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Prolapsed uterus, or uterine prolapse, is when the uterus descends from its normal position down into the vaginal canal. Muscles and ligaments called the pelvic floor hold the uterus in place. When these connections become weakened, the uterus can fall.
If a woman is suffering from a prolapsed uterus, she might experience a sensation similar to sitting on a small object or a sensation of pulling in the pelvic region. Other symptoms include painful sexual intercourse, backache and vaginal discharge. A woman might also experience frequent urination or bladder infection. With mild uterine prolapse, a woman might not experience any symptoms. In severe cases, the uterus could actually protrude from the vagina.
A prolapsed uterus can be caused by vaginal childbirth, particularly numerous births. Other risk factors include repeated heavy lifting, obesity, chronic cough or other conditions that can weaken the pelvic floor. The pelvic muscles and ligaments can weaken more as a woman gets older, especially after menopause when a woman’s body produces less estrogen. Uterine fibroids or tumors also can increase the risk of a prolapsed uterus. Women with Northern European ancestry have the greatest risk.
Uterine prolapse is diagnosed by pelvic examination. The physician will take a medical history and physically check for symptoms of a prolapsed uterus. In some cases, the doctor might recommend further tests, such as an ultrasound or magnetic resonance imaging (MRI) test.
For women with a mildly prolapsed uterus, treatment could be unnecessary. Treating contributing problems, such as chronic coughing or obesity, can help slow the progression. Kegel exercises to strengthen the pelvic floor also can help ameliorate symptoms.
One treatment option for more severe cases is use of a vaginal pessary. A vaginal pessary is a device that goes inside the vagina to help keep the uterus immobile. The device can be used as a temporary treatment, or it could be permanent. A vaginal pessary must be fitted by a physician. Some women experience irritation when using a pessary, and it is also necessary to frequently remove and clean the device.
For other women, surgery might be necessary to repair a prolapsed uterus. Surgery could involve a hysterectomy, a procedure during which the uterus is removed, or it could involve a tissue graft to strengthen the pelvic floor. If a woman plans to have additional children, surgery might not be the best choice of treatment, because the strain of pregnancy and childbirth can essentially negate the effects of surgery.
Women can take steps to try to prevent a prolapsed uterus, though it still could occur. A woman can decrease her risk by maintaining a healthy weight and treating chronic conditions that can contribute to uterine prolapse. Women also can use Kegel exercises to strengthen the muscles of the pelvic floor.