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Overview

The uterus (womb) is a muscular structure that’s held in place by pelvic muscles and ligaments. If these muscles or ligaments stretch or become weak, they’re no longer able to support the uterus, causing prolapse.

Uterine prolapse occurs when pelvic floor muscles and ligaments stretch and weaken and no longer provide enough support for the uterus. As a result, the uterus slips down into or protrudes out of the vagina and that’s why it is also referred to as a 'dropped uterus.' 


Symptoms Of Uterine Prolapse

Dr. Kajal Mangukiya says that mild uterine prolapse generally doesn't cause signs or symptoms. 

Signs and symptoms of moderate to severe uterine prolapse include:

- The sensation of heaviness or pulling in your pelvis

- Tissue protruding from your vagina

- Urinary problems, such as urinary incontinence or urine retention

- Trouble having a bowel movement

- Painful sexual intercourse.

- Sexual concerns, such as a sensation of looseness in the tone of your vaginal tissue

Often, symptoms are less bothersome in the morning and worsen as the day goes on.


Uterus Prolapse Causes

The following conditions can cause a prolapsed uterus:

 - Pregnancy/childbirths with normal or complicated delivery through the vagina

- Weakness in the pelvic muscles with advancing age

- Weakening and loss of tissue tone after menopause and loss of natural estrogen

- Conditions leading to increased pressure in the abdomen such as chronic cough (with bronchitis and asthma), straining (with constipation), pelvic tumors (rare), or an accumulation of fluid in the abdomen

- Being overweight or obese with its additional strain on pelvic muscles

- Major surgery in the pelvic area leading to loss of external support

- Smoking


Uterine Prolapse Stages

Uterine prolapse is described in stages, indicating how far it has descended. Other pelvic organs (such as the bladder or bowel) may also be prolapsed into the vagina.

The four categories of uterine prolapse are: 

Stage I – the uterus is in the upper half of the vagina

Stage II – the uterus has descended nearly to the opening of the vagina

Stage III – the uterus protrudes out of the vagina

Stage IV – the uterus is completely out of the vagina.

More severe cases may need surgery, but in the early stages, exercises may help.


Prolapsed Uterus Exercises

Gynaecologists in Vesu suggests that mild uterine prolapse can be treated with Kegel exercises, weight management and avoidance of heavy lifting.

Kegel exercises strengthen your pelvic floor muscles. A strong pelvic floor provides better support for your pelvic organs, prevents prolapse from worsening and relieves symptoms associated with uterine prolapse.

Kegel exercises may be most successful when they're taught by a physical therapist and reinforced with biofeedback.

To perform Kegel exercises:

- Tighten (contract) your pelvic floor muscles as though you were trying to prevent passing gas.

- Hold the contraction for five seconds, and then relax for five seconds. If this is too difficult, start by holding for two seconds and relaxing for three seconds.

- Work up to holding the contractions for 10 seconds at a time.

- Aim for at least three sets of 10 repetitions each day.

Once you've learned the proper method, you can do Kegel exercises discreetly just about anytime, whether you're sitting at your desk or relaxing on the couch.


Uterine Prolapse Treatment

There are several treatment options by Gynaecologists in Surat available for pelvic organ prolapse including both surgical and non-surgical options.

The most suitable will depend on:

- the severity of your symptoms

- the severity of the prolapse

- your age and health

- whether you're planning to have children in the future

You may not need any treatment if the prolapse is mild to moderate and not causing any pain or discomfort. Some strategies can reduce the risk of uterine prolapse developing and stop it from worsening.

These include performing Kegel exercises regularly and correctly, preventing and treating constipation, avoiding heavy lifting, using correct body mechanics whenever lifting is necessary, managing chronic coughing, maintaining a healthy weight through diet and exercise, considering estrogen replacement therapy during menopause

If the prolapse shows signs of worsening, other types of treatment may be necessary. Prolapse up to the third degree may spontaneously resolve. More severe cases may require medical treatment.

Options include:

1. Vaginal pessary:
This is a vaginal device that supports the uterus and keeps it in position. It is important to follow the instructions on care, removal, and insertion of the pessary. In cases of severe prolapse, a pessary can cause irritation, ulceration, and sexual problems. Discuss with your provider if this treatment is right for you.

2. Surgery:
Surgical repair of a prolapsed uterus can be performed through the vagina or abdomen. It involves skin grafting or using donor tissue or other material to provide uterine suspension. A hysterectomy may be recommended.

If future pregnancies are intended, surgery may not be recommended, due to the risks of undoing the effects of surgical repair.