Uterine prolapse

URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/001508.htm

Uterine prolapse is falling or sliding of the uterus from its normal position in the pelvic cavity
into the vaginal canal.

Causes
The uterus is held in position in the pelvis by muscles, special ligaments, and other tissue,. The
uterus drops into the vaginal canal (prolapses) when these muscles and connective tissues
weaken.

Uterine prolapse usually happens in women who have had one or more vaginal births. Normal
aging and lack of estrogen hormone after menopause may also cause uterine prolapse, Chronic
cough and obesity increase the pressure on the pelvic floor and may contribute to the prolapse..
Uterine prolapse can also be caused by a pelvic tumor, although this is rare.

Chronic constipation and the pushing associated with it can worsen uterine prolapse.

Symptoms
• A feeling as if sitting on a small ball
• Difficult or painful sexual intercourse
• Frequent urination or a sudden, urgent need to empty the bladder
• Low backache
• Pain during intercouse
• Protruding of the uterus and cervix through the vaginal opening
• Repeated bladder infections
• Sensation of heaviness or pulling in the pelvis
• Vaginal bleeding or increased vaginal discharge

Many of the symptoms are worse when standing or sitting for long periods of time.

Exams and Tests

A pelvic examination performed while the woman is bearing down (as if trying to push out a
baby) will show how far the uterus comes down.

• Uterine prolapse is mild when the cervix drops into the lower part of the vagina.
• Uterine prolapse is moderate when the cervix drops out of the vaginal opening.

The pelvic exam may reveal that the bladder, front wall of the vagina (cystocele), or rectum and
back wall of the vagina (rectocele) are entering the vaginal area. The urethra and bladder may
also be positioned lower in the pelvis than usual.

A mass may be noted on pelvic exam if a tumor is causing the prolapse (this is rare).

Treatment
Treatment is not necessary unless the symptoms are bothersome. Most women seek treatment by
the time the uterus drops to the opening of the vagina.

Uterine prolapse can be treated with a vaginal pessary or surgery.

VAGINAL PESSARY

A vaginal pessary is a rubber or plastic donut-shaped device that is inserted into the vagina to
hold the uterus in place. It may be a temporary or permanent form of treatment. Vaginal
pessaries are fitted for each individual woman. Some pessaries are similar to a diaphragm device
used for birth control. Many women can be taught how to insert, clean, and remove the pessary
herself.

Pessaries may cause an irritating and abnormal smelling discharge, and they require periodic
cleaning, sometimes done by the doctor or nurse. In some women, the pessary may rub on and
irritate the vaginal wall ( mucosa), and in some cases may damage the vagina. Some pessaries
may interfere with normal sexual intercourse by limiting the depth of penetration.

LIFESTYLE CHANGES

Weight loss is recommended in women with uterine prolapse who are obese.

Heavy lifting or straining should be avoided, because they can worsen symptoms.

Coughing can also make symptoms worse. Measures to treat and prevent chronic cough should
be tried. If the cough is due to smoking, smoking cessation techniques are recommended.

SURGERY

Surgery should not be done until the prolapse symptoms are worse than the risks of having
surgery. The specific type of surgery depends on:
 • Degree of prolapse
• Desire for future pregnancies
• Other medical conditions
• The women's desire to retain vaginal function
• The woman's age and general health

There are some surgical procedures that can be done without removing the uterus, such as a
sacrospinous fixation . This procedure involves using nearby ligaments to support the uterus.
Other procedures are available.

Often, a vaginal hysterectomy is used to correct uterine prolapse. Any sagging of the vaginal
walls, urethra, bladder, or rectum can be surgically corrected at the same time.

Outlook (Prognosis)
Most women with mild uterine prolapse do not have bothersome symptoms and don't need
treatment.

Vaginal pessaries can be effective for many women with uterine prolapse.

Surgery usually provides excellent results, however, some women may require treatment again in
the future.

Possible Complications
Ulceration and infection of the cervix and vaginal walls may occur in severe cases of uterine
prolapse.

Urinary tract infections and other urinary symptoms may occur because of a cystocele.
Constipation and hemorrhoids may occur because of a rectocele.

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have symptoms of uterine prolapse.

Prevention
Tightening the pelvic floor muscles using Kegel exercises helps to strengthen the muscles and
reduces the risk of uterine prolapse.

Estrogen therapy, either vaginal or oral, in postmenopausal women may help maintain
connective tissue and muscle tone.

Alternative Names
Pelvic relaxation - uterine prolapse; Pelvic floor hernia; Prolapsed uterus

References
Lentz GM. Anatomic defects of the abdominal wall and pelvic floor: abdominal and inguinal
hernias, cystocele, urethrocele, enterocele, rectocele, uterine and vaginal prolapse, and rectal
incontinence: diagnosis and management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM,
eds. Comprehensive Gynecology. 5th ed. Philadelphia, PA: Mosby Elsevier;2007:chap 20.

Update Date: 5/12/2008

Updated by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician
Assistant Studies, University of Washington, School of Medicine; Susan Storck, MD, FACOG,
Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget
Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and
Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve,
MD, MHA, Medical Director, A.D.A.M., Inc.

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Uterine prolapse - All Information

• Overview
• Symptom
• Treatment
• Prevention
• All Information

Alternative Names
Pelvic relaxation - uterine prolapse; Pelvic floor hernia; Prolapsed uterus

Definition of Uterine prolapse:

Uterine prolapse is falling or sliding of the uterus from its normal position in the
pelvic cavity into the vaginal canal.

Causes, incidence, and risk factors:

The uterus is held in position in the pelvis by muscles, special ligaments, and
other tissue,. The uterus drops into the vaginal canal (prolapses) when these
muscles and connective tissues weaken.

Uterine prolapse usually happens in women who have had one or more vaginal
births. Normal aging and lack of estrogen hormone after menopause may also
cause uterine prolapse, Chronic cough and obesity increase the pressure on the
pelvic floor and may contribute to the prolapse.. Uterine prolapse can also be
caused by a pelvic tumor, although this is rare.

Chronic constipation and the pushing associated with it can worsen uterine
prolapse.
Symptoms:

• A feeling as if sitting on a small ball

• Difficult or painful sexual intercourse
• Frequent urination or a sudden, urgent need to empty the bladder
• Low backache
• Pain during intercouse
• Protruding of the uterus and cervix through the vaginal opening
• Repeated bladder infections
• Sensation of heaviness or pulling in the pelvis
• Vaginal bleeding or increased vaginal discharge

Many of the symptoms are worse when standing or sitting for long periods of
time.

Signs and tests:

A pelvic examination performed while the woman is bearing down (as if trying
to push out a baby) will show how far the uterus comes down.

• Uterine prolapse is mild when the cervix drops into the lower part of the
vagina.
• Uterine prolapse is moderate when the cervix drops out of the vaginal
opening.

The pelvic exam may reveal that the bladder, front wall of the vagina
(cystocele), or rectum and back wall of the vagina (rectocele) are entering the
vaginal area. The urethra and bladder may also be positioned lower in the pelvis
than usual.

A mass may be noted on pelvic exam if a tumor is causing the prolapse (this is
rare).

Treatment:
Treatment is not necessary unless the symptoms are bothersome. Most women
seek treatment by the time the uterus drops to the opening of the vagina.

Uterine prolapse can be treated with a vaginal pessary or surgery.

VAGINAL PESSARY

A vaginal pessary is a rubber or plastic donut-shaped device that is inserted into

the vagina to hold the uterus in place. It may be a temporary or permanent
form of treatment. Vaginal pessaries are fitted for each individual woman. Some
pessaries are similar to a diaphragm device used for birth control. Many women
can be taught how to insert, clean, and remove the pessary herself.

Pessaries may cause an irritating and abnormal smelling discharge, and they
require periodic cleaning, sometimes done by the doctor or nurse. In some
women, the pessary may rub on and irritate the vaginal wall ( mucosa), and in
some cases may damage the vagina. Some pessaries may interfere with normal
sexual intercourse by limiting the depth of penetration.

LIFESTYLE CHANGES

Weight loss is recommended in women with uterine prolapse who are obese.

Heavy lifting or straining should be avoided, because they can worsen

symptoms.

Coughing can also make symptoms worse. Measures to treat and prevent
chronic cough should be tried. If the cough is due to smoking, smoking
cessation techniques are recommended.

SURGERY

Surgery should not be done until the prolapse symptoms are worse than the
risks of having surgery. The specific type of surgery depends on:

• Degree of prolapse
• Desire for future pregnancies
• Other medical conditions
• The women's desire to retain vaginal function
• The woman's age and general health

There are some surgical procedures that can be done without removing the
uterus, such as a sacrospinous fixation . This procedure involves using nearby
ligaments to support the uterus. Other procedures are available.

Often, a vaginal hysterectomy is used to correct uterine prolapse. Any sagging

of the vaginal walls, urethra, bladder, or rectum can be surgically corrected at
the same time.
Expectations (prognosis):
Most women with mild uterine prolapse do not have bothersome symptoms and
don't need treatment.

Vaginal pessaries can be effective for many women with uterine prolapse.

Surgery usually provides excellent results, however, some women may require
treatment again in the future.

Complications:
Ulceration and infection of the cervix and vaginal walls may occur in severe
cases of uterine prolapse.

Urinary tract infections and other urinary symptoms may occur because of a
cystocele. Constipation and hemorrhoids may occur because of a rectocele.

Calling your health care provider:

Call for an appointment with your health care provider if you have symptoms of
uterine prolapse.

Prevention:
Tightening the pelvic floor muscles using Kegel exercises helps to strengthen
the muscles and reduces the risk of uterine prolapse.

Estrogen therapy, either vaginal or oral, in postmenopausal women may help

maintain connective tissue and muscle tone.

Female reproductive anatomy

Uterus

• Reviewed last on: 5/12/2008

• Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of
Physician Assistant Studies, University of Washington, School of Medicine;
Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and
Gynecology, Group Health Cooperative of Puget Sound, Redmond,
Washington; Clinical Teaching Faculty, Department of Obstetrics and
Gynecology, University of Washington School of Medicine. Also reviewed by
David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
References
Lentz GM. Anatomic defects of the abdominal wall and pelvic floor: abdominal and
inguinal hernias, cystocele, urethrocele, enterocele, rectocele, uterine and vaginal
prolapse, and rectal incontinence: diagnosis and management. In: Katz VL, Lentz
GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed.
Philadelphia, PA: Mosby Elsevier;2007:chap 20.

Uterine Prolapse
What is uterine prolapse?
Uterine Prolapse Care Guide

• Uterine Prolapse
• Uterine Prolapse Aftercare Instructions
• Uterine Prolapse Discharge Care
• Uterine Prolapse Inpatient Care
• En Espanol

• Uterine prolapse is when your uterus falls down into your vagina. A woman's
uterus (womb) is the organ where a fetus (unborn baby) grows during
pregnancy. The uterus is found inside the pelvis, which is the area from your
belly button to your groin. Your uterus is held in place by strong tissues and
muscles. With uterine prolapse, these tissues and muscles cannot hold up
your uterus properly. Your uterus may press on other organs inside your
pelvis, such as your bladder (organ that holds urine), bowel, and vagina.

• You may have a small uterine prolapse that causes no symptoms. Uterine
prolapses that do not cause any discomfort may not need treatment. With a
more severe (very bad) prolapse, your uterus and other tissues may bulge
out of your vagina. You may feel pain, and you may leak urine. Treating your
uterine prolapse may help to place your uterus back in its normal place.
Treatment may relieve your symptoms such as feeling pain and pressure,
and stop any urine leakage.

What causes uterine prolapse?

When the tissues and muscles holding your uterus in place are damaged or weak, your uterus
may prolapse. The following may increase your risk for damaged or weakened tissues and
muscles:

• Age: The tissues and muscles holding your uterus in place may weaken as
you age. Menopause also occurs as a women ages causing the vagina to
shrink and become weaker. Menopause is when you no longer have your
monthly period.

• Childbirth: Having a baby stretches and tears the tissues and muscles
holding up your uterus. Your risk of uterine prolapse increases every time you
give birth vaginally. When forceps are needed to help you give birth, they
may damage your muscles and cause muscle weakness. Having a long labor
or a large baby may also increase your risk for uterine prolapse. Your risk
may also be increased if you are younger than 25 years old the first time you
have a baby.

• Constipation: Your stools may often be hard, dry, and difficult to pass.
When you have to push hard to have BM's, the tissues and muscles holding
up your uterus may weaken.

• Connective tissue disease: Diseases such as Ehlers-Danlos syndrome

make the connective tissues of your body weak. This includes the tissues that
hold up your uterus.

• Family history: If your mother or sister has had uterine prolapse, you may
have a higher risk for prolapse also.

• Obesity: Weighing more than what your caregiver suggests may increase
your risk for uterine prolapse. The extra weight may push on the tissues and
muscles holding up your uterus causing them to weaken.

• Surgery: Having had surgery in the area of your pelvis may increase your
risk for uterine prolapse.

What are the signs and symptoms of uterine prolapse?

• Feeling pressure or heaviness in your vagina or pelvis.

• Seeing or feeling something falling or sticking out of your vagina.

• Pain in your lower back, pelvis, or vagina.

• Feeling pain when having sex.

What other problems may I have with uterine prolapse?

 • Other organs in your pelvis may also prolapse. You may have a cystocele
(bladder prolapse), rectocele (bowel prolapse), or both. Ask your caregiver for
more information about these conditions.

• The muscles that hold up your uterus are also used when urinating and
having a BM. If these muscles are weak, you may have problems such as:

o Leaking urine or BM.

o Having to urinate more often than usual.

o Taking longer to urinate than usual.

o Feeling like there is something blocking your BM.

o Feeling like you still have to urinate after you think you are done.

o Needing to change position to start or continue urinating.

o Needing to push into your vagina to start or continue urinating or

having a BM.

How is uterine prolapse diagnosed?

Your caregiver may ask about any health problems you have, or have had. He may ask if any of
your family members have had uterine prolapse. Your caregiver may also ask about any past
surgeries you have had. He may ask about your signs and symptoms, and how many pregnancies
and vaginal births you have had. If you have had a baby in the past, tell your caregiver if you had
any problems while giving birth. You may need the following to diagnose your uterine prolapse:

• Pelvic exam:

o Your caregiver will ask you to lie down with your legs apart and your
feet placed in stirrups. He will look closely at your groin and vagina.
Your caregiver will insert his fingers into your vagina. He will feel for
your prolapse while you are relaxed. He may also ask you to cough
while his fingers are inside your vagina. Your caregiver may insert a
speculum (plastic or metal instrument) into your vagina. The speculum
helps your caregiver see how far your uterus has prolapsed. You may
be asked to push against the speculum when it is inside your vagina.

o Your caregiver may also check your prolapse while you are standing
up. This exam may help your caregiver learn how far your uterus has
fallen down into your vagina. The exam may also help your caregiver
feel how weak your muscles are.
 • Post-void residual: You may need this test if you have problems such as
leaking urine. For this test, you will be asked to urinate after you feel your
bladder is full. Once you have urinated, your caregiver will check for any
urine left in your bladder. He may use a small soft tube placed inside your
bladder to drain the urine. Your caregiver may also use an ultrasound to
check for urine in your bladder. An ultrasound is a test that uses sound waves
to show pictures of your bladder on a TV-like screen.

How is uterine prolapse treated?

The goal of treatment is to correct your uterine prolapse and relieve your signs and symptoms.
Your caregiver will work with you to decide which treatment is best for you. Treatment may
include any of the following:

• Pelvic floor muscle exercises: These exercises are done to strengthen the
muscles that hold your uterus in place. The exercises also tighten the
muscles used for urinating and having a BM. Ask your caregiver about how to
do these exercises.

• Vaginal devices: These devices hold your uterus in place and support your
muscles.

o Pessary: This is a silicone or plastic device that your caregiver will fit
inside your vagina. The pessary pushes your uterus back up into its
normal place. The pessary may also decrease any pressure on the
other organs in your pelvis. It is important to have regular follow-up
visits with your caregiver to check your pessary. Ask your caregiver for
more information about how to care for your pessary.

o Sphere: This is a ball with a string attached to it. The ball is inserted
into your vagina and works by holding up your prolapsed uterus. You
will be better able to do your pelvic floor muscle exercises with the
sphere in place. Ask your caregiver for more information about how to
use the sphere.

• Hormone cream: Your caregiver may give you hormone cream to put inside
your vagina. If you lack certain hormones (chemicals that control how your
body works) the tissue lining your vagina may become thin. Lacking
hormones may make your vaginal tissue weaker. Replacing your hormones
with cream may help stop your vagina from thinning.

• Surgery: You may need surgery to fix your uterine prolapse if it is severe.
You may not be able to have sex or get pregnant after having certain
surgeries to fix your prolapse. You and your caregiver will decide together
which type of surgery is best for you. Ask your caregiver for more information
about the following:
 o Hysterectomy: During this surgery your uterus will be removed from
your body.

o Obliterative surgery: During this surgery, all or a part of your vagina

will be closed to hold your uterus in place. With obliterative surgery,
you will no longer be able to have vaginal sex.

o Surgery to fix weakened tissue: During this surgery the muscles

and tissues that hold your uterus in place will be tightened. Your
caregiver may use a mesh (net-like) to push back your prolapse and
hold up your uterus. Your caregiver may also use a tissue graft to hold
your uterus in place. A tissue graft may be man-made, or may be
tissue from another part of your body. The tissue graft may also be
from a donor (another person).

Where can I get more information?

Many women with uterine prolapse are embarrassed about their problem. These feelings are
normal. Talk with your caregiver about your feelings and any concerns you may have. You may
also contact the following for more information about uterine prolapse:

• The National Women's Health Information Center

8270 Willow Oaks Corporate Drive
Fairfax , VA 22031
Phone: 1- 800 - 994-9662
Web Address: http://www.womenshealth.gov

When should I call my caregiver?

• The pain or fullness in your pelvis gets worse.

• The bulge from your vagina gets bigger than when you first saw it.

Care Agreement

You have the right to help plan your care. To help with this plan, you must learn about your
health condition and how it may be treated. You can then discuss treatment options with your
caregivers. Work with them to decide what care may be used to treat you. You always have the
right to refuse treatment.

Copyright © 2011. Thomson Reuters. All rights reserved. Information is for End User's use only
and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for
individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following
any medical regimen to see if it is safe and effective for you.
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• Uterine
Prolapse
WHAT YOU SHOULD
KNOW:
Uterine Prolapse (Aftercare
Instructions) Care Guide

• Uterine Prolapse
• Uterine Prolapse Aftercare
Instructions
• Uterine Prolapse Discharge Care
• Uterine Prolapse Inpatient Care
• En Espanol

• Uterine prolapse is when your

uterus falls down into your vagina.
 A woman's uterus (womb) is the
organ where a fetus (unborn
baby) grows during pregnancy.
The uterus is found inside the
pelvis, which is the area from your
belly button to your groin. Your
uterus is held in place by strong
tissues and muscles. With uterine
prolapse, these tissues and
muscles cannot hold up your
uterus properly. Your uterus may
press on other organs inside your
pelvis, such as your bladder
(organ that holds urine), bowel,
and vagina. You may feel no signs
or symptoms, or you may have
pain or fullness in your vagina.
With a more severe (very bad)
prolapse, your uterus and other
tissues may bulge out of your
vagina.
•

• Search: Search Button

• Your caregiver will do a pelvic exam to diagnose your uterine prolapse. You
may also need other tests such as an ultrasound if you are having trouble
emptying your bladder. With uterine prolapse you may also leak urine.
Treatment includes exercises, intravaginal devices, or surgery. Treating your
uterine prolapse may help to place your uterus back in its normal place.
Treatment may relieve your symptoms such as feeling pain and pressure,
and stop any urine leakage.

INSTRUCTIONS:
Follow-up visit:
• Ask your caregiver when to return for a follow-up visit. Keep all appointments.
Write down any questions you may have. This way you will remember to ask
these questions during your next visit.

• Tell your caregiver about any new signs and symptoms you may have. Tell
your caregiver if your old signs and symptoms are getting worse or better
with treatment. If you have a pessary, your caregiver may do an exam to see
if it still fits well. He may also check if you have problems related to your
pessary, like bleeding or infection. Ask your caregiver for more information
about how to care for your pessary.
Pelvic floor muscle exercises:
These exercises strengthen the muscles that hold your uterus in place. The exercises also tighten
the muscles used when you urinate or have a BM. It is important that you do these exercises
often and correctly. Ask your caregiver for more information about how to do these exercises.

Hormone cream:
Your caregiver may give you hormone cream to put inside your vagina. If you lack certain
hormones (chemicals that control how your body works) the tissue lining your vagina may
become thin. Lacking hormones may make your vagina weaker. Replacing your hormones with
cream may help stop your vagina from thinning.

Constipation:
If you are constipated, you may have a hard time having a bowel movement (BM) Do not try to
push the BM out if it is too hard. Walking is the best way to get your bowels moving. Eat foods
high in fiber to make it easier to have a BM. Good examples are high fiber cereals, beans,
vegetables, and whole grain breads. Prune juice may help make the BM softer. Caregivers may
give you fiber medicine or a stool softener to help make your BMs softer and more regular. You
can also buy these medicines at a grocery or drug store.

Chronic cough:
A chronic cough is a cough that lasts longer than 3 to 4 weeks. Coughing for a long period of
time may weaken the muscles holding up your uterus. Coughing may make your prolapse worse.
Ask your caregiver for more information about treatment for a chronic cough.

Drinking liquids:
Women 19 years old and older should drink about two Liters of liquid each day (close to 9 eight-
ounce cups). Good choices for most people to drink include water, juice, and milk. Ask your
caregiver how much liquid you should have each day.

Having sex:
You may need to avoid having sex for up to six weeks after surgery. Ask your caregiver when it
will be safe to have sex again.

Quit smoking:
It is never too late to quit smoking. Smoking may weaken the tissues that hold up your uterus
and increase your risk for having another prolapse. Smoking also harms your heart, lungs, and
blood. You are more likely to have a heart attack, lung disease, and cancer if you smoke. You
will help yourself and those around you by not smoking. Ask your caregiver for more
information about how to stop smoking if you are having trouble quitting.

Physical activity:
Heavy exercising or lifting may injure the muscles holding your uterus in place and make your
symptoms worse. You may have to learn safer ways to do activities such as lifting. Doing your
activities in a safer way may put less stress on your muscles. Ask your caregiver about safe ways
to exercise and lift objects.

Weight loss:
Weighing more than what your caregiver suggests may push on the tissues and muscles holding
up your uterus. The extra weight may cause a mild prolapse to become more severe. Losing
weight may help prevent your prolapse from getting worse. If you had surgery to fix your
prolapse, losing weight may prevent your uterus from prolapsing again. Talk to your caregiver
about a weight loss plan if you need to lose weight.

Wound care:
You may have a wound if you needed surgery to fix your uterine prolapse. Ask your caregiver
for instructions on how to care for your wound.

CONTACT A CAREGIVER IF:

• You are leaking urine or BM.

• You cannot urinate or are unable to have a BM.

• You have a fever (high body temperature).

• You have foul-smelling fluid coming from your vagina.

• You see blood coming from your vagina that is not from your normal monthly
period.

SEEK CARE IMMEDIATELY IF:

• You have bleeding from your vagina that does not stop.

• You have swelling in, or bruising on your pelvis after surgery that does not
get better.
Copyright © 2011. Thomson Reuters. All rights reserved. Information is for End User's use only
and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for
individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following
any medical regimen to see if it is safe and effective for you.

A Complete Overview of Uterine

Prolapse

By Kristi Patrice Carter

A uterine prolapse occurs when the muscles and ligaments

holding the uterus, or womb, in place have weakened
causing it to fall or droop down into the vaginal canal. The
word prolapse is used to indicate a descent or change in
the normal positioning of the uterus.
Causes

Causes and risk factors for developing uterine prolapse include:

- Age: Women of advanced age who have given birth several times may be at risk for a
prolapsed uterus due to weakened muscles and a loss of muscle tone.

- Being overweight: Being overweight or obese causes additional strain and pressure on the
pelvic muscles, weakening them over time, possibly leading to a prolapsed uterus.

- Menopause: A natural loss of hormones, such as estrogen, after entering into menopause
may cause a loss of muscle tone and a weakening of the uterine walls.

- Physical exertion: Women who lift weights excessively may be prone to uterine prolapse
due to the added strain and pressure on the abdominal muscles.
- Pregnancy: Giving birth vaginally multiple times, or having a difficult or unusually long
labor may lead to uterine prolapse, which is caused by added strain on the muscles that
hold the uterus in place.

- Race: For reasons that are still largely unknown, Caucasian women are affected more
often by uterine prolapse than women of other races.

- Surgery: Radical surgery performed in the pelvic area may lead to a loss of muscle tone
and cause the uterus to prolapse.

Symptoms

Classic symptoms that may indicate a prolapsed uterus include:

- Difficulty walking or standing

- Difficulty urinating or trouble having a bowel movement

- Lower back pain

- Painful sexual intercourse

- Pressure in the pelvic area

- The sensation that something is falling out of the vagina

Diagnosis

A complete medical history is necessary to ascertain whether or not uterine prolapse is a

possibility, or if the symptoms experienced are being caused by another condition. A
physical examination will be performed to determine if the uterus has in fact prolapsed. The
doctor will examine you in several positions, including standing, lying down, and ask you to
cough or strain to increase abdominal pressure.

Treatment options

Treatment options for uterine prolapse depend on the severity of the condition, how
weakened the supporting structures around the uterus have become, and the patient’s
overall health. In mild to moderate cases, exercises that strengthen the pelvic muscles may
be helpful in thwarting the prolapse. These exercises that isolate and tighten the pelvic floor
muscles are called Kegel exercises, named after Dr. Arnold Kegel who popularized the
practice.

A pessary is a small plastic ring that is inserted into the vagina for support. This method of
treatment is useful for patients who are not good candidates for surgery or who simply do
not want to have a surgical procedure. Before the insertion of the pessary, the uterus and
cervix are positioned into their normal place within the pelvis. Pessaries should not be used
in women with acute pelvic infections or other similar complications as the device may
cause additional discomfort, vaginal discharge or ulcerations, and bleeding.
Surgery is another treatment option for uterine prolapse, depending upon whether or not
future pregnancies are a factor, and also the severity of the condition. The uterus can be
repaired or completely removed in a procedure known as a hysterectomy. The vaginal walls,
urethra, and bladder may also be repaired during surgery, which can either be performed
abdominally, vaginally, or via a laparoscopic procedure.

How to Choose the Right Doctor to

Treat Uterine Prolapse

By Kristi Patrice Carter

Uterine Prolapse is a condition in which the pelvic floor muscles that support the uterus are
weak and unable to support it. This can cause your uterus to dip down and sag into the
opening of your vagina. Most women who have given birth to a baby vaginally will have
some type of prolapse, however, for very mild cases, there is usually no treatment given. It
is only if the prolapse becomes severe, irritating, or problematic.

Choosing the right doctor is a matter of asking questions, and expecting answers. You need
to be able to speak face to face with doctors and ask them about the procedures, recovery,
cost and benefits. If a doctor is 'too busy' to be able to schedule a time to speak with you,
I'd recommend moving on over to the next doctor on your list. Good doctors understand
that they must have a good communicating relationship with their patients, and won't
hesitate to answer questions and explain things to us.

Below are some tips and ideas that can help you choose the right doctor for treating your
Uterine Prolapse.

You can choose to speak with an urogynecologist or a gynecologist about treating you. An
urogynecologist is a doctor who has completed full gynecological training, and has further
studied and trained about the treatment of incontinence and prolapse.

Your doctor should perform a test to see exactly how severe your prolapse is. If your
prolapse is not severe, your doctor may suggest the use of a pessary. This is a device which
is inserted into the vagina, and used to hold the uterus in place. This can be temporary, and
your doctor will fit one to your own body shape. There are many drawbacks to using a
pessary, however, such as irritation of the vaginal tissues. Some women have even
developed ulcers or discharge when using one. They may also interfere with sexual
intercourse.

Surgery is an option for severe prolapse, and there are a couple of different types. Ask your
doctor is he will perform the surgery vaginally. Most doctors prefer to do so, since there is
less pain and no scars. Surgeries can be done to repair the pelvic floor muscles, however it
is likely that prolapse will reoccur. Your doctor may suggest a hysterectomy as well.
Don't be afraid to ask your doctor as many questions as you need to ask to be
comfortable. There is absolutely no reason why he or she shouldn't be able to answer
them. You are definitely not the only person to have this problem, so there is no reason to
feel embarrassed. A good doctor will tell you that, as well as explain exactly what your
options are. He or she should work with you to come up with a treatment plan that is right
for you. There are many different women and different situations, so your doctor should
understand that your treatment shouldn't necessarily be the same as another
woman's. Asking questions and stating concerns is the best way to choose the right doctor,
and a doctor you feel comfortable with is a must.

How to Properly do Kegel

Exercises During Pregnancy

By Kristi Patrice Carter

Kegel exercises are the best way to avoid post partum complications. Doing them daily will
ensure that your pelvic floor muscles are strong and in good shape. This is necessary for
good post partum health. Let's take a look at what they are and why you should do them.

Kegel exercise is the practice of strengthening your pelvic floor muscles. There are different
exercises, but they all are achieved the same way. Tightening up your pubococcygeus
muscles and then releasing them. These are the same muscles you use when you stop your
urine flow. Pretty easy, right? Well, the benefits are astounding. Imagine not being able to
laugh without urinating on yourself. This actually happens to some women after childbirth,
and that's one of the less problematic conditions you can develop. This is because after we
have a child, our pelvic floor muscles can be considerably weaker than before. Kegel
exercises will prevent this.

After you have a child, the muscles that support your uterus can become so weak that the
uterus can actually sag down into the vaginal opening. This is called Uterine Prolapse.

Those same muscles being too weak to support your bladder can lead to Cystocele, which is
a condition in which your bladder can dip down into the vaginal opening.

Not being able to retain your urine while you cough or laugh is called Incontinence, and this
arises from those same muscles being too weak.

Doing Kegel exercises is easy, and has other benefits as well, like increasing sexual
pleasure. Here are a few of the exercises and the proper way to do them.
The Elevator - Do this in a position that's comfortable for you. Pretend that you are on an
elevator, and tighten your pelvic floor muscles while you are going up. Pull all the way up
with your muscles. Then slowly release them as you imagine you are going back
down. Practice this exercise ten times a day.

Flickering - Again, find a position that is comfortable. Tighten and release your pelvic floor
muscles as quickly as you can, for about twenty seconds. You may find that you are not
able to do this for twenty seconds, but that's okay. You will get stronger as you do
them. Practice this one 25 to 30 times a day.

The Push and Pull - In your comfortable position, right? Okay, push with your pelvic floor
muscles as though you are urinating, except harder. Do it all the way out, and then
stop. Immediately tighten the muscles up as though you are stopping the flow of urine. Pull
it all the way in, and then stop. Do this ten times a day.

Although you may be laughing at the names of the exercises right along with me, the
benefits are outrageous. These exercises can save you money, embarrassment, and
pain. Practice these during pregnancy to ensure that none of these terrible conditions
develop.

The Symptoms of Uterine Prolapse

By Kristi Patrice Carter

Uterine prolapse, a condition in which the uterus (womb) is weakened and eventually
collapses into the vaginal canal, is usually the result of difficult or multiple childbirths.
During pregnancy, the ligaments and muscles that hold the womb in place become
stretched or slack, which causes the uterus to sag or droop.

Obesity, chronic coughing, and abdominal or pelvic tumors can also cause a prolapsed
uterus or pelvic relaxation, conditions which rarely affect younger women. The severity of a
prolapsed uterus is much more likely to progress over time following the post-reproductive
years, and may be caused by multiple or difficult pregnancies. The deprivation of estrogen
that occurs after menopause may also contribute to the weakening of the pelvic muscles.

The classic symptoms of a prolapsed uterus include:

- Difficulty having bowel movements

- Difficulty walking

- Difficulty urinating
- Pain in the lower back area

- Pain during sexual intercourse

- Pressure in the pelvis or a feeling of fullness

- The sensation that something is about to fall out of the vagina

Symptoms that require immediate medical attention include:

- Bowel obstructions

- Continual, worsening back pain

- Incontinence

- Increasing difficulty walking or standing

- Rectal urgency, a continual sensation or urge to have a bowel movement

- The ability to feel the cervix pressing against the vaginal canal

- Uterine prolapse, the uterus has actually completely come out of the vagina

There are other medical conditions that cause a weakening of the muscles that hold the
uterus in its proper place and may possibly lead to uterine prolapse. These conditions
include:

- Cystocele: A cystocele is a herniation of the vaginal wall caused by a part of the bladder
that is pressing into the vagina. This herniation causes a bulge in the walls of the vagina
and may lead to symptoms such as incontinence, urinary frequency, and urgency.

- Enterocele: An enterocele is a herniation of the upper, rear vaginal wall. A small section of
the bowel pushes, or bulges into the vagina causing a distinct pulling sensation, and
backaches while standing. Symptoms of an enterocele are usually relieved from lying down.

- Rectocele: A rectocele is a herniation of the lower, rear vaginal wall. A portion of the
rectum bulges or pushes into the vagina making bowel movement increasingly difficult. In
severe cases, pressure needs to be applied to the inside of the vagina in order to facilitate a
bowel movement.

The evidence of classic symptoms along with the patient’s history are usually enough to
suggest the presence of a prolapsed uterus. However, to accurately diagnose the condition,
a complete medical history along with a physical examination of the pelvic region will be
necessary. In many instances it is necessary to perform multiple examinations to determine
the extent of the condition, and to determine which organs may be involved.

Other tests to detect specific conditions or to rule out underlying causes may be necessary
to diagnose uterine prolapse, including a renal sonogram, and an ultrasound, which are
imaging tests that create pictures of the internal organs using sound waves.
 Exercises to Assist with Uterine
Prolapse

By Kristi Patrice Carter

Uterine prolapse, a condition affecting women who have given birth multiple times or who
may have had difficult vaginal deliveries, is caused by a weakening of the pelvic muscles
and ligaments. These tissues comprise the pelvic support system, which essentially holds
the uterus in place, and much like any other muscle, they can become weakened or slack
over time because of excessive strain.

Pelvic muscles can be damaged or weakened in several ways, including:

- Chronic constipation, which causes strain on the abdominal muscles

- Constant straining from coughing or lifting weights

- Obesity

- Pelvic tumors

- Pregnancy, particularly multiple pregnancies or multiple births such as twins

- Vaginal childbirth, especially following a prolonged labor

Pelvic floor exercises are beneficial for strengthening weakened muscles that cause uterine
prolapse. The most common of which is the Kegel exercise, named after the doctor who
popularized the practice of targeting and strengthening the pelvic diaphragm. Exercising the
pelvic floor muscles for just five minutes, three times each day can strengthen the tissue
and ligaments that hold the uterus, bladder, and other organs in their proper places.

To locate the correct pelvic muscles:

- Begin first by trying to stop the flow of urine while sitting down on the toilet, if you are
able to stop urinating, you’ve found the right muscles.

- Clench the muscles you would use if you were trying to stop yourself from passing gas.

- If you still are unsure as to whether or not you’re targeting the right muscle group, lie
down and insert one or two fingers into the vagina. Again, bear down or squeeze as if you
were trying to stop the flow of urine, if there is a tightening around your finger, you have
found the correct pelvic muscles.
To exercise the pelvic muscles:

- Lie down, tighten the pelvic muscles, and hold for a count of three. Relax for another
count of three working your way up to 10 to 15 sets each time you do the exercise, which
should be three times per day.

- Doing Kegel exercises while in varying positions helps to make pelvic muscles their
strongest. Try doing the exercises lying down, then standing, then sitting.

- Be sure not to hold your breath or tighten any other muscles at the same time you are
squeezing the pelvic muscle. Excessive pressure can be put on the bladder by squeezing the
wrong muscle group.

- Be patient as it may take several weeks to notice differences such as improved bladder
control.

Other points to remember to improve or avoid uterine prolapse are:

- Avoid constipation by following a diet high in fiber.

- Avoid heavy lifting and straining.

- Have regular pelvic examinations.

- Maintain a healthy weight.

- Remember to do daily exercises to strengthen pelvic muscles and to help control bladder
problems.

- Squeeze or clench your muscles when coughing and sneezing to prevent damage to
muscles caused by the onset of sudden pressure.

Women’s Common Postpartum

Issues

There are a wide variety of postpartum issues that any given woman could suffer from.
None of them are anything to be ashamed of, and there is support out there for you. These
medical illnesses and problems occur often in women after giving birth. Going through a
pregnancy and birth of your baby is not something that is simple. Your body physically and
physiology goes through a number of changes throughout your pregnancy and even after
you have given birth. It is only natural that things within your body would not be the same
after giving birth.
If you may have any of the following illnesses or know a woman that may, you should
consider reading this entire article. Information and knowledge can make us stronger.
Women can become empowered with knowledge of what can happen after pregnancy and
what can be done about it. You deserve to get better, feel better and know that these
illnesses are normal for you.

It is vital that the person suffering from any of these illnesses have the support they
deserve to have, because these illnesses can be painful, they can have an effect on a
woman’s life in general, and it can feel incredibly lonely to suffer from any one of these
illnesses. It is important that she have the support she needs to get through this trying
time.

Uterine Prolapse

Uterine prolapse happens when the ligaments and muscles that hold the uterus in place
weaken, and the uterus falls within the vaginal canal. This usually happens in women who
are postmenopausal, and have had more than one child via vaginal births. Over time the
uterus’ muscles and ligaments can weaken, gravity will do its job (unfortunately), and
hormones can cause uterine prolapse.

If you experience mild uterine prolapse you should not need any treatment, but should still
seek medical advise to be safe. If you find that this interrupts your life and daily activities
you might need surgery or an insertion of a supportive device that will take the place of
your uterine supportive muscles and ligaments.

Symptoms of Uterine Prolapse:

· You May Feel A Pulling Or Heaviness In Your Pelvis

· You May Experience Pain During Intercourse

· You May Find Something Protruding From Your Vagina

· You Also May Experience Lower Back Pain

· Pain And Symptoms Worsen At Night

Treatments for Uterine Prolapse:

Weight Management may be the first thing a medical professional will suggest if you are
overweight or obese. He or she may suggest that you avoid any heavy lifting or straining
and maintain a healthy lifestyle. You will also need to practice kegel exercises that can help
strengthen your pelvic floor muscles.

There is also a device that can be placed inside your vagina to properly hold the uterus in its
place. This would probably be the second option if the first does not apply.

The third and final option would be surgery to repair the uterine muscles by using tissue
grafting.

Incontinence
Urinary incontinence is simply a loss of bladder control and it happens to a lot of women
post pregnancy. This is not actually the illness itself, but rather a symptom of one. You will
have to work with your medical professional to see what the problem is and what treatment
needs to follow. Pregnancy and childbirth is at the top of the list for causes of urinary
incontinence, or otherwise known as stress incontinence. It can be caused by stress from
the weight of the baby, hormonal changes (do they always have to blame it one
hormones?), and vaginal delivery. Obviously, a vaginal delivery is physically stressful.
Vaginal childbirth can weaken your muscles and even damage your bladder’s nerves. You
may experience incontinence right after birth, or even several years later. Note the trying
not to pee a little after a sneeze or cough. It happens and it is all right.

Symptoms of Stress Incontinence:

· You May Experience Some Loss of Urine When You Sneeze, Cough, Laugh, Do Heavy
Lifting, or Exercise

· When Your Bladder is Too Full You Will Notice That Leakage Will Be Worse

Treatments of Stress Incontinence:

Exercise can help by practicing Kegel exercises every day. This will help strengthen your
pelvic floor muscles, which help control urination.

If Kegel exercises fail you your medical professional may offer bladder training. This means
you will have to try to hold urination when you get the urge for about ten minutes, and then
increase the time as you can.

If these do not help your medical professional may advise some medications, medical
devices, and even surgery. However, Kegel exercises have proven to be effective in helping
women with stress incontinence and usually stops there.

Diabetes Insipidus

This illness is specifically a postpartum illness. It is actually a postpartum complication.

Symptoms of Diabetes Insipidus:

· Incredibly Intense Thirst

· Large Amounts of Urine That is diluted

· Waking During the Night to Urinate

· Wetting the Bed

Treatments for Diabetes Insipidus:

Since this illness is usually caused by a hormone (lack of antidiuretic hormone) it can be
treated with this hormone, synthetically. Desmopressin can be used to help bring up this
hormone in your body to reduce the symptoms of this illness and therefore getting rid of it.
However, if your kidneys do not seem to respond to Desmopressin, your medical
professional may offer a diet low in salt. This decreases the amount of urine your kidneys
will produce.

Perineal Pain

Your perineum is the area just between your vagina and rectum. Pain in this area is very
common with women who delivery vaginally. The tissues in this area will become swollen,
sore, and possibly torn by vaginal delivery. As your body heals after childbirth the perineal
pain should lessen with time. To help relieve the pain you can use Sitz baths, cold packs,
warm water, and a donut shaped pillow to sit on. Some type of Ibuprofen or Aspirin can
help, too. But ask your medical professional what you should take if you are breastfeeding.

Postpartum Depression

There are so many changes that happen within your body and in your life when you go
through pregnancy and give birth. It can be exciting, scary, thrilling, and stressful all at the
same time.

Symptoms of Postpartum Depression:

· Sadness

· Anxious

· Afraid

· Confused

· Irritated

Nearly every woman who gives birth has these feelings after their baby is born. Usually the
feelings subside within a short time. If they do not, it could turn into Postpartum
Depression. When a woman’s ability to function is effected by her symptoms she will usually
be diagnosed with PD. It can be treated with counseling and medication if necessary. The
important thing to remember is that thousands of women suffer from PD. You are never
alone, and you can get through it.

No matter what you suffer from after pregnancy you can make it through with proper
support from family and friends. It can be an exciting and scary time for you, but you
should get the help you need with your family or friends standing beside you.

DANGERS OF UTERINE PROLAPSE

Uterine prolapse occurs when the ligaments that hold the uterus in place weaken, allowing
the uterus to slide from its normal position in the pelvic cavity into the vaginal canal. The
condition commonly arises following a complicated labor or the delivery of a particularly
large baby. Uterine prolapse is also common in older women who have undergone
menopause, when estrogen levels naturally reduce and muscles tend to weaken. Women
who are obese, who smoke or who suffer from chronic constipation are also more likely to
suffer uterine prolapse.

The severity of uterine prolapse can vary. In order to understand whether your prolapse is
mild or severe, your doctor will need to perform a physical examination. First degree
prolapse occurs when the uterus sags downwards into the upper vagina. When the cervix is
at or near the outside of the vagina, prolapse is known as second degree. Total prolapse, or
third degree prolapse, occurs when the entire uterus is outside the vagina.

Doctors often describe prolapse based on the parts of the uterus or vagina that are involved
in the prolapse. If the front wall of the vagina (below the bladder) is prolapsed, your
condition will be called cystocoele. When the back wall of the vagina has prolapsed, doctors
will refer to the condition as rectocoele. A uterus that is tilted forwards or backwards within
the pelvic cavity is sometimes referred to as a “tipped uterus”. In severe cases where the
cervix prolapses beyond the entrance of the vagina, the condition is described as
proccidentia.

Uterine prolapse can interfere with bowel, bladder and sexual function. In cystocoele
prolapse, urinary tract infections and other urinary symptoms are a common complication,
due to the involvement of the bladder. By contrast, the most common complications of
rectocoele are constipation and hemorrhoids. The downward pressure of your uterus on
your vagina can lead to ulceration of one or both of these organs. If left untreated, the
ulcerations may become infected and may have a toxic effect on the entirety of your body.

Since uterine prolapse worsens with time, all cases of uterine prolapse will need some form
of medical intervention. In mild cases, the condition may be reversed by performing special
pelvic floor exercises. Women whose prolapse is more severe are likely to require surgery to
repair the damaged pelvic support structures or to remove the uterus (hysterectomy). In
many cases, it is the after effects of surgery that can lead to dangerous complications and
unpleasant side effects.

As with all surgeries, there is a risk of blood clots, infection, excessive bleeding or an
adverse reaction to the anesthetic. In particular, surgeries for uterine prolapse can cause
damage to your urinary tract, bladder or rectum. There is also a chance that nerves may be
damaged during the operation – often it is the pudendal nerve, which is involved in sexual
arousal and orgasm that is damaged. Diminished sexual function and enjoyment is a serious
danger of uterine prolapse surgery.

Your doctor will be able to thoroughly evaluate your case to ensure that you receive the
treatment that will best treat your uterine prolapse, without causing danger to you.
PREVENTING UTERINE PROLAPSE:
THE IMPORTANCE OF KEGELS

Exercises which strengthen the pelvic floor muscles that support the uterus can not only
help to prevent the occurrence of uterine prolapse but, in milder cases of the condition, can
be a useful treatment.

The exercises most regularly recommended for the pelvic floor muscles are called Kegels.
Performing Kegel exercises are easy: simply tighten your pelvic muscles as if you were
trying to stop the flow of urine. Hold the muscles tight for a few seconds and then slowly
release them. It is recommended to perform these contractions in sets of ten, up to four
times a day. These exercises can be done anywhere, at any time of the day. Regular Kegels
will ensure that your pelvic floor muscles remain strong - which not only helps prevent
uterine prolapse, but can also assist during delivery of a baby and add to the intensity of
orgasm.

Whilst pelvic floor exercises are important for preventing uterine prolapse, so is whole-of-
body exercise. Experts recommend that all adults perform 20 to 30 minutes of aerobic
exercise between three to five times a week. If you haven’t been exercising regularly, it is a
good idea to consult your doctor for a check up to ensure that you are fit to embark on an
exercise routine. Exercise helps your muscles, tendons and ligaments stay strong and also
assists with weight control.

Eating the right food can help you control your weight, and thus reduce the pressure placed
on your pelvic floor muscles. A balanced diet that includes lots of fruit and vegetables will
ensure that your bowel movements are regular and stress-free. If you are not straining to
pass a motion, the pressure on your uterine ligaments is decreased.

We all know that smoking is bad for you, but did you know that it can contribute to the
development of uterine prolapse? Smokers are much more likely to develop a cough, which
is risk factor for stressing out your uterine ligaments. If you don’t smoke, you’re less likely
to cough and therefore less likely to suffer from a prolapsed uterus.

Another way to prevent uterine prolapse is to ensure that you lift heavy objects correctly.
Lift heavy objects keeping your back straight and bending only at the knees and hips.
Support your spine by tightening your stomach muscles, and lift the weight of the object
using your leg muscles rather than your abdomen. Ask a friend to help you lift heavy items,
rather than soldiering on by yourself.

Once you have reached menopause, it may be worthwhile considering estrogen replacement
therapy. It is the gradual reduction of estrogen that causes your muscles to weaken and
which may lead to uterine prolapse. With hormone replacement therapy, your muscles will
not degrade to such an extent and your risk of uterine prolapse is therefore reduced.
Uterine prolapse can often be prevented by maintaining strong and healthy pelvic floor
muscles. If you believe that you are suffering from uterine prolapse, seek the advice of a
qualified medical practitioner

Uterine Prolapse
Uterine prolapse ("dropped uterus") is a condition in which a woman's uterus (womb) sags or
slips out of its normal position. The uterus may slip enough that it drops partially into the vagina
(the birth canal), creating a perceptible lump or bulge. This is called incomplete prolapse. In a
more severe case-known as complete prolapse-the uterus slips to such a degree that some of the
tissue drops outside of the vagina.

Prolapse Definition

Prolapse literally means "to fall out of place." In medicine, prolapse is a condition where organs,
such as the uterus, fall down or slip out of place. It is generally reserved for organs protruding
through the vagina, or for the misalignment of the valves of the heart.

Anatomy of the Vagina

The vaginal vault has three compartments: an anterior compartment (consisting of the anterior
vaginal wall), a middle compartment (cervix), and a posterior compartment (posterior vaginal
wall). Uterine prolapse involves the cervix.

Signs & Symptoms

Women with mild cases of uterine prolapse may have no obvious symptoms. However, as the
slipped uterus falls further out of position, it can place pressure on other pelvic organs-such as
the bladder or bowel-causing a variety of symptoms, including:

• Pelvic pressure: a feeling of heaviness or pressure in the pelvis

• Pelvic pain: discomfort in the pelvis, abdomen or lower back
• Pain during intercourse
• A protrusion of tissue from the opening of the vagina
• Recurrent bladder infections
• Unusual or excessive discharge from the vagina
• Constipation
• Difficulty with urination, including involuntary loss of urine (female
incontinence), or urinary frequency or urgency 1
Symptoms may be worsened by prolonged standing or walking, due to added pressure placed on
the pelvic muscles by gravity.

Causes of Uterine Prolapse

Trauma incurred during the birthing process, particularly with large babies or after a difficult
labor and delivery, is one of the main causes of the muscle weakness that leads to uterine
prolapse. Reduced muscle tone from aging, as well as lowered amounts of circulating estrogen
after menopause, may also form contributing factors in pelvic organ prolapses. In rare
circumstances, uterine prolapse may be caused by a tumor in the pelvic cavity.

Genetics also may play a role; women of Northern European descent experience a higher
incidence of uterine prolapse than do women of Asian and African heritage. 2

Finally, increased intra-abdominal pressure, stemming from such diverse conditions as obesity,
chronic lung disease and asthma, can be contributing factors in uterine prolapse. 3

Risk Factors

• One or more pregnancies and vaginal births

• Giving birth to a large baby
• Increasing age
• Frequent heavy lifting
• Chronic coughing
4
• Frequent straining during bowel movements

Statistics

In the U.S., pelvic support defects are relatively common and increase with age. One study of
more than 16,000 patients found the rate of uterine prolapse to be 14.2%. The mean age at time
of surgery for pelvic organ prolapse was 54.6 years. 5

U.S. studies have found Hispanic race to be correlated with prolapse. By contrast, African
Americans had the lowest risk of uterine prolapse. These findings were independent of parity,
age, and body habitus, suggesting a genetic component to prolapse.

Stages of Uterine Prolapse

Four stages of uterine prolapse are commonly defined:

Staging Definitions

Eversion: A turning outward or turning inside out

Procidentia: A prolapse or falling down
 • Stage I of uterine prolapse is defined as descent of the uterus to any point in
the vagina above the hymen (or hymenal remnants).
• Stage II of uterine prolapse is defined as descent to the hymen.
• Stage III of uterine prolapse is defined as descent beyond the hymen.
• Stage IV of uterine prolapse is defined as total eversion or procidentia. 6

Uterine prolapse always is accompanied by some degree of vaginal vault prolapse.

Screening & Diagnosis

Diagnosing uterine prolapse requires a pelvic examination. You may be referred to a doctor who
specializes in conditions affecting the female reproductive tract (gynecologist). The doctor will
ask about your medical history, including how many pregnancies and vaginal deliveries you've
had. He or she will perform a complete pelvic examination to check for signs of uterine prolapse.
You may be examined while lying down and also while standing. Sometimes imaging tests, such
as ultrasound or magnetic resonance imaging (MRI), might be performed to further evaluate the
uterine prolapse. 7

Treatment

Losing weight, stopping smoking and getting proper treatment for contributing medical
problems, such as lung disease, may slow the progression of uterine prolapse.

If you have very mild uterine prolapse, either without symptoms or with symptoms that aren't
highly bothersome, no treatment is necessary. However, without treatment, you may continue to
lose uterine support, which could require future treatment.

1. http://www.clevelandclinic.org/health/health-info/docs/2600/2662.asp?index=9782
2. http://www.mayoclinic.com/health/uterine-prolapse/DS00700/DSECTION=3
3. http://www.emedicine.com/emerg/topic629.htm
4. http://www.mayoclinic.com/health/uterine-prolapse/DS00700/DSECTION=3
5. http://www.emedicine.com/emerg/topic629.htm
6. http://www.emedicine.com/emerg/topic629.htm
7. http://www.mayoclinic.com/health/uterine-prolapse/DS00700/DSECTION=6

While clinical studies support the effectiveness of the da Vinci ® System when used in minimally
invasive surgery, individual results may vary. Surgery with the da Vinci ® Surgical System may
not be appropriate for every individual. Always ask your doctor about all treatment options, as
well as their risks and benefits.

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• Common Gynecologic Symptoms
• Gynecologic Conditions
o Endometriosis / Adenomyosis
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o Uterine Fibroids
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