Uterine Procidentia

Uterine procidentia is a condition where the uterus, which is part of the female reproductive system, drops down into or outside the vagina. This happens because the muscles and ligaments that normally hold the uterus in place become weak or stretched. It mainly affects women who have had multiple vaginal deliveries or are older, especially after menopause. The main health impact is discomfort, difficulty with urination or bowel movements, and sometimes visible tissue protruding outside the body. It can also cause problems with sexual activity and increase the risk of infections. The condition involves the pelvic floor muscles and supportive connective tissue failing to maintain the uterus in its normal position. Symptoms often worsen with standing or physical activity.

Uterine procidentia is a severe form of pelvic organ prolapse characterized by the complete descent of the uterus through the vaginal introitus. It results from defects in the pelvic floor support structures, including the levator ani muscles, endopelvic fascia, and cardinal and uterosacral ligaments. The pathophysiology involves chronic increased intra-abdominal pressure and weakening of connective tissue, often due to multiparity, menopause-related estrogen deficiency, or pelvic trauma. Clinically, it presents with a visible protrusion of the uterus beyond the vaginal opening, associated with symptoms such as pelvic pressure, urinary incontinence, and recurrent infections. This condition is significant because it can lead to ulceration, bleeding, and severe functional impairment. Diagnosis is important to differentiate from other pelvic masses and to guide management.