prolapse of the uterus


pro·lapse of the u·ter·us

downward movement of the uterus due to laxity and atony of the muscular and fascial structures of the pelvic floor, usually resulting from injuries of childbirth or advanced age; prolapse occurs in three forms; first degree prolapse, the cervix of the prolapsed uterus is well within the vaginal orifice; second degree prolapse, the cervix is at or near the introitus; third degree prolapse (procidentia uteri), the cervix protrudes well beyond the vaginal orifice. Synonym(s): descensus uteri, falling of the womb

prolapse of the uterus

Downward displacement of the uterus from its normal position in the female reproductive tract. It can be classified by its severity: 1st degree: the cervix is within the vagina; 2nd degree: the cervix protrudes through the introitus; 3rd degree: the uterus and inverted vaginal walls lie outside of the vaginal introitus. Uterine prolapse is usually caused by relaxation of the tissues that provide support for the pelvic organs. Synonym: descensus uteri; hysteroptosia; procidentia

Etiology

This condition may be congenital or acquired; most often it is acquired. The etiological factors are congenital weakness of the uterine supports and injury to the pelvic floor or to the uterine supports during childbirth.

Symptoms

The condition is most often seen following instrumental deliveries or when the patient has been allowed to bear down during labor before the cervix is fully dilated. Frequently associated with this is a prolapse of the anterior and posterior vaginal walls, as seen in cystocele and rectocele. In the early stages there are dragging sensations in the lower abdomen, back pain while standing and on exertion, a sensation of weight and bearing down in the perineum, and frequency of urination and incontinence of urine in cases associated with cystocele. In the later stages, a protrusion or swelling at the vulva is noticed on standing or straining, and leukorrhea is present. In procidentia, there is frequently pain on walking, an inability to urinate unless the mass is reduced, and cystitis.

Treatment

The treatment depends on the age of the patient, the degree of prolapse, and the associated pathology. Abdominal surgery with fixation of the uterus is required if the prolapse is complete.

See also: prolapse