The most common genital prolapse is:
A. Cystocele
B. Procidentia
C. Rectocele
D. Enterocele
Correct Answer: A. Cystocele
Explanation
The most common genital prolapse is cystocele (anterior vaginal wall prolapse), where the bladder bulges into the vagina.
Explanation:
- Cystocele (Anterior prolapse): Most frequent type, usually due to weakening of the anterior vaginal wall and pelvic floor muscles. Common in women who have had vaginal deliveries.
- Rectocele (Posterior prolapse): Bulging of the rectum into the posterior vaginal wall. Less common than cystocele.
- Uterine prolapse (Procidentia): Descent of the uterus into or outside the vaginal canal. Common but less frequent than cystocele.
- Enterocele: Herniation of the small intestine into the upper vagina. Rare compared to the others.
So, cystocele > uterine prolapse > rectocele > enterocele in frequency.
Other Options Details
Here’s a clear description of all the options you listed, which are types of pelvic organ prolapse:
A. Cystocele
- Definition: Prolapse of the urinary bladder into the anterior wall of the vagina.
- Cause: Weakening of the anterior vaginal wall, often due to childbirth, aging, or chronic straining.
- Symptoms: Urinary incontinence, a bulge in the vagina, difficulty emptying the bladder, recurrent UTIs.
- Treatment: Pelvic floor exercises, pessary, or surgical repair.
B. Procidentia
- Definition: Complete prolapse of the uterus through the vaginal opening. Essentially, the uterus protrudes outside the vagina.
- Cause: Weakening of pelvic floor muscles, ligaments, and connective tissue, commonly after multiple vaginal deliveries or in elderly women.
- Symptoms: Visible mass outside the vagina, vaginal discomfort, difficulty walking or urinating.
- Treatment: Pessary for temporary relief or surgical intervention (hysterectomy with pelvic floor repair).
C. Rectocele
- Definition: Prolapse of the rectum into the posterior vaginal wall.
- Cause: Weakening of the rectovaginal septum, often from childbirth, chronic constipation, or straining.
- Symptoms: Bulging in the posterior vaginal wall, difficulty passing stool, sensation of incomplete evacuation, sometimes fecal incontinence.
- Treatment: Lifestyle modifications (high-fiber diet), pelvic floor exercises, pessary, or surgical repair.
D. Enterocele
- Definition: Herniation of the small intestine (or peritoneal sac) into the space between the vagina and rectum, often through the posterior vaginal wall.
- Cause: Weakening of the pelvic support structures, usually post-hysterectomy or with multiparity.
- Symptoms: Vaginal bulge, pelvic pressure, discomfort, sometimes lower back pain.
- Treatment: Surgical repair is usually required; pelvic floor exercises may help prevent worsening.
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Writer: Vandita Singh, Lucknow (GS India Nursing Group