Summary
Definition
History and exam
Key diagnostic factors
- vaginal protrusion/bulge
- sensation of vaginal pressure
Other diagnostic factors
- urinary incontinence
- defecatory dysfunction
- pelvic pain
- voiding dysfunction
- sexual dysfunction
Risk factors
- vaginal delivery
- advancing age
- obesity
- previous surgery for prolapse
- genetic factors
- white ancestry
- connective tissue disorders
- increased intra-abdominal pressure
Diagnostic tests
1st tests to order
- assessment of postvoid residual urine (PVR) volume
- urinalysis
Tests to consider
- urodynamics
Treatment algorithm
asymptomatic
symptomatic
Contributors
Authors
Lior Lowenstein, MD, MS, MHA, MBA
Associate Clinical Professor and Head of Gynecology Division
Rambam Health Care Campus
Rappaport Faculty of Medicine
Technion-Israel Institute of Technology
Haifa
Israel
Disclosures
LL declares that he has no competing interests.
Omer Anis, MD
Urology Department
Chaim-Sheba Medical Center
Tel Aviv
Israel
Disclosures
OA declares that she has no competing interests.
Acknowledgements
Dr Lior Lowenstein and Dr Omer Anis would like to thank Dr Linda Brubaker, a previous contributor to this topic.
Disclosures
LB has received editorial honoraria from JAMA, UpToDate, and the Female Pelvic Medicine and Reconstructive Surgery journal. LB is an author of some of the references cited in this topic.
Peer reviewers
Sarah Collins, MD
Associate Professor of Obstetrics and Gynecology
Northwestern University
Feinberg School of Medicine
Chicago
IL
Disclosures
SC declares that she has no competing interests.
Sushma Srikrishna, MRCOG
Locum Consultant Urogynaecologist and Obstetrician
Kings College Hospital
London
UK
Disclosures
SS declares that she has no competing interests.
Differentials
- Cervical elongation
- Vaginal cyst
- Gynecologic cancer
More DifferentialsGuidelines
- Non-neurogenic female LUTS
- AAGL practice report: practice guidelines on the prevention of apical prolapse at the time of benign hysterectomy
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