子宫脱垂（uterine_prolapse）狄文课件

《子宫脱垂（uterine_prolapse）狄文课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、UterineProlapseDIWENM.D.,Ph.D.,Professor&ChairmanDepartmentOfObstetrics&GynecologyRenjiHospitalAffiliatedtoSJTUSchoolofMedicineTheuterusgraduallydescendsintheaxisofthevaginatakingthevaginalwallwithit.Itmaypresentclinicallyatanylevel,butisusuallyclassifiedasoneofthreedegre

2、es.Definition2UterineProlapse3UterineProlapse4UterineProlapse5UterineProlapse6UterineProlapseCauses1.Thestretchingofmuscleandfibroustissue2.Increasedintra-abdominalpressure3.Aconstitutionalpredispositiontostretchingoftheligamentsasaresponsepresumablytoyearsintheerectposit

3、ion7UterineProlapse8UterineProlapse9UterineProlapseInrecentyears,theincidenceofprolapseisgreatlyreduced.Themoreliberaluseofcaesareansectionandtheeliminationoflaboursareprobablythetwomostimportantfactors.10UterineProlapseSymptomsSomethingcomingdownBackacheIncreasedfrequenc

4、yofmicturitionA‘bearingdown’sensationStressincontinenceCoitalproblemsDifficultyinvoidingurine11UterineProlapse12UterineProlapse13UterineProlapse14UterineProlapse15UterineProlapse16UterineProlapse17UterineProlapseDegreesofuterineprolapseFirstdegree:cervixstillinsidevagina1

5、8UterineProlapseDegreesofuterineprolapseSeconddegree:thecervixappearsoutsidethevulva.Thecervicallipsmaybecomecongestedandulcerated19UterineProlapseDegreesofuterineprolapseThirddegree:completeprolapse.Inthepicturetheuterusisretroflexed,andtheoutlineofbladdercanbeseen.Thisi

6、ssometimescalledcompleteprocidentia.20UterineProlapseDiagnosisApelvicexaminationrevealsprotrusionofthecervixintothelowerpartofthevagina(mildprolapse),pastthevaginalintroitus/opening(moderateprolapse),orprotrusionoftheentireuteruspastthevaginalintroitus/opening(severeprola

7、pse).21UterineProlapseTreatmentPessarytreatmentIndications:Patientprefersapessary.PelvicsurgeryunaviodablerisksProlapseamenabletopessaryThepatientisnotfitforsurgeryPatientwishestodelayoperation22UterineProlapse23UterineProlapse24UterineProlapse25UterineProlapse26UterinePr

8、olapse*Anteriorcolporrhaphy(andrepairofcystocele)*Posteriorcolpoperineorrhaphy(includingrepairof