Uterine prolapse is a descent or herniation of the uterus into or beyond the vagina. Uterine prolapse always is accompanied by some degree of vaginal wall prolapse. Uterine prolapse results from weakness of the pelvic support, including musculature, ligaments, and fascia. In adults, the condition usually results from obstetrical trauma and lacerations sustained during labor and delivery. In neonates, it is secondary to congenital weakness in the pelvic musculature or to defects in innervation.
Uterine prolapse affects females only.
It occasionally occurs in young or nulliparous women and rarely occurs in neonates. Accordingly, patients may feel better in the morning, with symptoms worsening throughout the day. A Sims speculum or a standard bivalve speculum with the anterior blade removed may facilitate diagnosis. Physical findings may be enhanced by having the patient strain during the examination or by having her stand or walk prior to examination. Mild uterine prolapse may be recognized only when the patient strains during the bimanual examination.