Uterine prolapse is a maternal illness where the pelvic oral, the uterus, the rectum or the bladder proudest in the vagina. in severe cases of prolapsed uterus, the uterus may even fall out of lie vagina. (UNFPA)
TYPES OF UTERINE PROLAPSED
Genital prolapse is more general term that includes several conditions, which may occurs separately or in combination. These include the following:-
· Uterine prolapse
· Vaginal prolapse
· Cytocele(dropped bladder)
· Rectocele (dropped rectum)
· Entercele (herination of the small bowel into the space between the rectum and vagina) (UNFPA)
SYMPTOMS
· Sensation of heaviness or pulling in the pelvis.
· A felling as if sitting on al ball
· Low backache
· Protrusion from the vaginal opening (immoderate severe cases)
· Difficult or painful sexual intercourse
STATE OF THE PROBLEM
Uterine prolapse in Nepal remains still morbidity. The backside of uterine propllse is lacking medical concern to get publicized. On the other hand women have compulsive sexual intercourse on the demand of their male partners. The Nepalese couples have less knowledge relating to sexual pleasure on the other hand vast majority of women in rural remote areas of Nepal are suffering from uterine prolapse. The wretched economical, social, religious, traditional practices accelerates this problem to still higher level almost 10,00,000 women in Nepal are having physical and psychological suffering due to uterine prolapse sexual violence like raping threaten etc are very Much in practice in the illiterate communities of Nepalese much of the Nepalese women are under nourished and are deprived of midwife another health facilities. Nepalese women face a number of social discrimination much of the Nepalese women has no right on their body, sex organs, violation and sexual adulteration are very much in practice. The women of Nepal suffer and live in the darkness of illiteracy.
ROOT CAUSES
The core element of uterine prolapse is taking place due to the lacking understanding of health and gender issues among different stakeholders active at policy and implementation level, from rights based approach has failed to address the structural causes leading to discriminating against women, which is the care causes for morbidity such as prolapsed uterus.
CAUSES INCIDENCE AND RISK FACTORS OF UTERINE AND GENITAL PROLAPSE
· Uterine and genital prolapse rarely caused by co genital (inherited) weakness of the pelvic floor
· It is more commonly caused by the damage to be pelvic floor during vagina deliveries, instrumental deliveries and vaginal delivery of large babies
· Intra abdominal pressure on a long term basis
o chromic cough
o chromic constipitation
o heavy weight lifting domestic
o obesity, ascitis
o weakness of the supported and muscle results from chronic ill health, malnutrition dysentery anemia
· Inadequate rest during pureperium
· Ageing and menopause
The uterus is normally supported by connective tissue and the pubococcygeus muscle and held in position by special ligaments. Weakening of these tissues allows the uterus to descend into the vaginal canal. Tissue trauma sustained during childbirth, especially with large babies or difficult labor and delivery, is typically the cause of muscle weakness.
The loss of muscle tone and the relaxation of muscle, which are both associated with normal aging and a reduction in the female hormone estrogen, are also thought to play an important role in the development of uterine prolapse. Descent can also be caused by a pelvic tumor; however, this is fairly rare.
MADELINE PLUS MEDICAL ENCYCLOPEDIA UTERINE
Uterine prolapse occurs most commonly in women who have had one or more vaginal and Caucasian women. However it can also occur in younger women married or unmarried. Other conditions associated with and increased risk of developing with the supportive tissues of the uterus includes obesity and chronic coughing or straining. Obesity places additional strain on the supportive muscle of the pelvis. As does excessive coughing caused by, lung condition such as chronic bronchitis and asthma. Chronic constipation and the pushing associated with it cause weakness in these muscles.
PRECAUTION AND PREVENTION
Most of the rural remote areas woman population are below poverty, burden of beast, lack of nutrition however this is major concerned issue of Nepalese women A large percentage knowledgeable that uterus prolapse is preventable, which affects 10 per cent of woman in reproductive age. It is indeed a very big challenge to meet the needs of the entire woman suffering from uterine prolapse more and more resources are needed for treatment and surgeries. Uterine prolapse can be prevented and treated effectively with increased awareness and services. The elimination of harmful practices, such as child marriage and sexual intercourse and or heavy labor soon after delivery, as well as delivery attended by trained midwives, would help prevent prolapse. Increase access by all woman especially those in rural areas, to reproductive health services is essential to preventing this condition. It should therefore, be our duty to commit and invest in uterine prolapse's prevention and treatment to improve the lives and protect the human, rights of the woman of Nepal. Reproductive health problems remain the leading cause of ill health and death for women of childbearing age nationwide, with women living in poverty suffering disproportionately. Addressing uterine prolapse contributes directly to the human rights and empowerment of women and adolescents, and promotes the achievement of the better health of suffering rural Nepalese women of nation.
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