Highlights & Basics
- Uterine prolapse is caused by the loss of anatomic support for the uterus.
- Late-stage prolapse usually presents as a palpable protruding cervix with vaginal tissue, which is often noticed by the patient.
- Symptoms include sensation of vaginal bulging, pelvic pressure, urinary frequency or incontinence, incomplete bladder emptying, defecatory dysfunction, and dyspareunia.
- Diagnosis is made by vaginal examination during resting and straining.
- Conservative management encompasses observation, physical therapy, and use of pessaries.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
American College of Obstetricians and Gynecologists. Practice bulletin no. 214: pelvic organ prolapse. Nov 2019 [internet publication].[Full Text]
Winters JC, Dmochowski RR, Goldman HB, et al; American Urological Association; Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction. Urodynamic studies in adults: AUA/SUFU guideline. J Urol. 2012 Dec;188(6 Suppl):2464-72.[Abstract]
National Institute for Health and Care Excellence. Urinary incontinence and pelvic organ prolapse in women: management. Jun 2019 [internet publication].[Full Text]
Maher C, Feiner B, Baessler K, et al. Surgery for women with anterior compartment prolapse. Cochrane Database Syst Rev. 2016 Nov 30;(11):CD004014.[Abstract][Full Text]
Baessler K, Christmann-Schmid C, Maher C, et al. Surgery for women with pelvic organ prolapse with or without stress urinary incontinence. Cochrane Database Syst Rev. 2018 Aug 19;(8):CD013108.[Abstract][Full Text]
Brubaker L, Cundiff GW, Fine P, et al; Pelvic Floor Disorders Network. Abdominal sacrocolpopexy with Burch colposuspension to reduce urinary stress incontinence. N Engl J Med. 2006 Apr 13;354(15):1557-66.[Abstract][Full Text]
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22. American College of Obstetricians and Gynecologists. Practice bulletin no. 214: pelvic organ prolapse. Nov 2019 [internet publication].[Full Text]
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26. Kobashi KC, Vasavada S, Bloschichak A, et al. Updates to surgical treatment of female stress urinary incontinence (SUI): AUA/SUFU guideline (2023). J Urol. 2023 Jun;209(6):1091-8.[Abstract][Full Text]
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28. National Institute for Health and Care Excellence. Urinary incontinence and pelvic organ prolapse in women: management. Jun 2019 [internet publication].[Full Text]
29. European Association of Urology. Non-neurogenic female LUTS. Mar 2023 [internet publication].[Full Text]
30. de Boer TA, Salvatore S, Cardozo L, et al. Pelvic organ prolapse and overactive bladder. Neurourol Urodyn. 2010;29(1):30-9.[Abstract][Full Text]
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36. United Kingdom Continence Society. UK clinical guideline for best practice in the use of vaginal pessaries for pelvic organ prolapse. Mar 2021 [internet publication].[Full Text]
37. Hagen S, Stark D. Conservative prevention and management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2011 Dec 7;(12):CD003882.[Abstract][Full Text]
38. Bø K. Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction. World J Urol. 2012 Aug;30(4):437-43.[Abstract]
39. Hagen S, Stark D, Glazener C, et al; POPPY Trial Collaborators. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. Lancet. 2014 Mar 1;383(9919):796-806.[Abstract][Full Text]
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41. Fitz FF, Resende AP, Stüpp L, et al. Biofeedback for the treatment of female pelvic floor muscle dysfunction: a systematic review and meta-analysis. Int Urogynecol J. 2012 Nov;23(11):1495-516.[Abstract]
42. Bugge C, Adams EJ, Gopinath D, et al. Pessaries (mechanical devices) for managing pelvic organ prolapse in women. Cochrane Database Syst Rev. 2020 Nov 18;11(11):CD004010.[Abstract][Full Text]
43. Abed H, Rahn DD, Lowenstein L, et al. Incidence and management of graft erosion, wound granulation, and dyspareunia following vaginal prolapse repair with graft materials: a systematic review. Int Urogynecol J. 2011 Jul;22(7):789-98.[Abstract]
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45. Haya N, Feiner B, Baessler K, et al. Perioperative interventions in pelvic organ prolapse surgery. Cochrane Database Syst Rev. 2018 Aug 19;8(8):CD013105.[Abstract][Full Text]
46. Barber MD, Brubaker L, Burgio KL, et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network. Comparison of 2 transvaginal surgical approaches and perioperative behavioral therapy for apical vaginal prolapse: the OPTIMAL randomized trial. JAMA. 2014 Mar 12;311(10):1023-34.[Abstract][Full Text]
47. Detollenaere RJ, den Boon J, Stekelenburg J, et al. Sacrospinous hysteropexy versus vaginal hysterectomy with suspension of the uterosacral ligaments in women with uterine prolapse stage 2 or higher: multicentre randomised non-inferiority trial. BMJ. 2015 Jul 23;351:h3717.[Abstract][Full Text]
48. Lukacz ES, Warren LK, Richter HE, et al. Quality of life and sexual function 2 years after vaginal surgery for prolapse. Obstet Gynecol. 2016 Jun;127(6):1071-9.[Abstract][Full Text]
49. Siddiqui NY, Grimes CL, Casiano ER, et al. Mesh sacrocolpopexy compared with native tissue vaginal repair: a systematic review and meta-analysis. Obstet Gynecol. 2015 Jan;125(1):44-55.[Abstract][Full Text]
50. Mahran MA, Herath RP, Sayed AT, et al. Laparoscopic management of genital prolapse. Arch Gynecol Obstet. 2011 May;283(5):1015-20.[Abstract]
51. Ganatra AM, Rozet F, Sanchez-Salas R, et al. The current status of laparoscopic sacrocolpopexy: a review. Eur Urol. 2009 May;55(5):1089-103.[Abstract]
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53. Anger JT, Mueller ER, Tarnay C, et al. Robotic compared with laparoscopic sacrocolpopexy: a randomized controlled trial. Obstet Gynecol. 2014 Jan;123(1):5-12.[Abstract][Full Text]
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55. Maher C, Feiner B, Baessler K, et al. Surgery for women with anterior compartment prolapse. Cochrane Database Syst Rev. 2016 Nov 30;(11):CD004014.[Abstract][Full Text]
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60. US Food and Drug Administration. FDA takes action to protect women's health, orders manufacturers of surgical mesh intended for transvaginal repair of pelvic organ prolapse to stop selling all devices. Apr 2019 [internet publication].[Full Text]
61. National Institute for Health and Care Excellence. Transvaginal mesh repair of anterior or posterior vaginal wall prolapse. Dec 2017 [internet publication].[Full Text]
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63. Baessler K, Christmann-Schmid C, Maher C, et al. Surgery for women with pelvic organ prolapse with or without stress urinary incontinence. Cochrane Database Syst Rev. 2018 Aug 19;(8):CD013108.[Abstract][Full Text]
64. Wei JT, Nygaard I, Richter HE, et al; Pelvic Floor Disorders Network. A midurethral sling to reduce incontinence after vaginal prolapse repair. N Engl J Med. 2012 Jun 21;366(25):2358-67.[Abstract][Full Text]
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68. Dällenbach P. To mesh or not to mesh: a review of pelvic organ reconstructive surgery. Int J Womens Health. 2015;7:331-43.[Abstract][Full Text]
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