# Uterovaginal prolapse

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class GD66 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Uterine Prolapse - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK564429/
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
UTEROVAGINAL PROLAPSE
Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class GD66 -
         condition scope only, no dose · No dose - referral pathway, no medicine given in primary
         care · Uterine Prolapse - StatPearls - NCBI Bookshelf -
         https://www.ncbi.nlm.nih.gov/books/NBK564429/
Review status: REVIEWED against the source listed above  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (3)
    - Vaginal bulging is the key complaint, yet many women with visible prolapse have no symptoms at
      all  [genital prolapse]
    - Stress or urge leakage, trouble voiding, or needing to splint to urinate can accompany
      prolapse  [genital prolapse]
    - Straining, feeling unemptied, needing laxatives, or leaking stool point to posterior-
      compartment involvement
  SIGNS - what you find (3)
    - Bulging is most obvious on exam when the patient bears down or coughs  [genital prolapse]
    - Prolapse not seen lying down may only show up once the exam is repeated with the patient
      standing
    - Pelvic floor strength is recorded as absent, weak, normal, or strong to guide the treatment
      plan
  TESTS (3)
    - POP-Q or Baden-Walker staging grades descent 0 through 4 relative to the hymen while the
      patient bears down
    - Post-void residual, urodynamics, or a stress-cough test with the prolapse reduced check for
      hidden urinary dysfunction
    - Dynamic MRI or defecography can help in a complex, multi-compartment case, but exam remains
      the main diagnostic tool
  IF NOT THIS - what else fits (2)
    - A urethral diverticulum, Gartner duct cyst, or Bartholin cyst can look like prolapse by
      forming a vaginal mass
    - An enterocele or a prolapsed ureterocele can look like, or occur alongside, uterovaginal
      prolapse
  Source  StatPearls "Pelvic Organ Prolapse" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    Uterovaginal (pelvic organ) prolapse; the GP recognises it, advises pelvic floor
            exercises and management of constipation/chronic cough, and refers to gynaecology for
            pessary fitting or surgery. Topical vaginal oestrogen is a plausible adjunct for
            associated vaginal atrophy. - Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Uterovaginal (pelvic organ) prolapse; the GP recognises it, advises pelvic floor
            exercises and management of constipation/chronic cough, and refers to gynaecology for
            pessary fitting or surgery. Topical vaginal oestrogen is a plausible adjunct for
            associated vaginal atrophy.
   Caution  No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - Inability to pass urine (acute retention), ulceration or incarceration of
            prolapsed tissue, or recurrent urinary tract infections.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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