Which one of the following is NOT a complication associated with uterine prolapse?

• A. Incarceration of the uterus
• B. Cystocele
• C. Pelvic inflammatory disease
• D. Ulcer

Answer: (C)

Cystocele, which refers to the protrusion of the bladder into the anterior wall of the vagina, is often associated with uterine prolapse due to the shared connective tissues and support structures involved in pelvic organ support. This means that as the uterus descends in prolapse, it can create or exacerbate a cystocele.

Incarceration of the uterus occurs when the prolapsed uterus becomes trapped and cannot be reduced back into the pelvic cavity, which can lead to significant complications. Similarly, ulcers can develop from the pressure of the prolapsed uterus on surrounding tissues, leading to ischemia and breakdown of the epithelium.

In contrast, pelvic inflammatory disease is an infection of the reproductive organs and is not a direct complication of uterine prolapse. While it may coexist due to other factors, it does not develop as a consequence of the mechanical issues related to uterine prolapse. Therefore, identifying pelvic inflammatory disease as the outlier illustrates that it is not a complication stemming from the physical changes associated with uterine prolapse.