Summary
Definition
History and exam
Key diagnostic factors
- vaginal protrusion/bulge
- sensation of vaginal pressure
Other diagnostic factors
- urinary incontinence
- constipation
- pelvic pain
- voiding dysfunction
- disordered defecation
- sexual dysfunction
- lower back pain
Risk factors
- vaginal delivery
- older age
- high BMI
- previous surgery for prolapse
- genetic factors
- white ancestry
- increased intra-abdominal pressure
Diagnostic investigations
1st investigations to order
- assessment of postvoid residual urine (PVR) volume
- urinalysis
Investigations 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.
Linda Brubaker, MD, MS

Professor
Dean of the Faculty of Medicine
Loyola University
Chicago
IL
Disclosures
LB has received an editorial honorarium from UpToDate.
Peer reviewers
Chiara Ghetti, MD
Assistant Professor
Department of Obstetrics, Gynecology, and Reproductive Sciences
Division of Urogynecology and Pelvic Reconstructive Surgery
University of Pittsburgh
Pittsburgh
PA
Disclosures
CG 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
More DifferentialsGuidelines
- Non-neurogenic female LUTS
- Pelvic organ prolapse
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