Uterine prolapse

From Wikipedia, the free encyclopedia

Female genital prolapse

Uterine prolapse in a 71-year-old woman, with the cervix visible in the

vaginal orifice.

Classification and external resources

Specialty

urology

ICD-10

N81.4

ICD-9-CM

618.1

DiseasesDB

13651

MedlinePlus

001508

MeSH

D014596

Uterine prolapse is a form of female genital prolapse. It is also called pelvic organ
prolapse or prolapse of the uterus (womb).

Risk factors for uterine prolapse include pregnancy, childbirth, chronic increases in intraabdominal pressure such as lifting, coughing or straining, connective tissue conditions, [1][2] and
damage to or weakness of the muscles.[3]
Treatment may be conservative or surgical and should be based upon patient symptoms and
preference.
Contents
[hide]

1Pathophysiology and causes

2Treatment

3Further reading

4References

5External links

Pathophysiology and causes[edit]

The uterus (womb) is normally held in place by a hammock of muscles and ligaments. Prolapse
happens when the ligaments supporting the uterus become so weak that the uterus cannot stay
in place and slips down from its normal position. These ligaments are the round
ligament, uterosacral ligaments, broad ligament and the ovarian ligament. The uterosacral
ligaments are by far the most important ligaments in preventing uterine prolapse.
The most common cause of uterine prolapse is trauma during childbirth, in particular multiple or
difficult births. About 50% of women who have had children develop some form of pelvic organ
prolapse in their lifetime.[citation needed] It is more common as women get older, particularly in those
who have gone through menopause. This condition is surgically correctable.

Treatment[edit]
Treatment is conservative, mechanical or surgical. Conservative options include behavioral
modification and muscle strengthening exercises such as Kegel exercise.[4] Pessaries are a
mechanical treatment as they elevate and support the uterus. [5][6] Surgical options are many[7] and
may include a hysterectomy or a uterus-sparing technique such as laparoscopic hysteropexy,
[8]
sacrohysteropexy[9][10] or the Manchester operation.[11]
In the case of hysterectomy, the procedure can be accompanied by sacrocolpopexy.[12] This is a
mesh-augmented procedure in which the apex of the vagina is attached to thesacrum by a piece
of medical mesh material.[13]