Clinical meaning
Uterine prolapse occurs when the uterus descends from its normal position into or beyond the vaginal canal due to weakening of the pelvic floor support structures. The pelvic floor consists of muscles (primarily the levator ani group) and connective tissue (endopelvic fascia) that hold the uterus, bladder, and rectum in place. When these structures weaken - from childbirth trauma, aging, chronic straining, or loss of estrogen after menopause - the uterus drops downward. Prolapse may be mild (the cervix descends into the upper vagina) or severe (the uterus protrudes outside the vaginal opening). Associated conditions include cystocele (bladder bulging into the vagina) and rectocele (rectum bulging into the vagina).
Exam relevance
Risk factors: - Multiple vaginal deliveries (especially traumatic or prolonged) - Aging and postmenopausal estrogen loss - Chronic constipation and straining - Chronic cough (COPD, smoking) - Obesity - Heavy lifting - Prior pelvic surgery - Family history of pelvic organ prolapse
Diagnostics: - Expect pelvic examination to assess degree of prolapse - Monitor for associated cystocele or rectocele - Expect assessment using POP-Q staging system by provider - Monitor urinary function (incontinence, retention) - Expect referral to urogynecology if surgical intervention considered