Uterine prolapse is a condition that occurs when the uterus slips down into, or protrudes out of, the vaginal canal. Normally, the uterus is supported by a network of muscles and ligaments. When the pelvic floor muscles and ligaments stretch and weaken, they provide inadequate support for the uterus, causing the uterus to prolapse (slip or fall) from its normal position. Uterine prolapse affects women of all ages, but most commonly affects postmenopausal women who have had vaginal deliveries during childbirth. Depending on the severity of the prolapse, treatment may or may not be necessary. For cases in which uterine prolapse does impact daily life, effective treatments are available. Uterine prolapse is estimated to account for approximately 200,000 prolapse surgeries each year in the United States.
Uterine prolapse is a condition that has a number of causes and risk factors. Most often, pregnancy and trauma during childbirth, especially with larger newborns and difficult labor or delivery, cause muscle weakness and stretching of the supporting tissues and ligaments of the uterus. The effects of aging, including decreased muscle tone and reduced amounts of estrogen, are also believed to contribute to uterine prolapse. Other risk factors for uterine prolapse include tumors in the pelvic cavity, collagen quality, smoking, and obesity.
Uterine prolapse can vary considerably in severity. Women with mild prolapse may experience no signs and symptoms. Moderate to severe cases may result in additional pressure on other pelvic organs, causing:
If these signs and symptoms begin to compromise your normal daily activities, or if they are persistent and severe, then you should contact a doctor to discuss diagnostic and treatment options.
Diagnosing Uterine Prolapse
A pelvic examination can be used to determine if the uterus has slipped from its normal position and to what extent. A full medical assessment may also be conducted to see how the uterine prolapse affects your ability to navigate daily activities and whether treatment may be necessary. Imaging tests are not usually necessary to detect uterine prolapse, but a doctor may use them to aid in determining the degree of prolapse.
Women with minor uterine prolapse may require no treatment, although regular screening may be suggested to monitor the extent of prolapse as time goes on. Self-care options, including exercise (Kegel exercises) can aid in strengthening the pelvic floor muscles and reducing pressure on other pelvic structures. Other non-surgical options are available. Vaginal pessary uses a rubber or plastic device to support the uterus and hold it in place. Estrogen replacement therapy (ERT) can limit further weakness to muscles and ligaments. As ERT does pose risks, including blood clots, gallbladder disease, and breast cancer, you should always explore this option with your doctor.
When uterine prolapse is moderate to severe, surgery may be required in order to repair damaged pelvic floor tissues. Although hysterectomy, removal of the uterus, was once a common treatment for uterine prolapse, new surgical, minimally invasive alternatives may make a hysterectomy avoidable. Laparoscopic surgery and da Vinci® surgery, for example, are options that offer fewer risks, less pain, and faster recovery.
Women who have been diagnosed with uterine prolapse should always fully explore all available treatment options. If your doctor has suggested a hysterectomy, have him or her fully clarify the scope of the procedure and why and how it should be used in your case. Obtaining second opinions are also encouraged. As Hysterectomy.com is intended to be a comprehensive resource for women to learn more about the procedure and available alternatives, including new, minimally invasive options, you can find the information you need from a medical professional who specializes in performing such techniques. Complete a contact form to learn more about uterine prolapse, hysterectomy, and options available for your specific situation.