Uterine Prolapse – Causes, Symptoms, Diagnosis, And Treatment
What is uterine prolapse?
Uterine prolapse is a condition that occurs when the uterus (womb) sags or slips from its normal position into the vaginal area. This condition is more common in women who have had one or more vaginal births.
What causes uterine prolapse?
Stretching or weakening of muscles or ligaments that support uterus causes uterine prolapse.
The following other things also can cause or lead to uterine prolapse:
- Normal aging
- Lack of estrogen after menopause
- Obesity, chronic cough, and other such conditions that put pressure on the pelvic muscles
- Pelvic tumor (rare)
Repeated straining to have a bowel movement due to long-term constipation can make the problem worse.
What are the symptoms of uterine prolapse?
The following are the symptoms of uterine prolapse:
- Uterus and cervix bulge into the vaginal opening
- Pressure or heaviness in the pelvis or vagina
- Problems with sexual intercourse
- A low backache
- Repeated bladder infections
- Vaginal bleeding
- Increased vaginal discharge
- Leaking urine or a sudden urge to empty the bladder
How is uterine prolapse diagnosed?
Your doctor will perform a pelvic exam. The doctor will ask you to bear down as if you are trying to push out a baby. This shows how far your uterus has dropped. Uterine prolapse is mild when the cervix drops into the lower part of the vagina. Uterine prolapse is moderate when the cervix drops out of the vaginal opening.
The pelvic exam may show the following other things:
- Cystocele (a bulge of the bladder into the vagina).
- Rectocele (weakening of the tissue wall between the rectum and the vagina).
- The urethra and bladder are lower in the pelvis than usual.
How is uterine prolapse treated?
Uterine prolapse may not need treatment if the symptoms are not bothersome. However, many women will get treatment by the time the uterus drops to the opening of the vagina.
Your doctor may recommend the following treatment:
Your doctor may recommend placing a pessary (a rubber or plastic donut-shaped device) into the vagina. This device holds the uterus in place.
Some pessaries are similar to a diaphragm used for birth control. Your doctor may recommend the pessary for short-term or long-term. The device is fitted for your vagina.
Your doctor will teach you how to insert, clean, and remove a pessary. Pessaries must be cleaned regularly. Sometimes they need to be cleaned by the doctor.
The following side effects may occur with a pessary:
- Foul smelling discharge from the vagina
- Irritation of the lining of the vagina
- Ulcers in the vagina
- Problems with normal sexual intercourse
Your doctor may recommend surgery if the prolapse symptoms are worsening. Usually, surgery is done only when the risks of having surgery are less than the risks of uterine prolapse symptoms.
Different types of surgeries are available. The type of surgery will depend on the severity of the prolapse, age, health status, other medical problems, and plans for future pregnancies.
Your doctor may recommend sacrospinous fixation. This is a surgical procedure that can be done without removing the uterus. This procedure involves using nearby ligaments to support the uterus.
Your doctor may also recommend other surgical procedures like colporrhaphy, sacrocoloppexy, or sacrohysteropexy depending on medical necessity.
The doctor may suggest the following lifestyle changes to help control your symptoms:
- Lose weight if you are obese.
- Avoid heavy lifting or straining.
- Get treatment for a chronic cough.
Quit smoking if your cough is due to smoking.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.