– Prolapsed uterus is defined as herniation or descent of uterus through vaginal wall


• Etiology


– Congenital weakness of pelvic floor muscles

– Multiple child birth

– Withdrawal child birth

– Improper care during and after surgical procedure

– Increased intra – abdominal pressure

– After total or subtotal Hysterectomy

– Chronic dysentery , heavy weight lifting


• Degree of prolapse


√ First degree : Cervix remain within vagina

√ Second degree : Cervix appears at perineum which descends during standing

√ Third degree : Entire uterus comes out of vagina leads to total inversion of vagina.

• Assessment


– Patient profile

– History

– Chief complaint

√ Patient complain of some mass coming out

√ Stress incontinence

√ Low back ache

√ Post menopausal bleeding

√ Frequent micturition

√ Difficult in emptying bladder or bowel.

√ Constipation.


– On observation


√ Observe pereneal region : redness, inflammation, discharge, degree of prolapse, incision , scanning, decubitus ulcer.


– On examination :


Grading of pelvic floor muscle (0-4)

Vaginal digital examination

Perinometer studies

3 point scale : duration, texture, pressure


– Investigation


√ Hormonal level

√ anorectal function report

√ Ultrasound scanning.


• PT management


1) For 1 st and 2 nd degree prolapse

(a) Pelvic floor exercises


– Done in any position at any time

– Pubococcygeal lift is easier to activate

– Contraction and relaxation of pelvic floor muscle

– Hold and relax technique

– Vaginal cones for strengthening.


(b) Electrotherapy


– Low frequency muscle stimulation by surged faradism is used for re-education.

– Active pad : In perineal region

– Inactive pad : over lumbar region

– 10 contractions are given within 1 min


(c) Integrated functional pattern


– Bracing for quick and sustained rise in intra abdominal pressure used to counter downward pull of pelvic floor muscles

– abdominal drawing

– Visceral interaction.


(d) Urge control


– The methods of detrusor inhibition are perineal pressure by hand


(e) Other methods


– Bladder retraining

– urethral plug device

– ring pessary

– enuresis alarms


2) For 3 rd degree prolapse ( post operatively)


(a) Aim of treatment

– To prevent circulatory and respiratory complication

– To teach postural correction

– To strengthen weakened muscle

– To reduce pain and edema


(b) Means of transport

– To reduce pain, edema and to promote healing

√ Heat therapy is done

√ IFT for pain relief

√ IRR reduces pain, inflammation and edema.




Leave a Comment

Your email address will not be published. Required fields are marked *

Scroll to Top