Uterine Descent/Prolapse

Uterine prolapse 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 partway into the vagina (birth canal), creating a lump or bulge. This is called incomplete prolapse. In a more severe case—called complete prolapse—the uterus slips so far out of place that some of the tissue drops outside of the vagina. Left untreated, uterine prolapse can interfere with bowel, bladder and sexual functions.

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

• A feeling of heaviness or pressure in the pelvis
• Pain 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 (incontinence), or urinary frequency or urgency

Symptoms may be worsened by prolonged standing or walking. This is due to the added pressure placed on the pelvic muscles by gravity. For further information about uterine prolapsed please visit our FAQ area.

Pessary

Some women with Uterine Descent benefit from a Pessary, a device worn in the vagina for support. It is important to avoid heavy lifting, maintain a healthy weight, and practice Kegel exercises. Medication such as estrogen might also help alleviate some of the symptoms. Eating high fiber foods are also recommended to help prevent straining that is associated with constipation.

Estrogen Replacement Therapy

Estrogen replacement therapy (ERT) — Taking estrogen may help to limit further weakness of the muscles and other connective tissues that support the uterus. However, there are some drawbacks to taking estrogen, such as an increased risk of blood clots, gallbladder disease and breast cancer. The decision to use ERT must be made with your doctor after carefully weighing all of the risks and benefits.

Surgical options

Hysterectomy — Uterine prolapse may be treated by removing the uterus in a surgical procedure called hysterectomy. This may be done through an incision made in the vagina (vaginal hysterectomy) or through the abdomen (abdominal hysterectomy). Hysterectomy is major surgery, and removing the uterus means pregnancy is no longer possible.

Uterine suspension— This procedure involves putting the uterus back into its normal position. This may be done by reattaching the pelvic ligaments to the lower part of the uterus to hold it in place. Another technique uses a special material that acts like a sling to support the uterus in its proper position.  Recent advances include performing this with minimally invasive techniques and laparoscopically (through small band-aid sized incisions) that decrease post operative pain and speed recovery.