Uterine Prolapse

Types of Uterine Prolapse

1. First-Degree Prolapse:

   • The uterus has descended into the upper part of the vagina but is still within the vaginal canal.

2. Second-Degree Prolapse:

   • The uterus has descended to the vaginal opening, and it may be visible outside the body when standing.

3. Third-Degree Prolapse (Complete Prolapse):

   • The uterus protrudes completely outside of the vagina.

Symptoms of Uterine Prolapse

Symptoms can vary depending on the severity of the prolapse and may include:

• Pelvic Pressure or Heaviness: A feeling of fullness or heaviness in the pelvic area.
• Vaginal Bulge: A visible bulge or protrusion from the vagina.
• Urinary Issues: Difficulty with urination, frequent urination, or urinary incontinence.
• Bowel Problems: Constipation or a feeling of incomplete bowel evacuation.
• Pain: Discomfort or pain in the pelvic area, which can sometimes radiate to the lower back.
• Sexual Dysfunction: Pain or discomfort during intercourse.
• Increased Symptoms with Activity: Symptoms may worsen with prolonged standing, lifting, or physical exertion.

Causes and Risk Factors

Several factors can contribute to uterine prolapse:

• Childbirth: Vaginal delivery, especially with multiple births or large babies, can weaken pelvic support tissues.
• Age: The risk increases with age, particularly after menopause when estrogen levels drop.
• Hormonal Changes: Reduced estrogen levels can affect the strength of pelvic tissues.
• Obesity: Excess weight increases pressure on the pelvic organs.
• Chronic Coughing: Persistent coughing from conditions like chronic bronchitis can increase abdominal pressure.
• Heavy Lifting: Frequent heavy lifting or straining can weaken pelvic support.
• Genetic Factors: A family history of prolapse or other pelvic support disorders.

Diagnosis

Diagnosis is typically made through:

1. Medical History: Discussing symptoms, childbirth history, and any other relevant health information.
2. Pelvic Exam: A physical examination to assess the extent of prolapse and the position of the uterus.
3. Imaging: In some cases, additional imaging tests like ultrasound or MRI may be used to evaluate pelvic organ support.

Treatment Options

Treatment for uterine prolapse depends on the severity of the condition, symptoms, and overall health:

1. Conservative Management:

   • Pelvic Floor Exercises (Kegels): Strengthening pelvic muscles to provide better support for the uterus.
   • Pessary: A device inserted into the vagina to help support the uterus and prevent further prolapse.

2. Surgical Options:

   • Surgical Repair: Procedures to reposition the uterus and repair the pelvic support tissues. Techniques may vary, including:
     • Anterior/Posterior Repair: Repairing the pelvic walls to support the uterus.
     • Hysterectomy: Removing the uterus, often done when prolapse is severe or other treatments are not effective.
   • Uterine Suspension: Surgical procedures to attach the uterus to the pelvic bones or ligaments.

3. Lifestyle Modifications:

   • Weight Management: Maintaining a healthy weight to reduce pressure on the pelvic organs.
   • Avoiding Heavy Lifting: Reducing activities that increase abdominal pressure.

Follow-Up and Management

Regular follow-up with a healthcare provider is important to monitor the condition, evaluate the effectiveness of treatments, and make adjustments as needed. Managing symptoms through lifestyle changes, exercises, or medical interventions can help improve quality of life.