Uterine Prolapse

Uterine prolapse is a medical condition where the uterus slips out of its normal position and into the vagina. This occurs when the muscles and ligaments that support the uterus weaken, allowing it to bulge into the vaginal canal.

Causes

• Weakening of the pelvic floor muscles due to childbirth, aging, or other factors
• Loss of estrogen after menopause, which can lead to a decrease in muscle mass and strength
• Chronic coughing or straining, such as during bowel movements or heavy lifting
• Obesity, which can put additional pressure on the pelvic floor muscles
• Prior surgeries, such as hysterectomy or other pelvic surgeries
• Genetic predisposition to weak connective tissue

Symptoms

• A feeling of heaviness or pressure in the pelvis
• A bulge or lump in the vagina
• Difficulty starting to urinate or a slow stream of urine
• Frequent urination or urinary incontinence
• Painful intercourse
• Lower back pain
• Discomfort or pressure in the vagina, especially when standing or walking

Types of Uterine Prolapse

• Mild prolapse: The uterus drops slightly into the vagina.
• Moderate prolapse: The uterus drops further into the vagina, but still remains inside.
• Severe prolapse: The uterus protrudes outside of the vaginal opening.

Diagnosis

Uterine prolapse is typically diagnosed through a physical examination by a healthcare provider. This may include:

• Pelvic exam to assess the position and condition of the uterus and vagina
• Medical history to identify any contributing factors or underlying conditions
• Imaging tests, such as ultrasound or MRI, to confirm the diagnosis and rule out other conditions

Treatment Options

Treatment for uterine prolapse depends on the severity of the condition and individual patient needs. Options may include:

• Conservative management: Lifestyle modifications, such as pelvic floor exercises (Kegel exercises), weight loss, and avoiding heavy lifting or straining.
• Pessary: A removable device inserted into the vagina to support the uterus and hold it in place.
• Surgery: Various surgical procedures, such as sacrohysteropexy or vaginal hysterectomy, may be performed to repair or remove the prolapsed uterus.

Complications

If left untreated, uterine prolapse can lead to complications, including:

• Urinary incontinence or retention
• Bowel obstruction or constipation
• Vaginal ulcers or sores
• Infection or abscess formation
• Decreased quality of life due to discomfort, pain, or limited mobility

Prevention

To reduce the risk of developing uterine prolapse:

• Practice pelvic floor exercises (Kegel exercises) regularly
• Maintain a healthy weight through diet and exercise
• Avoid heavy lifting or straining, especially during pregnancy or after childbirth
• Manage chronic coughing or constipation through lifestyle modifications or medical treatment