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Uterine and Pelvic Organ Prolapse

Deepali Maheshwari, MPH, DO and Lauren Simms, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Symptomatic descent of one or more of the following: (1,2)

    • The anterior vaginal wall (bladder or cystocele)

    • The posterior vaginal wall (rectum or rectocele)

    • The uterus and cervix

    • The va...

DIAGNOSIS

Less than half of women discuss symptoms with PCP. Only 10–12% seek medical attention. Barriers include embarrassment, social stigma, ability to cope, belief that POP is part of the aging pr...

TREATMENT

GENERAL MEASURES

  • Treatment is generally guided by degree of bother for the patient. It is important to document the patient’s desire, goals, and expectations.

  • Treatment should consider type an...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Patients who choose a pessary for management should be seen regularly. There is no standard of care established for follow-up but commonly: ...

REFERENCES

1
Raju R, Linder BJ. Evaluation and Management of Pelvic Organ Prolapse. Mayo Clin Proc. 2021;96(12):3122-3129.
2
Dumoulin  C, Hunter  KF, Moore  K, et al. Conservative...

ADDITIONAL READING

  • Baessler K, et al. Surgery for women with pelvic organ prolapse with or without stress urinary incontinence. Cochrane Database Syst Rev. 2018;8(8):CD013108.

  • ...

CODES

ICD10

  • N81.9 Female genital prolapse, unspecified

  • N81.10 Cystocele, unspecified

  • N99.3 Prolapse of vaginal vault after hysterectomy

  • N81.4 Uterovaginal prolapse, unspecified

  • N81.6 Rectocele

SNOMED

  • 7399800...

CLINICAL PEARLS

  • Many women do not discuss POP with their doctor—ask routinely.

  • Vaginal pessary is a non-surgical treatment option in any patients with symptomatic prolapse.

  • Treatment should be guided by...

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