What You Need to Know About Uterine Prolapse
Uterine prolapse is when the uterus drops or descends toward or into the vagina. It happens when the pelvic floor muscles and ligaments become weak and are no longer able to support the uterus.
In some cases, the uterus can protrude from the vaginal opening. Complications can include the ulceration of exposed tissue and prolapse of other pelvic organs, such as the bladder or rectum.
This article covers the stages, causes, treatments, prevention tips, and risk factors for uterine prolapse.
Stages of Uterine Prolapse
Medical professionals categorize uterine prolapse as incomplete or complete.
In an incomplete uterine prolapse, the uterus partially displaces the vagina but does not protrude. In a complete uterine prolapse, a portion of the uterus protrudes from the vaginal opening. This opening is also known as the introitus.
Doctors grade the condition by its severity, which is determined based on how far the uterus has descended.
Causes of Uterine Prolapse
Pelvic floor muscles can become weak for several reasons:
- – pregnancy and childbirth
- – advancing age and menopause
- – overweight and obesity
- – heavy lifting
- – chronic coughing
- – chronic constipation
- – history of pelvic surgery
- – genetic factors leading to weak connective tissue
Symptoms vary depending on how severe the prolapse is. In mild cases, there may be no symptoms, or symptoms may change in severity throughout the day.
Typical symptoms include:
- – pelvic heaviness or pulling
- – vaginal bleeding or an increase in vaginal discharge
- – difficulties with sexual intercourse
- – urinary leakage (incontinence, specifically stress incontinence)
- – bowel movement difficulties, such as constipation
- – lower back pain
- – uterine protrusion from the vaginal opening
- – sensation of sitting on a ball or that something is falling out of the vagina
- – weak vaginal tissue
Diagnosing Uterine Prolapse
A healthcare professional will ask about symptoms and perform a physical examination of the pelvis.
Medical treatment for prolapse depends on how bothersome the condition is to the person with uterine prolapse.
Options may include the use of a vaginal pessary, Kegel exercises with pelvic floor physical therapy, and surgery.
This is a vaginal device that supports the uterus and keeps it in position. It is important to follow the instructions on care, removal, and insertion of the pessary. In cases of severe prolapse, a pessary can cause irritation, ulceration, and sexual problems.
Talk with your doctor about if this treatment is right for you.
Surgeons can repair a prolapsed uterus through the vagina or abdomen. It involves skin grafting or using donor tissue or other material to provide uterine suspension.
In some cases, doctors may recommend a hysterectomy. This procedure involves removal of the uterus and, often, other parts of the reproductive system.
Preventing Uterine Prolapse
Some strategies can reduce the risk of uterine prolapse developing and prevent it from worsening.
These may include, but are not limited to:
- – performing pelvic floor exercises, such as Kegel exercises
- – preventing and treating constipation
- – using correct body mechanics whenever lifting is necessary
- – managing chronic coughing
- – maintaining a healthy weight through diet and exercise
- – considering estrogen replacement therapy in menopause
If the prolapse shows signs of worsening, other types of treatment may be necessary.
The most common risk factors for uterine prolapse include:
- – Multiple pregnancies and births: The risk for uterine prolapse increases with each pregnancy and birth. Vaginal deliveries may weaken pelvic floor muscles and connective tissues.
- – Overweight: People with a BMI greater than 25 are at a higher risk than people with a lower BMI. Excess weight can weaken pelvic muscles.
- – Previous hysterectomy: People who have had pelvic surgery, including a hysterectomy, may be more likely to experience prolapse.
- – Age: The structures supporting the uterus and vagina lose their strength as people age (especially in the absence of estrogen, such as during menopause without the use of estrogen replacement therapy).
- – Ethnicity: Studies show Hispanic and non-Hispanic white Americans are more likely to develop uterine prolapse than Asian Americans and African Americans.
- – Tissue disorders: Connective tissue disorders may impact the ligaments responsible for holding the uterus and other pelvic organs in place. These disorders may include Ehlers-Danlos syndrome and Marfan syndrome.
- – Pelvic floor disorders: Patients with pelvic organ prolapse, which includes uterine prolapse, have a high rate of coexisting pelvic floor disorders. This includes urinary incontinence, overactive bladder, and fecal incontinence.
- – Increased abdominal pressure: People who have constipation or a chronic cough may be more likely to experience this condition. These conditions and situations put increased pressure on the muscles in the abdomen, which can lead to weakening.
Although it can be uncomfortable, uterine prolapse is not a life-threatening condition. In fact, many patients may not experience symptoms or show signs of the condition until it has advanced to a later stage.
People who do have a detectable bulge or pressure in their vagina may be able to treat the prolapse without surgery. Noninvasive treatments, including exercises, may help the prolapse resolve or improve to a point where it is no longer bothersome. A vaginal pessary may be necessary to support the organs, too. Surgery is often highly successful and is recommended based on how bothersome the prolapse is to that individual person.
Certain risk factors increase a person’s chances of developing uterine prolapse. These include being overweight and having a history of multiple pregnancies and births. These individuals should have regular pelvic exams to check for signs of uterine prolapse.
Catching the condition in early stages may allow a person more time to strengthen the pelvic floor muscles and prevent more significant prolapse.
Contact us today to schedule a consultation if you have uterine prolapse, or symptoms of uterine prolapse, and would like to know which treatment options are best suited for you.