Prolapse Uterus
Uterine prolapse happens when the pelvic muscles and tissue deteriorate, insufficiently supporting the uterus. The uterus then descends into your vagina, occasionally exiting through the opening in your vagina. Although minor uterine prolapses don’t need to be treated, you might benefit from them if it causes you chronic discomfort.
Symptoms
If the prolapse is incomplete, a prolapsed uterus may occasionally show no symptoms at all. You might experience some discomfort or other symptoms, depending on how far the uterus has retracted into the vaginal canal.
The most typical warning signs and symptoms are:
- Vaginal or pelvic pressure or a sensation of heaviness
- Urinary discomfort, urination-related pain, urine retention, recurrent bladder infections, or urine leakage
- difficulty going to the bathroom
- Feeling as if you are sitting on a ball or as though your internal organs are “falling out” Visible tissue protruding from your vagina
- increased vaginal bleeding or discharge
- Back discomfort or pain in the lower back
- difficulties during sexual contact
Causes
Usually, the pelvic floor—a collection of muscles and ligaments—holds the uterus firmly in place above the vagina. When the pelvic muscles and ligaments that support the uterus deteriorate to the point where they can no longer do so, the uterus prolapses.
Women who have given birth vaginally are most likely to have this condition, but even those who have never given birth may occasionally experience uterine prolapse.
The following are the most typical causes of the prolapsed uterus:
Pregnancy
- a delivery assisted by a device (such as a forceps- or vacuum-assisted birth)
- delivery of a big baby
- Obesity: Having excess body weight doubles the risk of a prolapsed uterus.
- aging: It has been discovered that the pelvic muscles that support the uterus weaken as a result of the loss of estrogen after menopause.
Long-term constipation: Over time, straining to urinate puts too much strain on the pelvic muscles.
Risks Elements
The following are risk factors for prolapsed uterus:
- Excess weight
- Smoking Pregnancy or previous pregnancies
- Labor and delivery procedures involving the use of forceps or a vacuum
- Aging
- Pelvic muscle problems, such as those caused by protracted constipation
- Surgery on the pelvis before
- Genetics (family history of the prolapsed uterus)
- Uncontrollable or persistent cough
Diagnosis of Uterine Prolapse
Ultrasound or magnetic resonance imaging (MRI) is typically not required for the diagnosis of a uterine prolapse unless your doctor needs to evaluate the severity of the prolapse in serious cases.
The most typical ways to diagnose uterine prolapse include:
- Questionnaire: Your doctor can frequently rule out or diagnose uterine prolapse using a short questionnaire. A questionnaire can also help determine how much uterine prolapse may be impacting your life and can help determine the best course of treatment.
- Pelvic exam: To determine how far the uterus has slipped into your vagina, your doctor may ask you to bear down as if having a bowel movement. To test the strength of your pelvic muscles, your doctor may also ask you to tighten your pelvic muscles as if you were stopping the flow of urine. You can either lie down or stand up during this examination.
Prevention
You can take actions to safeguard and strengthen the pelvic floor to lessen the risk of uterine prolapse:
- After giving birth, refrain from heavy lifting and other strenuous activities.
- Lifting heavy objects safely and without strain requires a good form.
- Keep a healthy weight.
- Treat or avert constipation, for instance by consuming more fiber in your diet and drinking plenty of water.
- Regularly carry out Kegel exercises to bolster your pelvic floor.
Treating Prolapse Uterus Without Surgery
Non-surgical methods can be used to help treat your issues when symptoms become too severe to control through lifestyle changes. Commonly used therapies include:
VAGINAL PESSARY
An object that fits inside your vagina and holds the uterus in place is called a vaginal pessary. Used to treat moderate uterine prolapse, the device can be a temporary or permanent treatment option. You will be taught how to insert, remove, and clean a device that your doctor will specially fit for you to help with symptom relief. A vaginal pessary can irritate the vaginal tissue, causing sores and obstructing sexual activity, so it is typically not used for severe cases of uterine prolapse.
Therapy to replace estrogen (ERT)
Estrogen replacement therapy (ERT) may aid in preventing further uterine muscle and connective tissue weakness. A higher risk of blood clots, gallbladder disease, and breast cancer are a few of the negative effects.
Surgery to Treat Uterine Prolapse
More severe uterine prolapse cases can frequently be successfully treated using minimally invasive surgical techniques:
A LAPAROSCOPIC SUSPENSION OF THE UTERINE
A uterine suspension procedure, which supports the uterus and the pelvic floor structure by grafting your tissue, donor tissue, or artificial materials, can be carried out during a laparoscopy procedure. A small incision is made in the abdomen during a laparoscopy, and your doctor will insert a laparoscope—a thin, flexible tube with a video camera—through it to produce images that can be viewed on a computer screen. Then, your surgeon can treat uterine prolapse with minimally invasive techniques using precise equipment.
HYSTERECTOMY
In the most severe cases of uterine prolapse, a hysterectomy is performed, with partial hysterectomies being the most common procedure (removal of part of the uterus but not the cervix). Your physician will select the hysterectomy that is best for your condition. The urethra, bladder, rectum, and any sagging vaginal walls can all be surgically fixed at the same time.