Uterus, prolapse of

A condition in which the uterus descends from its normal position into the vagina. The degree of prolapse varies from 1st-degree prolapse, in which there is only slight displacement of the uterus, to 3rd-degree prolapse (procidentia), in which the uterus can be seen outside the vulva. Stretching of the ligaments supporting the uterus (during childbirth, for example) is the most common cause. Prolapse is aggravated by obesity. There are often no symptoms, but sometimes there is a dragging feeling in the pelvis. Diagnosis is made by physical examination. Pelvic floor exercises strengthen the muscles of the vagina and thus reduce the risk of a prolapse, especially following childbirth. Treatment usually involves surgery ( hysterectomy). Rarely, if surgery is not wanted or is not recommended, a plastic ring-shaped pessary may be inserted into the vagina to hold the uterus in position. (See also cystocele; rectocele; urethrocele.)