Uterine Prolapse is a condition which occurs when the uterus moves downwards from its usual position. The uterus and other organs of the pelvis are supported by layers of pelvic floor muscles and ligaments. Uterine prolapse occurs when these tissues become stretched out and are weak.
The Causes And Degrees Of Uterine Prolapse
There can be many reasons as to why the pelvic floor and associated supporting and connective tissue can become weakened or damaged. Some of the most common causes of uterine prolapse include;
- Pregnancy, especially in women who have had multiple pregnancies or multiple births (twins or triplets)
- Vaginal childbirth – the condition is more common in women who delivered their babies quickly, had a prolonged pushing phase in labour, or if the baby was large
- Severe coughing, often associated with chronic bronchitis and asthma
- Hormonal changes following menopause – low levels of oestrogen can contribute to the development of uterine prolapse
- Excessive straining on the toilet
- Obesity
Doctors tend to classify the degrees of uterine prolapse so that they can indicate how far the uterus has descended. It is possible for other pelvic organs such as the bladder and bowel to also prolapse into the vagina. The four degrees of uterine prolapse are;
- Stage 1, the uterus remains in the upper half of the vagina
- Stage 2, the uterus descends near the opening of the vagina
- Stage 3, the uterus begins to protrude out from the vagina
- Stage 4, the uterus is completely out of the vagina
Symptoms Of Uterine Prolapse
A prolapsed uterus can decrease a woman’s quality of life by affecting her physical and sexual activity. The condition often presents with the following symptoms;
- An awareness of heaviness or pressure in the vagina
- A distinct lump or bulge which can be felt in the vagina
- A bulge which protrudes out of the vagina
- Pain during sexual intercourse
Uterine prolapse can also cause problems with the urinary system, with women often have problems or difficulty in passing urine or emptying their bladders completely. Some women also complain of urinary incontinence or problems in holding their urine. Frequent urinary tract infections and difficulty in bowel movements can also occur.
Treatment Of Uterine Prolapse
For many women who only have mild prolapse and very few symptoms, doctors advise that self-care methods are all that is needed. Most importantly, pelvic floor exercises are recommended to improve symptoms and prevent the condition from worsening. If weight is a factor, losing weight is strongly advised. Women should also avoid heavy lifting which can usually make the condition worse and avoid or quickly treat constipation.
Vaginal pessaries are also available to relieve symptoms of uterine prolapse. These are flexible devices which are inserted into the vagina and work by keeping the prolapsed organs in their place. These are typically recommended for women who still wish to have more children, are unwell or unable to have an operation to correct the prolapse.
If pelvic floor exercises, weight management, and pessaries don’t work, surgery is available. Doctors usually recommend surgery to those women who don’t intend on having future pregnancies. There are different kinds of surgeries available, including reconstructive surgery or a hysterectomy.
