Uterine prolapse

Alternative names:

pelvic floor hernia; pudendal hernia

Symptoms:

• sensation of heaviness or pulling in the pelvis
• anus pain or a feeling as if "sitting on a small ball"
• low backache
• urinary difficulty - straining to void
• repeated urinary tract and bladder infections
• excessive vaginal discharge
• protrusion from the vaginal opening (in moderate to severe cases)
• sexual intercourse, difficult or painful

Signs and tests:

A pelvic examination (with the woman bearing down) reveals protrusion of the cervix into the lower third of the vagina (mild or first degree prolapse), past the vaginal introitus/opening (moderate or second degree prolapse), or protrusion of the entire uterus past the vaginal introitus/opening (severe or third degree prolapse).

These signs are usually accompanied by protrusion of the bladder and front wall of the vagina (cystocele) or rectum and back wall of the vagina (rectocele) into the vaginal space. The ovaries and bladder may also be positioned lower in the pelvis than usual.

A mass (aggregation of cells) may be noted if a tumor is the cause of the prolapse (rare).