Chapter 92 Vaginal Prolapse
INTRODUCTION
Description: Vaginal prolapse is loss of the normal support mechanism, resulting in descent of the vaginal wall down the vaginal canal. In the extreme, this may result in the vagina becoming everted beyond the vulva to a position outside the body. Vaginal prolapse is generally found only after hysterectomy and is a special form of enterocele.
Prevalence: Depends on the severity of the original defect, type of surgery originally performed and other risk factors (estimated to be between 0.1% to 18.2% of patients who have had a hysterectomy).
ETIOLOGY AND PATHOGENESIS
Causes: Loss of normal structural support because of trauma (childbirth), surgery, chronic intra-abdominal pressure elevation (such as obesity, chronic cough, or heavy lifting), or intrinsic weakness. A recurrence within 1 to 2 years of surgery is considered a failure of technique.
