Uterine prolapse

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 - options include uterine suspension (hysteropexy); removal of the uterus (partial or supra-cervical hysterectomy) with surgical fixation of the vaginal vault to a nearby pelvic structure; or permanent surgical closure of the vagina (colpocleisis). Outcomes following management are generally positive with reported improvement in quality of life.