Uterine Prolapse in Emergency Medicine Follow-up

  • Author: Raafat S Barsoom, MD; Chief Editor: Pamela L Dyne, MD   more...
 
Updated: Aug 1, 2011
 

Further Inpatient Care

  • Further inpatient care for patients with uterine prolapse is indicated only in cases complicated by severe ulceration, infection, or renal failure.
Next

Further Outpatient Care

  • Arrange for follow-up care with an obstetrician or gynecologist in 1-2 weeks.
Previous
Next

Deterrence/Prevention

  • A healthy diet, balanced in protein, fat, and carbohydrates, can help maintain a healthy body weight and prevent constipation.
  • Exercise should be performed on a regular basis.
  • Chronic straining, such as in chronic constipation, should be avoided.
  • Pelvic muscle exercise (Kegel exercises) should be performed.
  • Stopping smoking can reduce the risk of developing a chronic cough.
  • Correct lifting techniques should be used.
Previous
Next

Complications

  • Ulcers: In severe cases of uterine prolapse, the vaginal lining may be displaced and exposed. This may lead to vaginal ulcers that could become infected.
  • Incarceration: If the patient is a young woman and pregnant, it is important to replace the uterus before it enlarges and becomes trapped in the lower pelvis or vagina. If this happens, edema may cause incarceration and even loss of blood supply to the uterus.
  • Prolapse of other pelvic organs: If uterine prolapse occurs, prolapse of other pelvic organs, including the bladder and rectum, is possible. A prolapsed bladder bulges into the front part of the vagina, causing a cystocele that can lead to difficulty in urinating and increased risk of urinary tract infections. Weakness of connective tissue overlying the rectum may result in a prolapsed rectum (rectocele), which may lead to difficulty having bowel movements.
Previous
Next

Prognosis

  • Objective data on the natural history of uterine prolapse are very limited.
  • Neonatal uterine prolapse is associated with an excellent long-term prognosis with conservative management.
  • Uterine prolapse in adults may be corrected with a variety of surgical procedures, the descriptions of which are beyond the scope of this article. Preservation of fertility is generally possible in younger patients.
Previous
 
Contributor Information and Disclosures
Author

Raafat S Barsoom, MD  Staff Physician, Department of Emergency Medicine, State University of New York Downstate Medical Center

Raafat S Barsoom, MD is a member of the following medical societies: American College of Emergency Physicians and Emergency Medicine Residents Association

Disclosure: Nothing to disclose.

Coauthor(s)

Richard H Sinert, DO  Associate Professor of Emergency Medicine, Clinical Assistant Professor of Medicine, Research Director, State University of New York College of Medicine; Consulting Staff, Department of Emergency Medicine, Kings County Hospital Center

Richard H Sinert, DO is a member of the following medical societies: American College of Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

David S Howes, MD  Professor of Medicine and Pediatrics, Section Chief and Emergency Medicine Residency Program Director, University of Chicago Division of the Biological Sciences, The Pritzker School of Medicine

David S Howes, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Physicians-American Society of Internal Medicine, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Mark Zwanger, MD, MBA  Assistant Professor, Department of Emergency Medicine, Jefferson Medical College of Thomas Jefferson University

Mark Zwanger, MD, MBA is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and American Medical Association

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Pamela L Dyne, MD  Professor of Clinical Medicine/Emergency Medicine, University of California, Los Angeles, David Geffen School of Medicine; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center

Pamela L Dyne, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors, Thomas Mailhot, MD, and Allison J Richard, MD, to the development and writing of this article.

References

  1. Cardozo L, Staskin D, eds. Textbook of Female Urology and Urogynecology, Second Edition. Informa HealthCare; 2006.

  2. Swift SE. The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care. Am J Obstet Gynecol. Aug 2000;183(2):277-85. [Medline].

  3. Progetto Menopausa Italia Study Group. Risk factors for genital prolapse in non-hysterectomized women around menopause. Results from a large cross-sectional study in menopausal clinics in Italy. Eur J Obstet Gynecol Reprod Biol. Dec 2000;93(2):135-40. [Medline].

  4. Hagen S, Stark D, Maher C, Adams EJ. Conservative management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2008.

  5. Katz VL, Lentz G, Lobo RA, Gershenson D. Comprehensive Gynecology. 5th ed. Mosby; 2007.

  6. De Ridder D. Should we use meshes in the management of vaginal prolapse?. Curr Opin Urol. Jul 2008;18(4):377-82. [Medline].

  7. Daneshgari F, Kefer JC, Moore C, Kaouk J. Robotic abdominal sacrocolpopexy/sacrouteropexy repair of advanced female pelvic organ prolaspe (POP): utilizing POP-quantification-based staging and outcomes. BJU Int. Oct 2007;100(4):875-9. [Medline].

  8. [Guideline] American College of Obstetricians and Gynecologists (ACOG). Pelvic organ prolapse. Washington (DC). Sep 2007;[Full Text].

  9. DeLancey JO. Anatomy and biomechanics of genital prolapse. Clin Obstet Gynecol. Dec 1993;36(4):897-909. [Medline].

  10. Hagen S, Stark D, Maher C, Adams E. Conservative management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2004;CD003882. [Medline].

  11. Handa VL, Harris TA, Ostergard DR. Protecting the pelvic floor: obstetric management to prevent incontinence and pelvic organ prolapse. Obstet Gynecol. Sep 1996;88(3):470-8. [Medline].

  12. Haylen BT. The retroverted uterus: ignored to date but core to prolapse. Int Urogynecol J Pelvic Floor Dysfunct. Nov 2006;17(6):555-8. [Medline].

  13. Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A. Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity. Am J Obstet Gynecol. Jun 2002;186(6):1160-6. [Medline].

  14. Loret de Mola JR, Carpenter SE. Management of genital prolapse in neonates and young women. Obstet Gynecol Surv. Apr 1996;51(4):253-60. [Medline].

  15. Morley GW. Treatment of uterine and vaginal prolapse. Clin Obstet Gynecol. Dec 1996;39(4):959-69. [Medline].

  16. Ozel B, White T, Urwitz-Lane R, Minaglia S. The impact of pelvic organ prolapse on sexual function in women with urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. Jan 2006;17(1):14-7. [Medline].

  17. Rinne KM, Kirkinen PP. What predisposes young women to genital prolapse?. Eur J Obstet Gynecol Reprod Biol. May 1999;84(1):23-5. [Medline].

  18. Rush CB, Entman SS. Pelvic organ prolapse and stress urinary incontinence. Med Clin North Am. Nov 1995;79(6):1473-9. [Medline].

  19. Sanai T, Yamashiro Y, Nakayama M, Uesugi N, Kubo N, Iguchi A. End-stage renal failure due to total uterine prolapse. Urology. Mar 2006;67(3):622.e5-7. [Medline].

  20. Shaunik A. Pelvic organ myiasis. Obstet Gynecol. Feb 2006;107(2 Pt 2):501-3. [Medline].

  21. Silva WA, Kleeman S, Segal J, Pauls R, Woods SE, Karram MM. Effects of a full bladder and patient positioning on pelvic organ prolapse assessment. Obstet Gynecol. Jul 2004;104(1):37-41. [Medline].

  22. Soderberg MW, Falconer C, Bystrom B, Malmstrom A, Ekman G. Young women with genital prolapse have a low collagen concentration. Acta Obstet Gynecol Scand. Dec 2004;83(12):1193-8. [Medline].

  23. Swift S, Woodman P, O'Boyle A, et al. Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol. Mar 2005;192(3):795-806. [Medline].

  24. Tan JS, Lukacz ES, Menefee SA, Powell CR, Nager CW. Predictive value of prolapse symptoms: a large database study. Int Urogynecol J Pelvic Floor Dysfunct. May-Jun 2005;16(3):203-9; discussion 209. [Medline].

  25. Weber AM, Walters MD, Piedmonte MR. Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol. Jun 2000;182(6):1610-5. [Medline].

  26. Wheeler LD, Lazarus R, Torkington J, O'Mahony MS, Woodhouse KW. Lesson of the week: perils of pessaries. Age Ageing. Sep 2004;33(5):510-1. [Medline].

 
Previous
Next
 
Normal uterus versus a prolapsed uterus.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.