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Apical Prolapse (Uterine/Vaginal Vault Prolapse)

Downward descent of the uterus or vaginal vault; graded by the Pelvic Organ Prolapse Quantification (POP-Q) system.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Apical Prolapse (Uterine/Vaginal Vault Prolapse)?

Pelvic organ prolapse (POP) is a pelvic floor disease characterized by the downward displacement of organs when the vaginal walls and apical support are disrupted. Apical prolapse refers to descent of the uterus or vaginal vault and is usually accompanied by anterior/posterior wall defects.

Diagnosis is made with the POP-Q system. It ranges from stage 0 (no prolapse) to stage IV (complete eversion). Levator ani defects, postmenopause, multiparity, obesity, and chronic increased intra-abdominal pressure (cough, constipation) are common etiological factors.

Treatment begins in symptomatic cases. Conservative options include pelvic floor exercises and use of a pessary. Surgical options include sacrocolpopexy, sacrospinous fixation, uterosacral ligament suspension, and colpocleisis (in elderly patients).

Symptoms

Pelvic pressure and fullness
Sensation of a mass protruding from the vagina
Lower back pain and pelvic pain
Frequent urination or difficulty emptying
Constipation and difficulty with defecation
Sexual dysfunction
Symptom worsening with prolonged standing

Risk Factors

Vaginal delivery and multiparity
Menopause and estrogen deficiency
Obesity
Chronic cough or constipation
Heavy lifting
Levator ani injury

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When a sensation of something descending into the vagina occurs
  • When pain is felt with urination or constipation
  • When pelvic pain is persistent
  • When sexual dysfunction or pain develops
  • When quality of life is affected at POP-Q stage 2 or above

Treatment Methods

01
Pelvic floor exercises and physiotherapy
02
Pessary application
03
Intravaginal estrogen (in postmenopause)
04
Sacrocolpopexy (laparoscopic/robotic)
05
Sacrospinous fixation or uterosacral suspension
06
Colpocleisis (in elderly patients unsuitable for surgery)

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.