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Surgery

Uterine Prolapse

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JAMA

Published Online: September 25, 2023

JAMA Insights

Article Information and Disclosures

Oluwateniola E. Brown, MD¹;

Tsung P. Mou, MD²;

Mary F. Ackenbom, MD, MSc³

Author Affiliations

¹Northwestern University Feinberg School of Medicine, Chicago, Illinois
²Division of Urogynecology and Pelvic Reconstructive Surgery, Tufts Medical Center, Boston, Massachusetts
³Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania

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Pelvic organ prolapse is an overarching term used to describe the abnormal descent of the vaginal walls and the subsequent herniation of the uterus, uterine cervix, and other pelvic organs to or beyond the hymen.¹ Uterine prolapse is a particular form of pelvic organ prolapse that occurs in women with a uterus; it is diagnosed when pelvic organ prolapse affects the top of the vagina.² Uterine prolapse is a result of the weakening of pelvic floor muscles and connective tissues that support the vagina and is not the result of a problem with the uterus. In many cases of uterine prolapse, the uterus is normal. Even when there is uterine pathology, such as fibroids or abnormal uterine bleeding, uterine pathology does not cause uterine prolapse.

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Article Information

Corresponding Author: Oluwateniola E. Brown, MD, Northwestern University Feinberg School of Medicine, 250 E Superior, Ste 5-2113, Chicago, IL 60611 (oluwateniola.brown1@nm.org).

Published Online: September 25, 2023. doi:10.1001/jama.2023.16277

Conflict of Interest Disclosures: Dr Ackenbom reported grants from the National Institute on Aging, Alzheimer's Association, Pennsylvania Department of Health, and the Tamara Harris Foundation outside the submitted work. No other disclosures were reported.

References

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Haylen BT , Maher CF , Barber MD , et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Neurourol Urodyn. 2016;35(2):137-168. doi:10.1002/nau.22922 PubMed Google Scholar Crossref

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Bump RC , Mattiasson A , Bø K , et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175(1):10-17. doi:10.1016/S0002-9378(96)70243-0 PubMed Google Scholar Crossref

Siddique M , Ingraham C , Kudish B , Iglesia CB , Polland A . Hydronephrosis associated with pelvic organ prolapse: a systematic review. Female Pelvic Med Reconstr Surg. 2020;26(3):212-218. doi:10.1097/SPV.0000000000000683 PubMed Google Scholar Crossref

Hagen S , Stark D , Glazener C , et al; POPPY Trial Collaborators. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. Lancet. 2014;383(9919):796-806. doi:10.1016/S0140-6736(13)61977-7 PubMed Google Scholar Crossref

Li C , Gong Y , Wang B . The efficacy of pelvic floor muscle training for pelvic organ prolapse: a systematic review and meta-analysis. Int Urogynecol J. 2016;27(7):981-992. doi:10.1007/s00192-015-2846-y PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.