Page 368 - Critical Maternity & Newborn Health Nursing

4) Operation is done in the postmenstrual week to minimize the blood lose and to

allow healing to occur before the next menstruation.

Types of operations:

The choice of operation depends on the type of prolapse and age of the patient.

a) Operation for patients in the childbearing period:

1- Cystocele is treated by anterior colporrhaphy, classical repair where the

anterior vaginal wall is separated from the bladder. A foley catheter and a tight

vaginal back are usually inserted and left for 24 hours the back helps hemostasis

and prevents reactionary hemorrhage.

2- Posterior colpoperineorrhaphy: The posterior vaginal wall is separate from

the rectum. A Foley catheter and a tight vaginal back are usually inserted and left

24 hours, the pack helps hemostasis and prevents reactionary hemorrhage.

Fothergill’s operation: Combined vaginal and uterine prolapse when there is

supravaginal elongation of the cervix or when it located or infected.

It consisted of six steps:

1) A uterine sound is passed to measure the length of cervix.

2) Dilatation and curettage, curettage to remove the congested endometrium.

3) Anterior colporrhaphy to correct cystocele.

4) Amputation of the cervix to restore its normal length which is one inch.

5) The mackenrodet ligaments are sutured together on front of the cervix. This

shortens the ligaments and elevates the uterus upwards, also the cervix is pulled

backwards to correct retroversion.

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