Presenting symptoms

  • Female pelvic organ prolapse (feeling of a “lump coming down” or pressure “down below”)
  • Urinary incontinence
  • Obstructed defecation

Primary Care Assessment

  • Examine the patient in supine position to exclude pelvic masses, then consider assessing the prolapse using a Simms speculum in left lateral position, if available. Consider pelvic USS if pelvic mass found
  • Establish the grade of prolapse (mild = above, moderate = at, severe = below introitus)
  • If obstructed defecation, exclude rectal mass.