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Uterine prolapse is a form of pelvic organ prolapse in which the uterus and a portion of the upper vagina protrude into the vaginal canal and, in severe cases, through the opening of the vagina. [4] It is most often caused by injury or damage to structures that hold the uterus in place within the pelvic cavity. [ 2 ]
When operating a pelvic organ prolapse, introducing a mid-urethral sling during or after surgery seems to reduce stress urinary incontinence. [13] Transvaginal repair seems to be more effective than transanal repair in posterior wall prolapse, but adverse effects cannot be excluded. [ 14 ]
The incidence of cystocele is around 9 per 100 women-years. The highest incidence of symptoms occurs between ages of 70 and 79 years. Based on population growth statistics, the number of women with prolapse will increase by a minimum of 46% by the year 2050 in the US. Surgery to correct prolapse after hysterectomy is 3.6 per 1,000 women-years. [13]
What causes uterine prolapse? Anything from pushing due to chronic constipation to repeated heavy lifting can cause uterine prolapse, but Eilber says that the most common cause is vaginal childbirth.
The causes of pelvic floor dysfunction aren’t well understood. Experts know that weakened muscles and connective tissue in the pelvis can contribute to it, as can injuries to the pelvis.
Two common problems are uterine prolapse and urinary incontinence both of which stem from muscle weakness. Pelvic floor muscle therapy is the first line of treatment for urinary incontinence and thus should be considered before more invasive procedures such as surgery. [20]