Uterovaginal Prolapse
What is uterovaginal prolapse (UVP)?
This is the protrusion of the pelvic organs (bladder, uterus and rectum) down into or out of the vagina. Patients usually complain of feeling something heavy at the vagina or sensation of a lump protruding out of the introitus. There are different degrees of severity as shown in the diagram below (Figures 52.2, 52.3 and 52.4).
What are the cause of uterovaginal prolapse (UVP)?
• Vaginal delivery of baby
• Pregnancy
• Heavy lifting
• Chronic constipation
• Menopause
How can I prevent uterovaginal prolapse (UVP)?
The risks of UVP may be reduced by
• Pelvic floor exercises during pregnancy and after vaginal delivery
• Avoiding carrying heavy objects
• Treating chronic constipation
• Maintaining body weight in the healthy range
Management of uterovaginal prolapse (UVP)
The patient complains of a lump at the introitus. She would not be able to differentiate whether the protruding organ is the bladder (cystocele), womb or rectum (rectocele). The doctor needs to perform a pelvic examination to ascertain the site and degree of the prolapse.
Conservative measures include using a ring pessary and local hormone therapy. However, the use of the ring pessary may be associated with vaginal infection or ulceration of the vagina leading to vaginal discharge or bleeding. Surgery is presently the treatment of choice for pelvic organ prolapse unless patient is not fit for surgery. Conservation of the uterus is possible if the patient chooses to keep her womb. |