Gynaecological Prolapse

Last updated 20.09.12

 

Index

 

Features

-  Weakness or defect in the supporting tissues of vagina & cervix

-  50%+/- of women over 50 yrs

-  10-20% symptomatic

 

Types

-  Vaginal

-  Uterine

 

Cause

-  Genetics: defect in collagen & elastin

-  Chronic increased intra-abdominal pressure: obesity, constipation, chronic cough, heavy lifting, pregnancy

-  Direct pelvic floor trauma: vaginal delivery

-  Ageing: weak muscles

-  Decreased oestrogen: menopause

-  Previous pelvic Sx

 

Associated S/S

-  Heaviness or pressure in pelvis

-  Pelvic, abdominal or lower back pain

-  Dyspareunia

-  Protrusion of tissue from vagina

-  Urinary symptoms

-  Frequency

-  Urgency

-  Obstruction

-  Often S/S worsened by walking & standing

-  Vulvovaginal atrophy

 

Ix

-  Abdominal examination: tumour

-  Digital vaginal examination in the erect position

-  Pelvic floor muscle contractions to assess tone

-  POP-Q assessment to determine extent of prolapse

-  PR: sphincter tone: enterocoele

-  Vaginal exam: Sims speculum