Doctors refer to this downward movement of the uterus as uterine 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. Uterine prolapse can occur in women of any age. But it often affects postmenopausal women who've had one or more vaginal deliveries. Mild uterine prolapse usually doesn't require treatment.
But if uterine prolapse makes you uncomfortable or disrupts your normal life, you might benefit from treatment. Mild uterine prolapse generally doesn't cause signs or symptoms. Signs and symptoms of moderate to severe uterine prolapse include:.
See your doctor to discuss your options if signs and symptoms of uterine prolapse become bothersome and disrupt your normal activities. Uterine prolapse results from the weakening of pelvic muscles and supportive tissues. Causes of weakened pelvic muscles and tissues include:. Severe uterine prolapse can displace part of the vaginal lining, causing it to protrude outside the body. Vaginal tissue that rubs against clothing can lead to vaginal sores ulcers.
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Summary Read the full fact sheet. On this page. Symptoms of prolapse of the uterus Degrees of uterine prolapse Causes of uterine prolapse Treatments for uterine prolapse Pelvic floor exercises Prevention techniques Where to get help. Symptoms of prolapse of the uterus The symptoms of uterine prolapse include: a sensation of heaviness and pressure in the vagina a distinct lump or bulge within the vagina a bulge protruding out of the vagina painful sexual intercourse.
Degrees of uterine prolapse Uterine prolapse is described in stages, indicating how far it has descended. 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.
Causes of uterine prolapse The pelvic floor and associated supporting connective tissues can be weakened or damaged in many ways including: pregnancy, especially in the case of multiple births such as twins or triplets , or multiple pregnancies vaginal childbirth, especially if the baby was large or delivered quickly, or if there was a prolonged pushing phase obesity straining on the toilet to pass a bowel motion low levels of the sex hormone oestrogen after menopause severe coughing associated with conditions such as chronic bronchitis or asthma fibroids in rare cases, pelvic tumour.
Treatments for uterine prolapse Treatments for uterine prolapse include surgical and non-surgical options, the choice of which will depend on general health, the severity of the condition and plans for a future pregnancy. Treatment options include: pelvic floor exercises vaginal pessary vaginal surgery. Pelvic floor exercises Stage I and II uterine prolapse in particular can be helped by pelvic floor muscle exercises, but they need to be done correctly and practised long enough to strengthen the muscles.
To identify your pelvic floor muscles, try the following: Insert one or two fingers into the vagina and try to squeeze them. Imagine you are passing urine, and try to stop the flow midstream do not do this while urinating. Pelvic organ repair may be done through cuts incisions in the vagina. It's usually carried out under general anaesthetic , so you'll be asleep during the operation and won't feel any pain. If you're planning to have children and have a prolapse, your doctors may suggest delaying surgery until you're sure you no longer want to have any more children.
This is because pregnancy can cause the prolapse to recur. If the womb uterus is prolapsed, then removing it during an operation called a hysterectomy often helps the surgeon to give better support to the rest of the vagina and reduce the chance of a prolapse returning. A hysterectomy will usually only be considered in women who don't wish to have any more children, as you can't get pregnant after having a hysterectomy. Methods to elevate and support the uterus without removing it do exist, but these need to be discussed with your doctor.
All types of surgery carry some risks. Your surgeon will explain these in more detail, but possible complications could include:. Most prolapse operations require an overnight stay in hospital. More major operations, such as a hysterectomy, may require a few nights in hospital.
If you need to stay in hospital, you may have a drip in your arm to provide fluids and a thin plastic tube called a catheter to drain urine from your bladder. Some gauze may be placed inside your vagina to act as a bandage for the first 24 hours. This may be slightly uncomfortable. Your stitches will usually dissolve on their own after a few weeks.
For the first few days or weeks after your operation, you may have some vaginal bleeding similar to a period. You may also have some vaginal discharge. This may last three or four weeks. During this time, you should use sanitary towels rather than tampons. Enhanced recovery is an NHS initiative to improve patient outcomes after surgery and speed up recovery.
This involves careful planning and preparation before surgery, as well as reducing the stress of surgery, by:. Even with enhanced recovery, there may still be some activities you need to avoid while you recover from surgery. Your care team can advise about activities you may need to avoid, such as heavy lifting and strenuous exercise, and for how long.
Generally, most people are advised to move around as soon as possible, with good rests every few hours. You can usually shower and bathe as normal after leaving hospital, but you may need to avoid swimming for a few weeks. Home Illnesses and conditions Sexual and reproductive Pelvic organ prolapse. Pelvic organ prolapse See all parts of this guide Hide guide parts 1. About pelvic organ prolapse 2. Treating pelvic organ prolapse. About pelvic organ prolapse Pelvic organ prolapse is bulging of one or more of the pelvic organs into the vagina.
These organs are the uterus, vagina, bowel and bladder. Symptoms may include: a sensation of a bulge or something coming down or out of the vagina, which sometimes needs to be pushed back discomfort during sex problems passing urine — such as slow stream, a feeling of not emptying the bladder fully, needing to urinate more often and leaking a small amount of urine when you cough, sneeze or exercise stress incontinence Some women with a pelvic organ prolapse don't have any symptoms and the condition is only discovered during an internal examination for another reason, such as a cervical screening.
When to see your GP Pelvic organ prolapse isn't life-threatening, but it can affect your quality of life. Initial treatment Pelvic organ prolapse can be a long-lasting condition. These changes might include: Doing pelvic floor Kegel exercises every day to tighten and strengthen pelvic muscles. Eating high-fibre foods to prevent constipation. Get at least 20 g of fibre a day. Reaching and staying at a healthy weight.
Avoiding activities that stress your pelvic muscles, such as heavy lifting. Ongoing treatment Pelvic organ prolapse can be a long-lasting condition. Treatment if the condition gets worse If you have pain and discomfort from pelvic organ prolapse that does not respond to non-surgical treatment and lifestyle changes, you may want to consider surgery.
Types of surgery for pelvic organ prolapse include: Repair of the bladder cystocele or urethra urethrocele. Removal of the uterus hysterectomy.
Repair of the rectum rectocele or small bowel enterocele. Repair of the vaginal wall vaginal vault suspension. Closure of the vagina vaginal obliteration. What to think about If you are considering having children, you may want to delay pelvic organ surgery. Prevention Pelvic organ prolapse is most often a result of tissue damage caused by labour and childbirth.
Lifestyle changes that may slow the prolapse process include: Reaching and staying at a weight that is healthy for your height. Not smoking. The chronic cough associated with smoking may cause or speed pelvic organ prolapse. Correcting constipation. The straining caused by constipation weakens and damages the connective tissue and muscles in the pelvis.
Avoiding heavy lifting and jumping. Doing pelvic strengthening exercises Kegel exercises every day. These exercises help strengthen the muscles of the pelvis. Home Treatment Home treatment can relieve the discomfort of pelvic organ prolapse. Do Kegel exercises every day to strengthen the muscles and ligaments of the pelvis. Prevent or correct constipation. The straining caused by constipation increases pressure from the bowel on the vaginal wall and weakens and damages the connective tissue and muscles in the pelvis.
Try gentle exercise. Take a short walk each day. Gradually increase your walking time until you are walking for at least 20 minutes each day. Make sure you drink enough fluids. Eat plenty of high-fibre foods such as whole grains, fruits, and vegetables every day. Have a bran muffin or bran cereal for breakfast, and try eating a piece of fruit for an afternoon snack. Try to eat about 20 g of fibre every day. Schedule time each day for a bowel movement—after breakfast, for example.
Having a daily routine may help. Take your time. If you continue to be constipated, try taking processed or synthetic fibre such as Metamucil or Prodiem each day.
If your stools are very hard, try taking a stool softener, such as Colace, to prevent straining. Avoid activities that stress your pelvic muscles, such as heavy lifting. Medications Although taking or applying the hormone estrogen will not cure an existing pelvic organ prolapse, it is sometimes prescribed for women during menopause to preserve or strengthen the tissues of the pelvis, which may help prevent prolapse.
Surgery If you have pain and discomfort from pelvic organ prolapse that does not respond to non-surgical treatment and lifestyle changes, you may want to consider surgery.
For help deciding about surgery, see: Urinary Incontinence in Women. Other Treatment You may be able to relieve symptoms of pelvic organ prolapse by using a pessary. What to think about Many women can successfully control symptoms of pelvic organ prolapse for years using a vaginal pessary.
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