Asthma and Lung Diseases”
“A Simple Guide to Allergies”
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“Life and Death of a Lymphocyte (Immune Man)”
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“Life and Death of a Hair Follicle Cell (Hairy Man)”
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“Life and Death of a Pancreatic Islet Cell (Insulin Man)”
“Life and Death of a Pancreatic Duct Cell (Pancreas Man)”
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“Life and Death of a Thymus Gland Cell (Thymus Man)”
“Life and Death of an Adrenal Gland Cell (Adrenaline Man)”
“Life and Death of a Parathyroid Gland Cell (Calcium Man)”
“Life and Death of a Thyroid Gland Cell (Energy Man)”
“Life and Death of a Testis Gland Cell (Virile Man)”
“Life and Death of a Ovary Gland Cell (Fertile Female)”
“A Simple Guide to Digestion of Food in the Stomach”
“A Simple Guide to Digestion of Food in the Intestines”
“A Simple Guide to Digestion of Food in the Mouth and Gullet”
“A Simple Guide to SARS and Related Influenza Epidemics”
“A Simple Guide to Urinary Excretion and Kidney Function”
“A Simple Guide to Male Reproductive System”
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“A Simple Guide to Larynx and Its Function”
“A Simple Guide to The Lungs and Its Functions”
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“A Simple Guide to The Tongue and Its Functions”
“A Simple Guide to The Spleen and Its Functions”
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“A Simple Guide to The Nail and Its Functions”
“A Simple Guide to The Bone and Its Functions”
“A Simple Guide to The Knee and Its Functions”
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“A Simple Guide to the Healthy Lifestyle Part 2 EXERCISE”
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A Family Doctor's Tale 