Name of the Condition

• Complete Uterovaginal Prolapse
• Also referred to as pelvic organ prolapse or fourth-degree prolapse.

Summary

Complete uterovaginal prolapse is a condition where the uterus and vaginal walls descend completely through the vaginal opening due to weakened pelvic floor muscles and ligaments.

Causes

• Childbirth, particularly vaginal deliveries
• Hormonal changes during menopause
• Chronic pressure on the abdomen (such as obesity or constipation)
• Previous pelvic surgery, including hysterectomy

Risk Factors

• Aging and menopause
• Multiple vaginal deliveries
• Obesity
• Chronic cough or straining
• Family history of pelvic organ prolapse

Symptoms

• A sensation of fullness or pressure in the pelvis
• Visible protrusion from the vagina
• Discomfort during sexual intercourse
• Urinary incontinence or difficulty with bowel movements

Diagnosis

• Physical examination, including a pelvic exam
• Imaging tests like an ultrasound or MRI may be necessary in some cases.

Treatment Options

• Pelvic floor exercises to strengthen muscles
• Pessary devices to support pelvic organs
• Surgery, such as vaginal or abdominal repair, to restore normal anatomy

Prognosis and Follow-Up

• With appropriate treatment, many women experience relief of symptoms.
• Long-term monitoring is important, especially following surgical interventions.

Complications

• Chronic pain
• Recurrent urinary infections
• Ulceration of protruded tissue
• Impact on sexual function

Lifestyle & Prevention

• Maintaining a healthy weight
• Practicing pelvic floor exercises (Kegel exercises)
• Avoiding heavy lifting and managing constipation

When to Seek Professional Help

• Persistent pelvic pressure or bulge
• Difficulty urinating or defecating
• Pain during sexual intercourse

Additional Resources

• American Urogynecologic Society (www.augs.org)
• National Association for Continence (www.nafc.org)

Tips for Medical Coders

• Ensure the ICD code N81.3 clearly reflects complete prolapse, not partial prolapse.
• Be mindful of patient history and co-existing conditions that may influence coding accuracy.