Kegel Exercises

For mild cases of uterine prolapse, Kegel exercises are recommended to strengthen the pelvic muscles. These exercises are easy to do and can be done anywhere, at any time. To perform Kegel exercises:

• Squeeze the pelvic muscles as though you are trying to hold back urine.
• Hold this position for a count of ten, then release slowly.
• Do this ten times, four times daily.

Referral to a Specialist

You may be referred to a gynecologist or a urogynecologist for further evaluation or surgery.

Pessary Insertion

This is a rubbery, doughnut-shaped device. It is inserted by your doctor into the upper portion of the vagina. A pessary helps to prop up the uterus and bladder, and temporarily prevents sagging into the vagina. It will need to be removed for cleaning and before sexual intercourse.

Surgery

Surgery may be necessary to correct uterine prolapse. These procedures are generally not done until you have finished having children. Surgical procedures include:

• Vaginal hysterectomy —removal of the uterus through the vagina. This procedure will permanently resolve uterine prolapse, but also results in infertility .
• Vaginal repair—This is usually done with a hysterectomy. The repair can be done with sutures and with insertion of mesh or slings.
• Colpocleisis—This is a procedure that cures the prolapse, but results in a foreshortened vagina that will not permit intercourse.

You and your doctor should discuss all risks and benefits when considering these surgical options.

Complications

Urinary tract infections and other urinary symptoms may occur due to the frequently associated cystocele . This is a hernia-like disorder in women that occurs when the wall between the bladder and the vagina weakens, causing the bladder to drop or sag into the vagina.

Hemorrhoids and constipation may also occur as a result of the associated rectocele (a similar condition to cystocele, only the rectum protrudes into the vagina). If you are constipated, eating more fiber can help. *¹

In more severe cases of prolapse, ulceration and infection may occur.