What Is a Prolapsed Uterus?
Uterine prolapse describes a condition in which the tissues and muscles of the uterus become weak. Uterine descent, also known as uterine prolapse, is a medical condition that occurs when the supportive tissues and muscles of the uterus weaken, leading to its descent or dropping directly into the vaginal canal. While uterine prolapse can affect women of various ages, it is more commonly observed in females after menopause and in those who have undergone multiple vaginal deliveries. Dr. Andrew Krinsky and his expert team bring you the answers in this blog post.
The pelvic floor muscles support the rectum, the bladder, the uterus, and other pelvic organs. Prolapse happens when these muscles are weakened or damaged, so they can no longer support the organs.
About Uterine Prolapse
The condition may range from mild to severe, depending on the state of the supporting muscles. In the instance of an incomplete prolapse, the uterus may be only partway into the vagina, creating a bulge or lump. In more severe cases, the uterus may even come out of the vagina, which is called a complete prolapse.
For the most part, healthcare experts use a classification system to categorize these prolapses. The four stages are the following:
- Stage I: The uterus has slipped into the upper part of the vagina
- Stage II: The uterus slips into the vagina’s lower part.
- Stage III: The uterus protrudes from the vagina
- Stage IV: The entire uterus drops to the vagina’s outside.
The condition is also fairly common, with the risk of developing it increasing with age. As mentioned above, those who’ve had several vaginal deliveries are also at higher risk.
The prolapse can disrupt everyday activities and may lead to discomfort. Mild cases usually require no treatment, but complicated cases will as they can make having a bowel movement and urination difficult.
Causes and Uterine Prolapse Symptoms
Mild cases may produce no apparent symptoms, but as the organ slips more and more out of its position, it can put pressure on the rest of the pelvic organs. That said, the most common uterine prolapse symptoms can include the following:
- Constipation
- Feelings of fullness, pressure, and heaviness in the pelvis
- Lower back, abdominal, or pelvic pain
- Painful intercourse
- Visible uterine tissue falling through the vaginal opening
- Trouble inserting tampons
- Urination problems
The symptoms will usually get worse when sneezing, coughing, standing up, and walking for extended periods.
What causes a prolapsed uterus? As mentioned above, uterine prolapse is usually the result of weakened pelvic muscles. What are the things that contribute to this weakening? According to experts, the following are the most common contributing factors:
- Pregnancy
- Menopause-induced loss of muscle tone
- Vaginal childbirth
- OBestity
- Chronic constipation
- Chronic straining or coughing
- Repeated heavy lifting
Diagnosing Uterine Prolapse
For the most part, the condition is diagnosed with the help of a pelvic exam. During the examination, your doctor will insert a speculum into the vagina to check for any bulges caused by a slipped uterus. They may also assess the weakness of your pelvic muscles during the exam.
Treatment For a Prolapsed Uterus
Nonsurgical and surgical options may also be able to address to condition. Still, the treatment your doctor will go with will depend on the severity of your case, age, general health, and whether you will want children in the future.
Here are the most common treatment options:
Nonsurgical Treatment for a Prolapsed Uterus
- Physical Exercise: Specific Kegel exercises tailored to strengthen the pelvic floor muscles offer potential benefits for managing mild cases of prolapse.
- Vaginal Support Device: Vaginal pessaries, resembling doughnuts made of plastic or rubber, can support the uterus by encircling the cervix. Your healthcare provider will properly insert and adjust the pessary, necessitating regular cleaning and removal before intercourse.
- Lifestyle and Dietary Modifications: Implementing changes to your lifestyle and diet can alleviate specific symptoms of uterine prolapse, such as constipation. Increasing fiber and water intake may prove helpful in this regard. Additionally, maintaining a healthy body weight can help reduce pressure on the pelvic muscles.
Surgical Treatment for a Prolapsed Uterus
- Hysterectomy and prolapse repair: The prolapse may be treated by removing the uterus (hysterectomy). Usually, the procedure is performed by making an incision in the vagina or through the abdomen. The removal of the uterus means that the patient will lose the ability to get pregnant.
- Prolapse repair without hysterectomy: Experts try to put the uterus back to its normal position. Also called uterine suspension, the procedure is done by reattaching the ligaments of the pelvis to the uterus’s lower part. The surgery may be performed through the abdomen or the vagina.
Again, mild cases might not be treated if they don’t interfere with everyday life. On the other hand, more severe cases may affect other organs, like the rectum and the bladder, and in these cases, experts will usually recommend treatment.
As far as prevention goes, women take several steps to strengthen their pelvic floor muscles, such as:
- Learning proper lifting techniques
- Avoid constipation and straining
- Maintaining a healthy weight and exercising regularly
- Performing Kegel exercises
- Stopping smoking, which can lead to the development of chronic cough.
Prognosis
In the majority of cases, treatment will be successful, and the prolapse won’t come back. Still, there are cases when the problem may develop again. This is more common if patients are:
- Obese
- Younger than 60
- Had a very severe case of uterine prolapse
Still, the outlook for uterine prolapse can be described as very good. Treatment and small lifestyle changes can successfully prevent the prolapse from returning. Still, it’s always a good idea to consult with your provider about your concerns about the condition. Together with your doctor, you can devise an effective treatment plan that will be able to prevent future problems with uterine prolapse.
When To See a Doctor?
Reach out to your provider if you experience any of the following symptoms of uterine prolapse:
- A feeling that something might be coming out of your vagina.
- Painful bowel movements and/or urination.
- Chronic pelvic pressure or low back pain that’s not the result of another condition.
Find Out More
Uterine prolapse is a condition that frequently occurs in individuals who have had multiple vaginal deliveries or have reached menopause. The symptoms can differ based on the degree of displacement of the uterus, but they can often cause significant discomfort. If you experience symptoms such as vaginal bulging or pelvic pressure indicating a prolapsed uterus, it is recommended to consult your healthcare provider. There are treatment options available to alleviate your discomfort and prevent complications involving other organs.
That said, contact our practice if you want to learn more about treatments and prevention.
