Uterine Prolapse

Uterine prolapse is a gynecological condition that occurs when the ligaments holding the uterus in place become weak and lax causing the uterus to slip into the vagina. The condition occurs due to weak or stretched pelvic muscles resulting from childbirth or surgery.

Causes:

The common causes include:

• Advanced age
• Lack of estrogen
• Multiple vaginal childbirths
• Chronic cough (asthma and bronchitis)
• Obesity
• Chronic constipation
• Tumors of the pelvic floor

Symptoms:

The symptoms vary depending on the degree of uterine prolapse. However, the symptoms include:

• You may feel a bulge coming out of the vaginal opening.
• Feeling of heaviness or pressure in the pelvis.
• Low back pain
• Painful sexual intercourse
• Abnormal vaginal discharge
• Vaginal bleeding
• Chronic bladder infections
• Disturbed bowel movements
• Urinary incontinence

Prolonged standing or walking aggravates these symptoms and interfere with the normal activities of life.

Diagnosis:

Your doctor will diagnose the condition by performing physical examination, including pelvic exam, and taking a medical and family history. Various tests may be recommended such as x-rays, ultrasound, magnetic resonance imaging (MRI) to view the internal pelvic organs.

Treatment:

The treatment options for uterine prolapse include:

Non-surgical treatment

• Pelvic floor muscle training exercises to strengthen the muscles.

• Medications: Oral or vaginal estrogen therapy to improve the tonicity of the pelvic muscles

• Pessary is a medical device that fits into the vagina to help support the uterus or bladder and rectum. It is a firm ring similar to the outer ring of a diaphragm that functions to reduce urine leakage by pressing against the vaginal and urethral walls.

Disadvantages of pessary:

-With continuous use of a pessary, you may feel a sensation of pressure or rubbing.
-Vaginal ulcers
-Increase in vaginal discharge or secretions
-Painful sexual intercourse

Surgical treatment is considered when non-surgical treatment fails to reduce the symptoms of uterine prolapse.
Hysterectomy is the surgical removal of the entire uterus. This procedure will stop periods and is not suggested in women who desire to have children.

Hysterectomy may be performed in different ways: abdominal, vaginal, and laparoscopic techniques.

Uterine suspension is done to correct uterine prolapse through laparoscopy, where the uterus is pushed to its original position. This is done by reconnecting the ligaments of the pelvis to the base of the uterus.

Complications:

Untreated cases of uterine prolapse may affect the bowel and bladder functions

Prevention:

You can avoid a uterine prolapse by:

• Losing weight
• Eat a highly nutritious fiber-rich diet.
• Avoid lifting heavy weights
• Regular exercises to strengthen the pelvic muscles