Uterine prolapse and urinary tract obstruction

Five patients are described with hydronephrosis and hydroureter associated with advanced uterine prolapse. Various hypotheses have been advanced in the literature to account for this neglected syndrome. A trial was carried out to assess whether all patients presenting with uterine prolapse should be screened to exclude urinary tract obstruction. Thirty-seven patients on the waiting list for surgery for various degrees of prolapse had an IVU and a blood urea estimation. No cases of ureteric obstruction were found, presumably because the lesser grades of prolapse predominated. It is, therefore, considered that all patients with prolapse do not need intravenous urography, which should be restricted to women with complete procidentia.