The uterus is held inside the pelvis by muscles, ligaments, and other structures. If these tissues weaken, the uterus drops. Uterine prolapse is the womb displacement into the vaginal area.
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It often happens in women who have had one or more vaginal births.
Other factors, such as aging, a lack of estrogen after menopause, a pelvic tumour, obesity or chronic cough that pressures pelvic muscles, can also cause uterine prolapse.
Furthermore, prolonged constipation and the effort to defecate can worsen the problem.
In order to diagnose the prolapse, a pelvic exam is made. The doctor will ask the patient to push as if she was about to deliver a baby during childbirth. This exam shows how much the uterus descends.
- If the cervix drops to the bottom of the vagina, the uterine prolapse is mild.
- If the cervix drops out of the vaginal opening, the uterine prolapse is moderate.
On the other hand, if the bladder and the vaginal anterior wall move into the vagina, the prolapse is called cystocele. If the rectum and the posterior vaginal wall are the ones that move, the prolapse is called rectocele.
The symptoms of uterine prolapse are:
- Urinary incontinence or sudden urge to urinate.
- Pain during sex.
- Vaginal or pelvic pressure.
- Repeated bladder infections.
- Vaginal bleeding.
- Increased vaginal discharge.
- Displacement of the uterus and cervix into the vagina.
Most women, who have a mild uterine prolapse, do not present symptoms that require treatment.
In more severe cases, complications such as infections and ulceration of the cervix and vaginal walls may arise.
The symptoms get worse when the woman sits or stands for too long.
On the other hand, exercising or lifting weights can also worsen the prolapse.
Treatment is only necessary if the symptoms cause discomfort. Many women receive treatment when the uterus has descended into the vaginal opening.
Changes in lifestyle, such as losing weight or exercising, can help control the symptoms.
In some cases, a device called pessary is recommended. This device can be made of rubber or plastic and is placed inside the vagina so it can hold the uterus into place.
The pessary should be regularly cleaned and may have some side effects, like the emergence of vaginal ulcers or problems during sex.
If symptoms are severe, you can resort to surgery and, if needed, the uterus can be removed. A vaginal hysterectomy is often performed.
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