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Gynaecology & Obstetrics General c9f7cf69

A 38-year-old woman complains to a physician because of having chronic pelvic pressure. On fuher questioning, she repos chronic lower back pain, constipation, difficulty in walking, and difficulty while intercourse. Pelvic examination showed uterine cervix lying low within the vaginal canal, but does not protrude through the introitus. Which of the following is the most likely diagnosis?

A
Cystocele
B
Femoral hernia
C
Rectocele
D
Uterine prolapse
High-Yield Explanation
Uterine prolapse is the term used for when the uterus descends from its normal position to one lower in the body. The prolapse is graded based on the level of descent. This woman has first degree prolapse, with descent of the cervix into the vagina. Second degree prolapse is characterized by protrusion of the cervix through the introitus. Third degree prolapse is characterized by complete eversion of the vagina. Uterine prolapse, rectocele, and cystocele are usually due to problems with the strength of the muscles forming the pelvic floor, and the lesions are classified as pelvic relaxation disorders. A history of trauma (notably related to multiple pregnancies) and hormonal changes (e.g., menopause) is frequently elicited. Cystocele refers to the descent of the bladder to a lower than normal position. It is usually due to problems with the strength of the muscles forming the pelvic floor, and the lesions are classified as pelvic relaxation disorders. A history of trauma (notably related to multiple pregnancies) and hormonal changes (e.g., menopause) is frequently elicited. A femoral hernia would present with a mass in the upper pa of the thigh, adjacent to the groin. Rectocele refers to descent of the rectum to a lower than normal position.

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