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Clinical Crossroads
Clinician's Corner
April 27, 2005

An 80-Year-Old Woman With Vaginal Prolapse

Author Affiliations

Clinical Crossroads Section Editor: Margaret A. Winker, MD, Deputy Editor.


Author Affiliation: Dr Cundiff is a Professor of Gynecology and Obstetrics at Johns Hopkins School of Medicine and serves as the Chair of the Department of Obstetrics and Gynecology at Johns Hopkins Bayview Medical Center, Baltimore, Md.

JAMA. 2005;293(16):2018-2027. doi:10.1001/jama.293.16.2018

DR SHIP: Mrs H is an 80-year-old woman with Medicare insurance who recently began feeling tissue coming out of her vagina. She called to make an appointment to see her longtime gynecologist.

She feels generally well and lives with her husband of more than 50 years. She has systolic hypertension and osteoporosis. Decades ago, Mrs H had 4 vaginal deliveries of healthy, term infants. She has had regular Papanicolaou smear screening, but her most recent smear showed atypical cells of undetermined significance. It was her first abnormal smear. She denies vaginal bleeding or urinary incontinence; she does experience some urinary urgency. Her bowels are regular. She is sexually active, without dyspareunia or other problems.

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