gynecology and obstetrics
Anterior and Posterior Vaginal Wall Prolapse
Diagnosis of Vaginal Wall Prolapse
Examination of the anterior or posterior vaginal wall while patients strain Diagnosis of vaginal wall prolapse is confirmed by examination. Cystocelesandcystourethrocelesare detected by applying a single-bladed speculum against the posterior vaginal wall while patients are in the lithotomy position. Asking patients to strain makes cystoceles or cystourethroceles visible or palpable as soft reducible masses bulging into the anterior vaginal wall. Enterocelesandrectocelesare detected by retracting the anterior vaginal wall while patients are in the lithotomy position. Asking patients to strain can make enteroceles and rectoceles visible and palpable during rectovaginal examination. Patients are also examined while standing with one knee elevated (eg, on a stool) and straining; sometimes abnormalities are detected only by rectovaginal examination during this maneuver. Evaluation , if present, is also evaluated. 