ABSTRACT
Patients with anterior vaginal prolapse complain of symptoms directly related to vaginal protrusion or of associated symptoms such as urinary incontinence or voiding difficulty. Symptoms related to prolapse may include the sensation of a vaginal mass or bulge, pelvic pressure, low back pain, and sexual difficulty. Stress urinary incontinence commonly occurs in association with anterior vaginal prolapse. Voiding difficulty may result from advanced prolapse. Women may require vaginal pressure or manual replacement of the prolapse in order to accomplish voiding or they may relate a history of urinary incontinence that has since resolved with worsening of their prolapse. This can occur with urethral kinking and obstruction to urinary flow; women in this situation are at risk for incomplete bladder emptying, recurrent or persistent urinary tract infections and for the development of de novo stress urinary incontinence after the prolapse is repaired.
