Uterine Prolapse: Symptoms, Risk Factors, and Management Strategies

What is uterine prolapse?

When the muscles and ligaments of the pelvic floor, the crucial structures responsible for supporting the uterus, weaken or stretch beyond their capacity, it can lead to uterine prolapse. The condition primarily affects postmenopausal women who have had one or more vaginal births. Mild cases usually do not require treatment, but moderate to severe cases may benefit from appropriate interventions.

What are the stages of uterine prolapse?

Understanding each stage of uterine prolapse will help identify the uterine prolapse symptoms and select the appropriate treatment.

Here are the primary stages:

• First stage of uterine prolapse: The uterus dips into the upper half of the vagina.
• Second stage of uterine prolapse: The uterus extends until the vaginal opening.
• Third stage of uterine prolapse: The uterus protrudes out of the vagina.
• Fourth stage of uterine prolapse (procidentia): The entire uterus slips outside the vagina.

Who gets uterine prolapse?

Although it can occur at any age, uterine prolapse mainly affects post-menopausal women who have given birth vaginally. Factors that increase risk include older age at first birth, obesity, chronic constipation, repeated heavy lifting, and declining estrogen levels post-menopause.

What does a prolapsed uterus feel like?

Mild uterine prolapse usually does not show symptoms; however, moderate to severe cases can lead to complications. Recognizing uterine prolapse symptoms is crucial in seeking timely medical attention.

You might experience:

• A feeling of heaviness or pulling in the pelvis
• Feeling tissue bulge out of the vagina which is visible
• The bladder is not completely empty
• Difficulty with bowel movement, which should be eliminated by pressing on the vagina with the fingers
• Feels like sitting on a small ball or vaginal cloth rubbing against clothing
• Discomfort or pressure in the pelvis or lower back

What causes uterine prolapse?

The primary uterine prolapse cause is weakening of the pelvic muscles and supporting tissues. This can be due to factors such as vaginal birth, difficult delivery, the birth of a large baby or an ongoing illness such as a chronic cough or bronchitis.

What conditions are associated with uterine prolapse?

Uterine prolapse is often accompanied by other pelvic organ prolapses, such as:

• Anterior Prolapse (cystocele): This occurs when a weak connective tissue between the bladder and roof of the vagina causes the bladder to fall into the vaginal opening.
• Posterior Vaginal Prolapse (rectocele): This results from weakened tissue between the rectum and floor of the vagina, causing the rectum to bulge into the front of the vagina.

How is uterine prolapse diagnosed?

A uterine prolapse diagnosis typically includes a comprehensive medical history review as well as a physical examination. Your doctor may use an instrument called a speculum to view the vagina and cervix. You might also be asked to bear down as if during a bowel movement, simulating conditions that often cause a prolapse to protrude.

How do you treat uterine prolapse?

Whether you require a uterine prolapse treatment depends on the severity of your condition. Minor cases often require no treatment; however, moderate to severe prolapse may benefit from various approaches.

Treatment strategies include:

• Physical Therapy: Strengthening the pelvic floor muscles with Kegel exercises can reduce pain.
• Vaginal Pessary: A medical device is inserted into the vagina to support the uterus.
• Surgery: Options range from pelvic floor tissue repair to hysterectomy (removal of the uterus), depending on the patient's condition and reproductive plans.

It is essential to consult a doctor before opting for any form of uterine prolapse treatment.

What happens if a prolapsed uterus is left untreated?

If a prolapsed uterus is left untreated, it can lead to:

• Progressive Worsening: The prolapse can worsen over time, leading to increased discomfort and more severe symptoms.
• Impaired Mobility: Difficulty walking or standing for long periods due to pelvic pressure and discomfort
• Infection Risk: Increased susceptibility to vaginal infections and sores due to exposed and irritated tissues
• Impact on Daily Activities: Difficulty performing everyday activities and reduced quality of life
• Pelvic Organ Prolapse: Potential prolapse of other pelvic organs, such as the bladder (cystocele) or rectum (rectocele)

What are the complications of uterine prolapse?

Ignoring uterine prolapse  doesn't make it disappear and may lead to complications, including:   

• Urinary Issues: Difficulty urinating, urinary incontinence, frequent urination, and urinary tract infections (UTIs)
• Bowel Problems: Constipation or difficulty with bowel movements
• Sexual Dysfunction: Painful intercourse or a decrease in sexual satisfaction
• Vaginal Ulceration: Ulceration of the vaginal tissue due to persistent irritation and exposure
• Pelvic Pressure: A sensation of heaviness or pulling in the pelvis, leading to chronic discomfort
• Psychological Impact: Emotional distress, anxiety, or depression due to the physical and social limitations imposed by the condition

How to prevent uterine prolapse?

Preventing uterine prolapse involves adopting certain lifestyle modifications.

Here are a few suggestions:

• Prevent constipation: A high-fibre diet rich in fruits, vegetables, beans, and whole grains helps maintain regular bowel movements.
• Avoid heavy lifting: Always use correct lifting techniques that engage your legs instead of your waist or back.
• Control coughing: Seek treatment for chronic cough or bronchitis and steer clear of smoking.
• Maintain a healthy weight: Consult with your doctor about ideal weight guidelines and weight loss strategies, if necessary.

What’s the outlook for uterine prolapse?

With an understanding of uterine prolapse causes and proactive management strategies, living with uterine prolapse is possible. Remember, early detection and appropriate treatment go a long way in managing this condition effectively while minimising any potential discomfort.

Conclusion

Knowledge is power when it comes to managing your health. Understanding uterine prolapse symptoms, risk factors, and treatment methods can help you make informed decisions about your healthcare. If you suspect you may be dealing with this condition, do not hesitate to reach out to a medical professional. At Metropolis Labs, we are committed to delivering reliable pathology services and personalised care that empower you to prioritise your health. Our expert team of technicians is equipped to perform at-home blood sample collections that are processed at our advanced diagnostic labs, and the reports are shared conveniently online for easy access.