Uterine prolapse occurs when the uterus (womb) slips out of place and into the vaginal canal due to weakening of the muscles and ligaments of the lower abdomen (called the “pelvic floor”), which normally support the uterus and other organs in the pelvis. The severity of uterine prolapse is defined as:
Recently, more sophisticated methods of measuring and describing the degree of prolapse have been developed. These resemble three-dimensional engineering diagrams.
Other organs, such as the ovaries or bladder, may also be out of place due to the weakening of the pelvic floor tissues.
The uterus is normally supported by pelvic connective tissue, the pubococcygeus muscle, and held in position by special ligaments. Weakening of these tissues causes the uterus to descend into the vaginal canal.
A risk factor is something that increases your chance of getting a disease or condition. The following factors are associated with an increased risk of uterine prolapse:
There may be no symptoms for mild cases of uterine prolapse. Symptoms for more severe cases may include:
Your healthcare provider will ask about your symptoms and medical history, and perform a physical exam, including a thorough pelvic exam.
Treatment may include:
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:
You may be referred to a gynecologist or a urogynecologist for further evaluation or surgery.
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 may be necessary to correct uterine prolapse. These procedures are generally not done until you have finished having children. Surgical procedures include:
You and your doctor should discuss all risks and benefits when considering these surgical options.
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.
To help prevent uterine prolapse:
RESOURCES:
American College of Obstetricians and Gynecologists
http://www.acog.org
The National Women's Health Information Center
http://www.4woman.gov
CANADIAN RESOURCES:
The Society of Obstetricians and Gynaecologists of Canada
http://sogc.medical.org/
Women's Health Matters
http://www.womenshealthmatters.ca/index.cfm
References:
Harvard Guide to Women's Health . Harvard University Press; 1996.
National Library of Medicine, Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/001508.htm .
*¹10/21/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Shariati A, Maceda JS, Hale DS. High-fiber diet for treatment of constipation in women with pelvic floor disorders. Obstet Gynecol. 2008;111:908-913.
Last reviewed November 2008 by Jeff Andrews, MD, FRCSC, FACOG
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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