Uterine Prolapse | Causes, Symptoms, and Diagnosis:
Uterine prolapse, though not life-threatening, can be a serious condition that can negatively affect one’s quality of life. Thus, it is important to seek prompt treatment. However, uterine prolapse often goes noticed until it reaches severe conditions. This article explores the causes, symptoms, and diagnosis of uterine prolapse, and how the condition can be treated.
What is Uterine Prolapse?
The uterus (commonly known as the womb) is held inside the pelvis by different muscles, tissues, and ligaments. Sometimes, due to certain bodily stresses like pregnancy, difficult labor, and vaginal childbirth, the muscles and ligaments supporting the uterus weaken.
With advancing age, the estrogen level drops in women. The natural loss of estrogen also contributes to the weakening of the uterine support system. Consequently, the uterus slips from its normal position and drops into the vaginal canal, resulting in a condition called uterine prolapse.
If the uterus partially sags into the vagina, the condition is called incomplete uterine prolapse. On the other hand, complete uterine prolapse is a condition when the uterus drops into the vaginal so far that some of the uterine tissues protrude outside the vagina.
Why am I Having Uterine prolapse? (Causes of Uterine Prolapse)
Uterine position can change due to the weakening of the pelvic muscles and other tissues resulting from:
- Vaginal delivery
- Late pregnancy and childbirth.
- Difficult labor and delivery
- Trauma during childbirth
- Delivery of a large baby
- Being overweight
- Postmenopausal low estrogen level
- Chronic constipation
- Straining with bowel movements
- Chronic cough or bronchitis
- Repeated heavy lifting
What are the Risk Factors for Uterine Prolapse?
The risk of developing uterine prolapse increases due to:
- One or more vaginal childbirth
- Delivery of a large baby
- Childbirth at an older age
- Prior pelvic surgery
- Chronic constipation
- Family history of weak connective tissue
- Being Hispanic or white
- Chronic coughing
The Symptoms of Uterine Prolapse
Mild uterine prolapse is common after delivery, but it is often asymptomatic. Usually, women come to know about mild uterine prolapse after a routine pelvic exam. On the other hand, moderate to severe uterine prolapse may show symptoms like:
- Uterine tissues protruding out of the vagina
- A heavy feeling in the lower abdominal region
- Pulling sensation in the pelvis.
- Feeling the bladder does not empty completely after using the bathroom.
- Leaking urine involuntarily (urine incontinence)
- Difficulty in bowel movement
- Discomfort sitting, especially for a long time.
- Feeling as if your vaginal tissues are getting rubbed on your clothes
- Painful sexual intercourse
- Lower back pain
When Should You See A Doctor?
If you are feeling any difficulty in urination and/or bowel movement or feeling as if the urethra has got blocked, immediately consult your doctor. You should also seek medical care without delay in case of complete uterine prolapse or uterine prolapse bleeding.
Also, notify your doctor if:
- You feel a constant pressure in your lower abdomen, or feel as if something is coming out of your vagina
- You have a persistent discomfort in your pelvic area
- You feel urge to urinate or to have a bowel movement frequently
- You feel a continuing pain in the low back and have difficulty while walking, urinating, or moving bowels.
- Urine dribbling
Therapy and Self-care for Uterine Prolapse
For mild uterine prolapse, treatment is often not required. Moderate to severe uterine prolapse can be managed by self-care or surgical treatment.
- Self-care measures like Kegel exercises can help strengthen the pelvic muscles. It prevents the prolapse from getting worse. Losing weight and managing constipation also helps with uterine prolapse.
- Vaginal pessaries is a silicone device inserted into the vagina. It helps support the uterine tissues. Pessaries can be removed and cleaned too.
Your doctor might advise you to undergo surgical treatment if uterine prolapse has advanced to a severe stage.
- Typically, minimally invasive surgery called laparoscopic surgery is done. Often, vaginal surgery is also performed.
- Hysterectomy (surgical removal of the uterus) is recommended for severe uterine prolapse.
- Another surgery, called uterus-sparing procedure is performed if the person wants to have another pregnancy. However, not much is studied about how effective these surgeries are.
Often uterine prolapse accompanies other pelvic organ prolapse. Managing such cases might be a bit more complicated. Doctors perform various surgical procedures along with hysterectomy, such as:
- Fixing the pelvic floor structures using stitches
- Colpocleisis: Closing the opening of the vagina.
- Placing a piece of mesh to provide support to the uterus and other pelvic structures.
FemiCushion for Uterine Prolapse
If you do not wish to undergo surgical treatment, or have any medical condition that makes you ineligible for surgery, you might opt for Femicushion. Femicushion is a newly developed device designed specifically for women who have dropped uterus due to uterine prolapse or suffer from other pelvic organ prolapse. It is a non-invasive cushion-like silicone device that helps provide the necessary support to your pelvic organs. Additionally, it has an in-built belt that can be adjusted according to your needs and unfastened during bathroom visits.
Supervising Doctor of This Article
Koichi Nagao, MD PhD
Professor, Department of Urology, Toho University Faculty of Medicine
Director of Urinary tract reconstruction center, Toho University Omori Medical Center
Director of Reproduction Center, Toho University Omori Medical Center
Professor Nagao specializes in plastic surgery in the field of reproductive medicine. He completed eight years of plastic surgery training at Showa University before majoring in urology at Toho University. With his meticulous surgical techniques and careful examinations that combines urology and plastic surgery, Professor Nagao became a Board Certified Specialist with multiple associations including the Japanese Urological Association, the Japan Society for Reproductive Medicine, and the Japanese Society for Sexual Medicine.