What is Utero-vaginal prolapse?
Prolapse is a medical condition where an organ descends or drops from its normal anatomic position. Pelvic organ prolapse can include structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself fall out from their normal position.
Utero-vaginal prolapse is a downward movement of the uterus and/or vagina. The main cause of the prolapse is the weakness in the supporting tissues of the uterus and vagina. The common factors such as the frequent lifting of heavy objects, chronic cough, severe constipation, menopause, childbirth, and pregnancy may increase your risk of developing uterovaginal prolapse. There can also be a strong genetic component to this condition.
Symptoms of Utero-Vaginal Prolapse
A woman with mild prolapse may not experience any symptoms. However, women with more advanced forms of prolapse may experience:
- A sensation of pulling in the lower abdomen or pelvis
- An uncomfortable feeling of fullness/pressure or bulge in the vagina
- Low back pain
- Urinary problems, such as urine frequency, leakage or urine retention
- Difficulty in urinating and emptying the bowels
- Sexual difficulties
Diagnosis of Utero-Vaginal Prolapse
Your doctor will diagnose the condition by taking a detailed history and performing a physical examination. During the examination, you may be asked to cough or bear down. The doctor may also perform computerized testing of the bladder to test for urinary leakage (Urodynamics).
Treatment for Utero-Vaginal Prolapse
If the symptoms are mild, non-surgical treatment options such as medications, pelvic floor exercises, vaginal pessary (a device that is inserted into the vagina to support the pelvic floor), estrogen-containing vaginal cream, and lifestyle changes may be helpful.
Surgery can be considered in patients with troublesome symptoms of uterovaginal prolapse. There are different types of procedures to address the prolapse, such as a hysterectomy (removal of the uterus), hitching up the bladder or vagina, or repair and 'tightening' of the vagina. The surgery may be done through an incision in either the abdomen or the vagina, depending upon the condition. The aim of the surgery is to restore the normal anatomy and function of the pelvic organs.
Risk and Complications of Utero-Vaginal Prolapse
If left untreated, severe cases of uterovaginal prolapse can cause ulceration and infection of the cervix and vaginal walls, urinary tract infections, abnormal bleeding, thickening of the skin of the cervix, urinary obstruction, and worsening of the prolapse including complete eversion of the pelvic organs..
Prevention of Utero-vaginal Prolapse
Although uterovaginal prolapse is not always preventable, there are certain measures that can be taken to help reduce the risk of developing uterovaginal prolapse or prevent it from getting worse. These include:
- Perform Kegel exercises to strengthen your pelvic floor muscles especially during pregnancy and after childbirth
- Take hormone replacement therapy after menopause
- Avoid constipation and strong straining with bowel movements
Avoid heavy lifting, prolonged standing, and chronic cough