Uterine Prolapse
When the uterus drops down into the vagina, it is called uterine prolapse. The distance the uterus drops may vary. Mild degrees of prolapse are com-mon. It often does not cause symptoms and does not need surgery. Women with more severe forms of this condi-tion often will have a feeling of pelvic pressure or a pulling feeling in the groin or lower back. The cervix (the opening of the uterus) may stick out from the vagina. This may cause discomfort or problems with sex. Uterine prolapse most often occurs when other pelvic organs are also out of place.

Vaginal Prolapse
Sometimes after hysterectomy (removal of the uterus), the top of the vagina loses its support and drops. This is called vaginal prolapse. The degree of prolapse varies. The top of the vagina may drop part of the way into the vagina and remain there, or it may extend part or all of the way through the vaginal opening. Most women who have vaginal prolapse also have an enterocele. Women who have complete vaginal prolapse also may have problems with bladder and bowel function.

Diagnosis
Proper diagnosis is key to treating pelvic support problems. Diagnosis is not always simple, though. The symptoms of pelvic support problems often mimic those of other conditions. In most cases, a woman with these symptoms will know that she has a problem, but the cause may be unclear. The exact cause of the problem must be found before the best treatment can be given. To make an exact diagnosis, your doctor will take your medical history and do a thorough pelvic exam. You may be examined while you are lying down and again while you are standing. Your bladder function also may be tested.

If you have a problem with either passing or controlling urine, other tests may be needed:

• Cystoscopy and urethroscopy-the inside of the bladder and urethra is viewed through a small, lighted telescope
• Cystometry-the amount the bladder can hold and control is measured
• Uroflowmetry-urine flow is measured