Prolapse

From Wikipedia, the free encyclopedia

Prolapse literally means "To fall out of place." In medicine, prolapse is a condition where organs, such as the uterus, fall down or slip out of place. It is generally reserved for organs protruding through the vagina, or for the misalignment of the valves of the heart.

Contents

Prolapse can involve several structures within the pelvis:

Symptoms include pain, incontinence of urine and/or feces, discomfort in specific positions (standing, bicycling).

Diagnosis is by history and physical examination. When generalised weakness of the pelvic floor is suspected, additional tests might be considered. When incontinence is a feature, urodynamics may give some information on the interplay between prolapse and the incontinence.

Specific types include:

Oviduct prolapse is an often fatal condition in egg-laying birds. When an egg is laid, the vagina everts through the cloaca to deliver the egg. Large eggs and avian obesity are contributors to this condition. Immediate veterinary assistance is paramount to the survival of a bird with prolapse. Even with immediate medical intervention the chances for survival are usually uncertain. Untreated birds will begin to tear at the injury site. Other flockmates will begin to cannibalise the prolapse area. This behaviour is commonly known as pickout.

Uterine prolapse in cattle, particularly dairy cattle, generally occurs in the first 12 hours post-calving. Frequent causes are hypocalcemia combined with irritation of the birth canal, causing straining. Replacement of the organ, which can be from softball-sized to the entire uterus hanging down below the hocks, is done with the cow in sternal recumbancy, an epidural injection, and hindlimbs 'frogged' rearwards to allow the pelvis to tip forward, easing replacement. Careful washing and cleaning prior to replacement is important as is ensuring that the horns are completely everted once inside the cow. Often a Buhner suture is placed in the vulva to prevent subsequent re-prolapse.

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