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Concept
Uterine prolapse
Summary
Uterine prolapse is a form of pelvic organ prolapse in which the uterus and a portion of the upper vagina protrude into the vaginal canal and, in severe cases, through the opening of the vagina. It is most often caused by injury or damage to structures that hold the uterus in place within the pelvic cavity. Symptoms may include vaginal fullness, pain with sexual intercourse, difficulty urinating, and urinary incontinence. Risk factors include older age, pregnancy, vaginal childbirth, obesity, chronic constipation, and chronic cough. Prevalence, based on physical exam alone, is estimated to be approximately 14%.
Diagnosis is based on a symptom history and physical examination, including pelvic examination. Preventive efforts include managing medical risk factors, such as chronic lung conditions, smoking cessation, and maintaining a healthy weight. Management of mild cases of uterine prolapse include pelvic floor therapy and pessaries. More severe cases may require surgical intervention, including removal of the uterus or surgical fixation of the upper portion of the vagina to a nearby pelvic structure. Outcomes following management are generally positive with reported improvement in quality of life.
While uterine prolapse is rarely life-threatening, the symptoms associated with uterine prolapse can have a significant impact on quality of life. The severity of prolapse symptoms does not necessarily correlate with the degree of prolapse, and one may experience little to no bothersome symptoms with even advanced prolapse. Additionally, different forms of pelvic organ prolapse often present with similar symptoms.
Most women who experience pelvic organ prolapse do not have symptoms. When symptoms are present, the most common and most specific symptoms for uterine prolapse—and organ prolapse in general—into the vagina are bulge symptoms, such as pelvic pressure, vaginal fullness, or a palpable vaginal bulge, and these symptoms are often more common and more severe if the prolapse reaches the vaginal hymen.
Official source
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