Prolapsed Uterus

Uterus is one of the important organs of female reproductive system. It is normally located in the pelvis with different muscles, ligaments and tissues. Sometimes, during childbirth or difficult delivery, these muscles become weak. With aging, there is a natural loss of estrogen, due to which uterus can collapse into the vaginal canal. This condition is known as prolapsed uterus or uterine prolapse. Some other conditions that weaken the muscles that hold the uterus in place include cystocele (herniation of upper front vaginal wall), enterocele (herniation of upper rear vaginal wall) and rectocele (herniation of lower rear vaginal wall).

Uterine prolapse is of three types such as first-degree prolapse, second-degree prolapse and third-degree prolapse. In first-degree prolapse, uterus collapses into upper vagina. In second-degree prolapse, cervix sticks to the opening of vagina. In third-degree uterine prolapse, cervix or entire uterus is outside the vagina. This condition is known as procidentia.

Causes of Prolapsed Uterus

Pregnancy, multiple childbirths with normal childbirth through vagina is the main cause of uterine prolapse. Trauma occurred during childbirth and difficult delivery, are the major causes of weakening and stretching of supporting muscles and tissues, resulting in uterine prolapse. Loss of muscle tone related to aging and decreased levels of circulating estrogen after menopause are also responsible for a prolapsed uterus.

Certain conditions such as chronic cough due to asthma or bronchitis, pelvic tumors or straining due to constipation cause increased pressure in abdomen, which may result in uterine prolapse. Some other causes of prolapsed uterus are obesity, radical surgery in the pelvic area and excess weight lifting.

Symptoms of Prolapsed Uterus

In case of mild uterine prolapse, there may be no significant symptoms. In case of moderate and severer uterine prolapse, following symptoms can be found:

• Tissue protruding from the vagina
• Sensation of heaviness or pulling in the pelvis
• Lower back pain
• Urinary difficulties such as urine leakage or urge incontinence
• Trouble having a bowel movement
• Painful sexual intercourse
• Difficulty in walking

These symptoms of prolapsed uterus should not be neglected. If left untreated, there may develop some severe complications. In case of severe uterine prolapse, part of vaginal lining is exposed outside the body, which can cause vaginal ulcers. In some cases, the sores may get infected. In some cases, there may be a prolapse of other pelvic organs such as rectum and bladder. It can cause difficulty in urination and increased risk of urinary tract infections.

Diagnosis of Uterine Prolapse

A pelvic examination is required for the diagnosis of uterine prolapse. It is done in standing and lying down position. In case of ureteral obstruction due to complete prolapse, renal sonography or intravenous pyelogram is required. Ultrasound is done to rule out other pelvic problems.

Treatment for Prolapsed Uterus

In case of mild prolapse with no symptoms, medical treatment is not required. Various treatment options include lifestyle changes, vaginal pessary and surgery. If you are overweight, then it is necessary to achieve and maintain a healthy weight. You can try some exercises (Kegel exercises) to strengthen the pelvic floor muscles. A vaginal pessary that fits inside the vagina is helpful for holding the uterus in place. Estrogen cream or suppository ovules or rings inserted into vagina help restore the strength of muscles and supporting tissues. If these treatment options fail to relieve the symptoms, then surgical option is advised. It requires vaginal hysterectomy, in which uterus as well as excess vaginal tissues are removed.

You can prevent the uterine prolapse by maintaining a healthy weight, practicing Kegel exercises and preventing coughing. Besides, for a woman's health, regular exercises and maintaining a healthy body weight are quite beneficial too.