Uterine Prolapse

WHAT IS UTERINE PROLAPSE?

Uterus is normally supported by the pelvic muscles and when it sinks from its normal location, causing it to bulge into the vagina, it is called prolapse. It usually affects women over 40. In its most pronounced form (stage 3), it projects outside the vagina.

SIGNS & SYMPTOMS

  • Lump in front or back of the vagina, or projecting outside it. Feeling of "something coming down …"
  • Vague discomfort in the pelvic region.
  • Backache that worsens with lifting weights.
  • Discomfort while passing urine.
  • Occasional stress incontinence
  • Difficulty in passing stools.
  • Painful sexual intercourse.

CAUSES

Prolapse occurs when muscles and ligaments supporting the uterus become extremely lax, usually as a result of multiple childbirth or aging.

WOMEN MORE AT RISK

  • Obesity.
  • Repeated childbirth, although one pregnancy and vaginal delivery can weaken the area enough to lead to prolapse eventually.
  • Straining to have bowel movements.

CAN IT BE PREVENTED?

  • Practice Kegel exercises during pregnancy and after childbirth (given below).
  • Avoid obesity.

DIAGNOSTIC MEASURES

  • Typical symptoms.
  • Examination by a doctor.

    POSSIBLE COMPLICATIONS

    • Total prolapse, requiring surgery.
    • Ulceration of the cervix, if not operated.
    • Increased risk of infection or injury to pelvic organs.

    TREATMENT

    GENERAL MEASURES

    Learn to recognize, control and develop the pelvic muscles. These are the ones you use to interrupt urine in mid-stream or hold back stools. The following exercises (Kegel exercises) strengthen these muscles so you can control or relax them completely:

    • To identify which muscles are involved, alternately start and stop urinating when using the toilet.
    • Practice tightening and releasing these muscles while sitting, standing, walking, driving, or watching TV.
    • Tighten the muscles little at a time, "like an elevator going up to the 10th floor." Then release very slowly, "one floor at a time."
    • Tighten the muscles from front to back, including the anus, as in the previous exercise.
    • Practice exercises every morning, afternoon and evening. Start with 5 times each, and gradually work up to 20 or 30 each time.

    MEDICATION

    Medicine is not necessary. Your doctor may prescribe a pessary made of rubber or other material to fit inside the vagina to if it is early prolapse.

    ACTIVITY

    No restrictions. If surgery is necessary, resume your normal activities gradually.

    CALL YOUR DOCTOR, IF

    • You notice typical symptoms.
    • Symptoms don't improve in 3 months despite treatment or exercise, or symptoms become intolerable and you plan surgery.

    | Stage1 | Stage2 | Stage3 |