Pelvic organ prolapse (POP) is a medical condition that occurs when the normal support of the vagina is lost, resulting in “sagging” or dropping of the bladder, rectum, urethra and cervix. As the prolapse of the vagina and uterus progresses, women can feel bulging tissue protruding through the opening of the vagina.
Uterine prolapse is the second most common after bladder and urethral prolapse. The uterus is held in position in the pelvis by muscles, special ligaments, and other tissue; when these muscles and connective tissues weaken, the uterus drops (prolapses) into the vagina.
Uterine prolapse is fairly common in women who have had one or more vaginal births, especially when delivering babies over nine pounds. The risk of developing this condition increases with age.
During a woman’s childbearing years normal levels of estrogen help to keep the pelvic muscles strong. Normal aging and decreased production of the female hormone estrogen after menopause may cause uterine prolapse. After menopause, hormone replacement therapy can help to maintain muscle tone. Chronic cough, constipation and obesity can worsen the condition by increasing the pressure on the pelvic floor. Uterine prolapse can also be caused by a pelvic tumor, although this is rare.
Some symptoms of uterine prolapse include:
• A feeling as if sitting on a small ball
• Protruding of the uterus and cervix through the vaginal opening
• Difficult or painful sexual intercourse
• Frequent urination or a sudden, urgent need to empty the bladder
• Vaginal bleeding or increased vaginal discharge
• Low backache
• Repeated bladder infections
• Sensation of heaviness or pulling in the pelvis
Many of these symptoms are worse when standing or sitting for long periods of time. Treatment is not necessary in mild cases unless the symptoms are bothersome, however, most women seek treatment by the time the uterus drops to the opening of the vagina. In severe cases, untreated uterine prolapse can interfere with bowel, bladder and sexual functions. Uterine prolapse can be treated with a vaginal pessary or surgery.
A vaginal pessary is a rubber or plastic donut-shaped device that is inserted into the vagina to hold the uterus in place similar to a diaphragm device used for birth control. It may be a temporary or permanent form of treatment and are most effective for women with mild uterine prolapse symptoms. Vaginal pessaries are fitted for each individual woman, and the patient must learn how to remove, clean, and reinsert the pessary device.
For more severe cases where quality of life is compromised, pelvic
reconstructive surgery may be necessary. New technology and improved materials have made the procedure more appealing to patients and physicians. The non-invasive procedure is performed through the vagina under regional or general anesthesia. The surgeon repositions the prolapsed organ or organs and provides tissue reinforcement and stabilization using a synthetic mesh material.
For women with uterine prolapse, a few lifestyle changes are recommended, such as avoiding heavy lifting or straining as it may worsen the condition, and quitting smoking if chronic coughing is caused by tobacco use. Obese women are also urged to lose weight. In many cases using Kegel exercises—contracting and relaxing the muscles that form part of the pelvic floor several times per day—reduces the risk of developing uterine prolapse.
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Hello...I have been in for two surgeries to suspend and lift my uterus. The first surgery only lasted 6 months and then my uterus was back to where it had originally been. Second surgery I went to a different doctor who performed a different surgery leaving permanent stitches inside to hold up uterus. This caused horrible complications and they had to go back in to let out stitches. Now I have scar tissue affecting my nerves and sex is not an option right now. I am only 36 years old and really want another child. They are tellling me I need a partial hysterectomy taking out cervix and uterus. I am so scared and do not know what to do?
October 27, 2011 - 3:27pmThis Comment