Uterine Prolapse - Causes, Symptoms and Treatment

Uterine prolapse means your uterus has dropped from its position within the pelvis into your vagina. A combination of muscles and ligaments in the pelvis called the pelvic floor support the uterus and vagina, to keep them in their correct position inside the pelvis. Pelvic organ prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of prolapse in later life, but because many women don't seek help from their doctor the actual number of women affected by prolapse is unknown.

Causes

Uterine prolapse occurs most commonly in women who have had one or more vaginal births, and in Caucasian women.
Other conditions associated with an increased risk of developing problems with the supportive tissues of the uterus include obesity and chronic coughing or straining. Obesity places additional strain on the supportive muscles of the pelvis, as does excessive coughing caused by lung conditions such as chronic bronchitis and asthma. Chronic constipation and the bearing-down associated with it causes weakness in these muscles.

Symptoms

Women with mild cases of uterine prolapse may have no obvious symptoms. However, as the uterus slips further out of position, it can place pressure on other pelvic organs--such as the bladder or bowel--causing a variety of symptoms. In severe cases, the uterus may be easily felt or be visible to the woman, while in other cases there may be no symptoms.

* Sensation of vaginal or pelvic fullness
* Urinary complaints including urinary incontinence (involuntary urination), frequency, or urgency (the sensation of the immediate need to urinate)
* Bowel symptoms, including pain with defecation, constipation, or incontinence
* Sexual complaints, including pain with intercourse

Treatment

If you experience only mild uterine prolapse, treatment usually isn't needed. But if you experience discomfort or interruption of your lifestyle as a result of uterine prolapse, you might benefit from surgery to repair the prolapse, or you may elect to use a special supportive device (pessary), which is inserted into your vagina.

Inserting a pessary, which is a rubber, diaphragm-like device, around the cervix to help prop up the uterus? The pessary does have drawbacks. It may dislodge or cause irritation, it may interfere with intercourse, and it must be removed regularly for cleaning.

Most commonly, vaginal surgery is preferred because the patient usually has a shorter recovery time with this approach. In addition, it is selected if a vaginal approach is planned for the correction of incontinence (eg, for placement of a suburethral sling) or when concomitant vaginal reconstruction is indicated.

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