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Prolapse (uterine prolapse): Treatment, symptoms, advice and help

About prolapse (uterine prolapse)

Uterine prolapse occurs when muscles of the pelvic floor and its ligaments stretch and weaken, due to which, adequate support to the uterus is not provided and the uterus then drops into the vaginal canal. It can be incomplete or, in more severe cases, complete when the uterus slips and drops outside the vagina.

Prolapse (uterine prolapse): Incidence, age and sex

Approximately half of all women older than 50 years, may complain of symptomatic prolapse.

Signs and symptoms of prolapse (uterine prolapse): Diagnosis

One may feel as if she is sitting on a small ball. Sexual intercourse may be painful. There may be an urge to urinate frequently. Low backache may be associated with these symptoms. There may be repeated bladder infections. The uterus may protrude through the vaginal opening and this may be associated with vaginal bleeding or increased vaginal discharge. Most of these symptoms may get worse after standing or sitting for a longer period of time. Gynaecological examination is needed to establish such diagnosis.

Causes and prevention of prolapse (uterine prolapse)

Pregnancy and normal delivery is believed to be the main cause of uterine prolapse. It may occur immediately after pregnancy or even later.

Large fibroids or tumours, which increase the weight of the uterus, may also result in uterine prolapse. As age progresses, the pelvic muscles get weaker and the reduced level of oestrogen during menopause may also cause pelvic muscles to lose their elasticity. Severely overweight women are at increased risk of prolapse. Also, chronic coughing, constipation, or straining during defection and lifting heavy weights may put one at increased risk of prolapse.

Women with a genetic collagen deficiency (Marfan syndrome or Ehlers-Danlos syndrome) are at an increased risk of prolapse even if they do not have any of the other risk factors. Previous pelvic surgery like bladder repair procedures and muscular atrophy conditions may also put a woman at an increased risk of prolapse.

Prolapse (uterine prolapse): Complications

Ulceration and infection of the cervix (neck of the uterus) and vaginal walls may occur in severe cases of uterine prolapse. Some other severe cases may end in urinary tract infections.

Prolapse (uterine prolapse): Treatment

Treatment may not be required till these symptoms become bothersome. Most women seek treatment by the time the uterus drops to the opening of the vagina. If required, uterine prolapse can be treated with a vaginal pessary or even surgery.

A vaginal pessary is a rubber or plastic donut-shaped device which is inserted in order to hold the uterus in place. Surgery should not be generally attempted till the symptoms outweigh the risks of surgical procedure. The decision to undergo surgery depends upon the extent of prolapse, desire for future pregnancies, woman’s age and overall health, and other medical conditions. Often, a vaginal hysterectomy is also attempted to correct uterine prolapse. Any sagging of the vaginal walls, urethra, bladder, or rectum can also be corrected at the same time.