gynecology and obstetrics
Anterior and Posterior Vaginal Wall Prolapse
Key Points
Urethrocele is virtually always accompanied by cystocele, and cystocele, urethrocele, enterocele, and rectocele are likely to occur together. Risk factors for vaginal organ prolapse are age, obesity, and vaginal delivery. To help detect cystoceles or cystourethroceles, apply a single-bladed speculum against the posterior vaginal wall while patients are in the lithotomy position, and ask them to strain. To help detect enteroceles and rectoceles, retract the anterior vaginal wall while patients are in the lithotomy position, and during rectovaginal examination, ask patients to strain. Recommend pessaries and/or pelvic floor exercises, but if they are ineffective, consider surgical repair. 