Uterine prolapse is a condition that happens to women, where their womb (uterus) slips or sags out of its usual position. Sometimes, the slip is so severe that the womb actually enters the vagina or birth canal. This leads to bulges and lumps, which can be very painful. This is known as an incomplete prolapse. The more severe cases, known as complete prolapse, lead to the uterus actually dropping out of the vagina itself.
Symptoms of Uterine Prolapse
When a mild case of uterine prolapse occurs, there are generally no symptoms at all. However, as the uterine prolapse stages progress, the pelvic organs will notice pressure. This is mainly felt in the bowels and bladder. This can lead to a variety of problems, including:
• Feelings of pressure
• Pain and discomfort, particularly during intercourse
• Lumps and bulges in the vaginal area
• Frequent bladder and urinary tract infections
• Vaginal discharge
• Incontinence and other changes in urination
If patients walk or stand for long periods of time, the symptoms often worse, due to gravity placing additional pressure on the muscles of the pelvis.
Uterine Prolapse Causes
Muscles and ligaments within the pelvis hold the uterus in place. These structures weaken over time, making it difficult for them to hold the uterus in place. A few things can make this situation worse, such as:
• Age leading to loss of muscle tone
• Birthing injuries, for instance when a woman has large babies or many babies
• Medical conditions such as obesity, chronic constipation, chronic coughing and so on.
Who Is at Risk of Uterine Prolapse?
The vast majority of women who have uterine prolapse have either had more than one child, or they are post-menopausal. This is mainly because oestrogen is no longer produced after the menopause and this hormone is crucial to the maintenance of pelvic muscles. The condition is fairly common, particularly in older women.
Uterine Prolapse Diagnosis
If a woman suspects uterine prolapse, she will have a pelvic examination to confirm it. A speculum is inserted into the vagina, to allow the physician to perform his examination. They will then feel whether or not there are any bulges inside the vaginal canal.
Uterine Prolapse Treatment
There are different options to treat uterine prolapse. Some include surgery, others do not. The severity of the condition will determine which treatment is most suitable, as well as looking at the general health of the woman.
Kegel exercises work very well to strengthen the muscles of the pelvis and these exercises are often enough to solve the problem. If not, a vaginal pessary can be fitted into the cervix to help prop it up. It must be removed and cleaned regularly. Another option is to have ORT – Oestrogen Replacement Therapy – which can support the uterus. However, there are possible complications, including gall bladder disease, blood clots and breast cancer.
There are two types of uterine prolapse surgery available:
• A hysterectomy, whereby the uterus is completely removed and stops the chances of further pregnancy.
• Uterine suspension, whereby the uterus is replaced and the ligaments are strengthened, which is a less invasive procedure.
Uterine Prolapse Prevention
Most cases of uterine prolapse cannot be prevented. However, women can reduce the chance of it happening by:
• Ensuring they have a healthy body weight
• Exercising regularly, as well as doing Kegel exercises
• Eating healthily, including unsaturated fats, carbohydrates and proteins in their diet
• Not smoking
• Having ORT after menopause
• Learning about the right lifting techniques