Information From Your Health Care Provider

UTERINE PROLAPSE

Basic information

Uterine prolapse means the uterus has fallen or dropped from its normal position in the pelvis. This causes it to bulge into or beyond the vagina. Other types of genital prolapse may also occur:
- Cystocele (part of bladder bulges into the vagina).
- Enterocele (small bowel bulges into the vagina).
- Rectocele (rectum bulges into the vagina).

A lump in front or back of the vagina, or a lump that extends outside of the vagina.
Vague discomfort or pressure in the pelvic region.
Backache that gets worse with lifting.
Frequent and painful urination.
Stress incontinence (urine leakage when laughing, sneezing, or coughing) may occur.
Problem in moving bowels.
Pain with sexual intercourse.

Prolapse occurs when muscles and ligaments of the pelvic floor become overstretched and weak.

Being overweight.
Having one or more vaginal births.
Obstetrical trauma and lacerations sustained during labor and delivery.
Normal aging and decreased estrogen.
Strain on the supportive muscles due to chronic coughing (from smoking or lung disorder) or chronic constipation.
Previous pelvic surgery.
Work or other activities requiring heavy lifting.
Tumors or large fibroids.

Mild prolapse usually responds to conservative treatment. A more severe prolapse can be helped with surgery.

Your health care provider can usually diagnose the prolapse with a pelvic exam. Medical tests may be done to check for other pelvic disorders or complications.
Treatment options depend on the severity of the prolapse. Other factors to consider are the patient's age, if pregnancy is still desired, and other pelvic disorders.
Patients with mild symptoms can usually be treated without surgery. This may include an exercise program (e.g., Kegel), hormone therapy, or use of a pessary (supportive device).
Avoid wearing tight girdles or clothing that increases intra-abdominal pressure.
Get treatment for any chronic coughing problem.
Quit smoking. Find a plan that will work for you.
Kegel exercises. Learn to recognize, control, and develop the pelvic muscles. These are the ones you use to interrupt urination in mid-stream.
A pessary is a small device inserted into the vagina to help maintain the uterus in a normal position. They come in different shapes, and are individually fitted.
Surgery may be needed for severe prolapse. Several methods are available and it can be performed to save the uterus if desired. Your options will be discussed.