Uterine prolapse

Intermittent evaluation of patients who are asymptomatic, or have a few minor symptoms but sufficient bladder emptying and normal renal function, and are undergoing physical therapy (pelvic floor muscle training) or expectant management should occur approximately every 3 to 6 months, to assess the efficacy of treatment and whether a pessary is required.

Patients who are being observed or monitored, rather than actively treated, should return for a follow-up visit at regular intervals, typically 6 to 12 months.

Commonly, patients treated with a pessary are asked to come for a follow-up visit for evaluation of their symptoms. The physician should evaluate the patient for prolapse symptoms, as well as vaginal symptoms (e.g., pain, vaginal discharge, odor, or bleeding). Regular follow-up and adherence to pessary care instructions are important.

The recovery time from surgical treatment varies, depending on the type of surgery. Women should be offered a postoperative review 6 months after surgery, to evaluate the objective and subjective outcomes, and the adverse events, following surgery. The review should include a vaginal exam and, if mesh was used during the surgical procedure, check for mesh exposure. Women should be referred if they have recurrent prolapse symptoms or complications from surgical treatment.