Early manifestation of genital prolapse in women aged 35–45 years: clinical and anamnestic signs of a suspected neurogenic component

Abstract

DOI: 10.52705/2788-6190-2026-02-4
УДК 618.14-007.44-053.8:616.833-008.6

Genital prolapse is traditionally considered a condition associated with age, childbirth-related pelvic floor trauma, connective tissue weakness, and increased intra-abdominal pressure. However, in some women, symptoms occur as early as 35–45 years of age and may not correspond to the severity of obstetric history. This suggests the possible role of a neurogenic component in early pelvic floor dysfunction.
The objective: to determine the clinical and anamnestic features of early genital prolapse in women aged 35–45 years and to identify signs that may indicate a suspected neurogenic component of pelvic floor dysfunction.
Materials and methods. A clinical and anamnestic analysis was conducted involving 65 women aged 35–45 years with stage I–III genital prolapse. The main group included 35 patients with early prolapse and radiological signs of non-fusion of the L5–S1/S1–S2 vertebral arches, considered indirect signs of suspected occult neural tube defects. The comparison group included 30 women with genital prolapse without radiological or clinical signs of neural tube defects. Age at symptom onset, disease duration, prolapse stage, obstetric history, perineal discomfort, urinary symptoms, sexual discomfort, and subjective pelvic floor weakness were assessed.
Results. In the main group, prolapse symptoms appeared earlier, had a longer duration, and were more often associated with pelvic floor weakness, sexual discomfort, and lower urinary tract symptoms. Obstetric history did not always explain the severity of clinical manifestations. The most informative signs suggesting a possible neurogenic component were prolapse onset before 37 years of age, mismatch between parity and prolapse severity, and the combination of prolapse with pelvic discomfort, reduced muscular control, and sexual complaints.
Conclusions. Early manifestation of genital prolapse in women aged 35–45 years requires not only standard anatomical assessment but also careful evaluation of clinical and anamnestic signs of suspected neurogenic pelvic floor dysfunction. Recognition of these signs may help identify patients who require further functional assessment and individualized rehabilitation.