What is
Uterine Prolapse?
Uterine prolapse is the descent of the uterus from its normal position into or outside the vaginal canal due to weakness of the pelvic floor muscles and ligaments.
Symptoms
Sensation of something coming down or vaginal bulge
Pelvic pressure or heaviness
Backache or dragging pain in lower abdomen
Difficulty in walking or sitting
Urinary symptoms – frequency, urgency, incontinence, retention
Bowel symptoms – constipation, incomplete evacuation
Dyspareunia (painful intercourse)
Vaginal discharge or ulceration of prolapsed part
Problems that may occur if the Uterine Prolapse is left untreated
- Multiparity (multiple vaginal deliveries)
- Prolonged labor / traumatic childbirth
- Aging and menopause (estrogen deficiency)
- Weak pelvic floor muscles
- Chronic increase in intra-abdominal pressure (cough, constipation, obesity)
- Congenital weakness of pelvic support
- Pelvic surgery
- Connective tissue disorders
Uterine Prolapse Treatment
Conservative Management:
- Indicated in mild prolapse or medically unfit patients.
- Pelvic floor (Kegel) exercises
- Vaginal pessary (ring pessary)
- Treat contributing factors (cough, constipation, obesity)
- Topical estrogen in postmenopausal women
Surgical Management:
- Vaginal Hysterectomy with pelvic floor repair (common in completed family).
- Uterine suspension procedures (sacrospinous fixation, sacrohysteropexy) — uterus preserving.
- Colpocleisis (vaginal closure in elderly non–sexually active women).
- Repair of associated cystocele or rectocele if present.
Important information for patients
- Early stages can be managed conservatively.
- Definitive treatment in advanced cases is surgical correction of the support defects.
- Pelvic floor rehabilitation plays a major role in prevention
