Uterine prolapse | |
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Other names | Pelvic organ prolapse, prolapse of the uterus (womb), female genital prolapse, uterine descensus |
Depiction of uterine prolapse in which the uterus descending into the vaginal canal, towards the opening of the vagina | |
Specialty | Gynecology |
Symptoms | Vaginal fullness, pain with sex, trouble urinating, urinary incontinence[1] |
Usual onset | Gradual[2] |
Types | 1st to 4th degree[1] |
Risk factors | Pregnancy, childbirth, obesity, constipation, chronic cough[1] |
Diagnostic method | Based on examination |
Differential diagnosis | Vaginal cancer, a long cervix[1] |
Treatment | Pelvic floor therapy, Pessary, surgery |
Frequency | About 14% of women[3] |
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.[4] It is most often caused by injury or damage to structures that hold the uterus in place within the pelvic cavity.[2] Symptoms may include vaginal fullness, pain with sexual intercourse, difficulty urinating, and urinary incontinence.[4][1] Risk factors include older age, pregnancy, vaginal childbirth, obesity, chronic constipation, and chronic cough.[1] 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.[4] Preventive efforts include managing medical risk factors, such as chronic lung conditions, smoking cessation, and maintaining a healthy weight.[1] 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.[4] Outcomes following management are generally positive with reported improvement in quality of life.[5]
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