WHAT IS PROLAPSED UTERUS SYMPTOMS AND ANGLE ?
It might be asked, to what extent, then, is the mobilty
of the uterus normal? From clinical observation, I
should say that any descent of the uterus, except what
has been already indicated, is abnormal. But the antero-
posterior position of the uterus can vary in health
through fairly wide limits.
It moves on its axis from a position of anteversion with an empty bladder, through an angle of 45°, so that in the standing position the cervix looks slightly forwards and downwards, and the fundus backwards a little upwards .
It moves on its axis from a position of anteversion with an empty bladder, through an angle of 45°, so that in the standing position the cervix looks slightly forwards and downwards, and the fundus backwards a little upwards .
PROLAPSED UTERUS SYMPTOMS AND SIGNS
The symptoms of prolapsed uterus are more marked in the
early than the later stages.
As soon as the uterine
ligaments begin to stretch the patient suffers from pain
in the back low down at the junction of the sacrum to
lumbar spine.
She usually feels a bearing-down pain
within the pelvis, which is worse on walking or standing,
and relieved by lying down.
Many complain of pain in
the left ovarian region as well.
The bladder is sometimes
irritable, with frequent micturition.
Young unmarried
women may have slight metrorrhagia.
It is in the early
stage that prolapse is most likely to be overlooked.
Many patients, if examined lying down and told to force down, show little or no sign of prolapse, but if the examination is made while the patient is standing, the uterus is found to come down a little lower than normal.
MORE SYMPTOMS OF PROLAPSE
She usually feels a bearing-down pain within the pelvis, which is worse on walking or standing, and relieved by lying down.
The cervix is found to be enlarged and usually covered
with erosion, while profuse leucorrhoea is present.
The
lower the uterus and the longer it has been down the
more marked are these symptoms.
Added to this there
may be actual ulceration of the cervix in such a condition
of neglect that it might be mistaken for an epithelioma.
The vagina undergoes certain changes in chronic pro-
cidentia. It is usually much dilated and larger than
normal, the rugse are lost, the epithelial surface loses its
mucous character and becomes hard and horny.
In all doubtful cases, when the patient has
symptoms of prolapse she should be examined standing,
and if she is told to bear down as much as possible,
whatever the degree of prolapse it will be revealed.
At
the same time, any bulging of the vaginal walls or
general drop of the pelvic floor should be noted.
In order to succeed in the treatment of these cases it
is highly important to form an accurate opinion as to
whether the pelvic floor or the uterine ligaments are most
at fault, or whether as often happens, both have given
way.
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