In Procidentiawhich of the following is true?

Ans is 'c' i.e., Both uterus and vagina outside the introitusUterine descentDescent of the cervix into the vagina.Descent of the cervix up to the introitus.Descent of the cervix outside the introitus.Procidentia - All of the uterus outside the introitusProcidentia: Procidentia refers to the complete prolapse beyond the level of the hymen distally so the uterus (or vaginal vault if uterus is absent) is permanently protruding out of the vagina.Women with procidentia have poor coordination of pelvic muscle relaxation and contraction, associated bowel dysfunction, and underlying urinary incontinence. INVESTIGATIONS:The investigations required with procidentia are few, but renal ultrasonography and mid-stream urinalysis may be impoant, owing to potential for kinking of the ureters leading with consequent hydronephrosis and urine stasis due to incomplete emptying.In addition, some authors have suggested urodynamic investigations prior to surgery to help identify occult stress urinary incontinence and to attempt to predict those women with underlying voiding dysfunction. MANAGEMENT:Surgical options for procidentia include: vaginal hysterectomy with anterior and posterior traditional colporrhaphy; or vaginal hysteropexy utilising uterosacral and cardinal ligament complex; sacrospinous fixation; or abdominal or laparoscopic hysteropexy, with or without mesh.