What are the main causes of uterine prolapse. How is uterine prolapse diagnosed. What are the most effective treatment options for uterine prolapse. Can uterine prolapse be prevented. How does uterine prolapse affect quality of life. What are the risk factors for developing uterine prolapse. When should you seek medical attention for uterine prolapse.

Understanding Uterine Prolapse: An Overview of the Condition

Uterine prolapse is a pelvic floor disorder that occurs when the muscles and ligaments supporting the uterus weaken, causing it to descend into or protrude out of the vagina. This condition affects millions of women worldwide, particularly those who have given birth or are postmenopausal. To fully grasp the implications of uterine prolapse, it’s crucial to understand its underlying causes, symptoms, and available treatment options.

Are there different stages of uterine prolapse? Indeed, medical professionals classify uterine prolapse into four stages based on the severity of the condition:

• Stage 1: The uterus descends into the upper vagina
• Stage 2: The uterus descends to the opening of the vagina
• Stage 3: The uterus protrudes outside the vagina
• Stage 4: The uterus is completely outside the body

Common Causes and Risk Factors for Uterine Prolapse

Understanding the causes and risk factors associated with uterine prolapse is essential for prevention and early intervention. The primary reason for this condition is the weakening of the pelvic floor muscles and ligaments that support the uterus. Several factors can contribute to this weakening:

• Pregnancy and childbirth, especially multiple vaginal deliveries
• Age and hormonal changes, particularly during menopause
• Obesity and overweight conditions
• Chronic coughing or constipation
• Heavy lifting or strenuous physical activities
• Genetic predisposition to weak connective tissue

Does uterine prolapse only affect older women? While the condition is more common in postmenopausal women, it can affect women of any age, especially those who have given birth or have a family history of pelvic floor disorders.

Recognizing the Symptoms of Uterine Prolapse

Identifying the symptoms of uterine prolapse is crucial for timely diagnosis and treatment. The severity of symptoms often correlates with the stage of prolapse. Common signs and symptoms include:

1. A feeling of heaviness or pulling in the pelvis
2. A bulge or protrusion from the vagina
3. Difficulty urinating or having a bowel movement
4. Lower back pain
5. Discomfort during sexual intercourse
6. Recurrent urinary tract infections

Can uterine prolapse cause pain? While some women may experience discomfort or a sensation of pressure, uterine prolapse itself is not typically associated with severe pain. However, related symptoms such as lower back pain or discomfort during intercourse can occur.

Diagnostic Procedures for Uterine Prolapse

Accurate diagnosis of uterine prolapse is essential for determining the appropriate treatment plan. Healthcare providers typically employ a combination of methods to assess the condition:

• Physical examination, including a pelvic exam
• Medical history review
• Imaging tests such as ultrasound or MRI
• Urodynamic testing to evaluate bladder function

How is the severity of uterine prolapse determined? The severity is primarily assessed through a physical examination, where the healthcare provider evaluates the position of the uterus and the extent of its descent. Additional tests may be performed to assess the impact on surrounding organs and pelvic floor function.

Treatment Options for Uterine Prolapse

The treatment approach for uterine prolapse depends on various factors, including the severity of the condition, the patient’s age, overall health, and desire for future pregnancies. Treatment options range from conservative measures to surgical interventions:

Non-Surgical Treatments

• Pelvic floor exercises (Kegel exercises)
• Pessary devices
• Lifestyle modifications (weight loss, avoiding heavy lifting)
• Hormone replacement therapy for postmenopausal women

Surgical Interventions

• Vaginal hysterectomy
• Sacrocolpopexy
• Uterosacral ligament suspension
• Manchester procedure

Is surgery always necessary for uterine prolapse? Not always. Many women with mild to moderate prolapse can effectively manage their symptoms with non-surgical treatments. Surgery is typically reserved for severe cases or when conservative measures fail to provide relief.

Prevention Strategies and Lifestyle Modifications

While not all cases of uterine prolapse can be prevented, certain lifestyle modifications and preventive measures can reduce the risk or slow the progression of the condition:

• Maintaining a healthy weight
• Practicing regular pelvic floor exercises
• Avoiding heavy lifting and high-impact activities
• Managing chronic cough and constipation
• Quitting smoking
• Eating a balanced diet rich in fiber

How effective are Kegel exercises in preventing uterine prolapse? Kegel exercises, when performed correctly and consistently, can significantly strengthen the pelvic floor muscles, potentially reducing the risk of prolapse or improving symptoms in mild cases.

Impact of Uterine Prolapse on Quality of Life

Uterine prolapse can have a significant impact on a woman’s quality of life, affecting physical, emotional, and social well-being. Common challenges faced by women with this condition include:

• Reduced physical activity and exercise
• Decreased sexual function and intimacy
• Emotional distress and body image issues
• Social isolation due to embarrassment or discomfort
• Work-related difficulties

Can uterine prolapse affect fertility? While mild cases of uterine prolapse may not directly impact fertility, severe prolapse can potentially interfere with conception and pregnancy. Women with prolapse who wish to become pregnant should consult with their healthcare provider to discuss management options.

Complications Associated with Untreated Uterine Prolapse

Left untreated, uterine prolapse can lead to various complications that may significantly impact a woman’s health and well-being:

1. Urinary incontinence or retention
2. Recurrent urinary tract infections
3. Bowel dysfunction
4. Ulceration of vaginal tissue
5. Increased risk of pelvic organ prolapse

Can uterine prolapse resolve on its own? In most cases, uterine prolapse does not resolve without intervention. However, mild cases may be effectively managed with conservative treatments and lifestyle modifications, preventing progression to more severe stages.

Emerging Research and Future Directions in Uterine Prolapse Management

As medical science advances, new approaches to managing uterine prolapse are being explored. Current areas of research include:

• Regenerative medicine techniques using stem cells
• Advanced biomaterials for pelvic floor support
• Minimally invasive surgical techniques
• Improved pessary designs for better comfort and efficacy
• Targeted exercises and physical therapy protocols

What role does genetics play in uterine prolapse? Recent studies suggest that genetic factors may contribute to an individual’s susceptibility to pelvic floor disorders, including uterine prolapse. Ongoing research aims to identify specific genetic markers that may help predict risk and inform preventive strategies.

Patient Education and Support for Women with Uterine Prolapse

Empowering women with knowledge and support is crucial in managing uterine prolapse effectively. Key aspects of patient education include:

• Understanding the condition and its progression
• Learning proper pelvic floor exercise techniques
• Awareness of lifestyle modifications that can help manage symptoms
• Information on available treatment options and their pros and cons
• Access to support groups and counseling services

How can healthcare providers better support women with uterine prolapse? Healthcare providers can offer comprehensive care by adopting a patient-centered approach, providing clear information, addressing concerns, and offering ongoing support throughout the treatment process.

Navigating Pregnancy and Childbirth with Uterine Prolapse

For women with uterine prolapse who are considering pregnancy or are already pregnant, special considerations are necessary:

1. Pre-conception counseling to discuss potential risks and management strategies
2. Close monitoring throughout pregnancy
3. Pelvic floor exercises during and after pregnancy
4. Consideration of cesarean delivery in some cases
5. Postpartum care and support to prevent worsening of prolapse

Is it safe to have a vaginal delivery with uterine prolapse? The safety of vaginal delivery depends on the severity of the prolapse and other individual factors. Some women with mild prolapse may safely deliver vaginally, while others may require a cesarean section. Consultation with an obstetrician is crucial for making informed decisions.

The Role of Multidisciplinary Care in Uterine Prolapse Management

Effective management of uterine prolapse often requires a multidisciplinary approach, involving various healthcare professionals:

• Gynecologists and urogynecologists
• Pelvic floor physical therapists
• Urologists
• Colorectal surgeons
• Nutritionists
• Mental health professionals

How does a multidisciplinary approach benefit patients with uterine prolapse? A collaborative care model ensures comprehensive assessment and tailored treatment plans, addressing all aspects of the condition and its impact on the patient’s overall health and well-being.

Psychological and Emotional Aspects of Living with Uterine Prolapse

The psychological impact of uterine prolapse is often overlooked but can significantly affect a woman’s mental health and self-esteem. Common emotional challenges include:

• Anxiety about the condition worsening
• Depression related to physical limitations
• Body image concerns
• Relationship stress, particularly regarding intimacy
• Fear of judgment or embarrassment

How can women cope with the emotional challenges of uterine prolapse? Seeking support from mental health professionals, joining support groups, and open communication with partners and healthcare providers can help women navigate the emotional aspects of living with uterine prolapse.

Long-term Outlook and Management of Uterine Prolapse

Understanding the long-term prognosis and management strategies for uterine prolapse is essential for women living with this condition. Key considerations include:

1. Regular follow-up appointments with healthcare providers
2. Ongoing pelvic floor exercises and lifestyle modifications
3. Adaptation of treatment plans as needed
4. Monitoring for potential complications
5. Addressing age-related changes that may affect the condition

Can uterine prolapse recur after treatment? While treatments can be highly effective, there is a risk of recurrence, particularly after surgical interventions. Maintaining a healthy lifestyle, continuing pelvic floor exercises, and regular check-ups can help reduce the risk of recurrence.

Advancing Public Awareness and Destigmatizing Uterine Prolapse

Increasing public awareness and reducing the stigma surrounding uterine prolapse is crucial for early detection and improved patient outcomes. Strategies to achieve this include:

• Educational campaigns targeting women of all ages
• Incorporation of pelvic health education in school curricula
• Encouraging open discussions about pelvic floor health
• Media representation of women’s health issues
• Support for research and advocacy organizations

How can healthcare providers contribute to destigmatizing uterine prolapse? Healthcare providers can play a vital role by normalizing discussions about pelvic health, providing accurate information, and creating a supportive environment for patients to discuss their concerns openly.

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Uterusprolaps Vektor Icon Set

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Medicine: Rectal prolapse, illustrationElaine Holmes of Scottish Mesh Survivors group gives evidence of her experience of transvaginal mesh implants, to the Scottish Parliament’s Public…Dr Wael Agur, consultant gynaecologist and obstetrician, gives evidence on the risks associated with transvaginal mesh implants, to the Scottish…Dr Wael Agur, consultant gynaecologist and obstetrician, gives evidence on the risks associated with transvaginal mesh implants, to the Scottish…Elaine Holmes and Olive McIlroy of Scottish Mesh Survivors group give evidence on their experience of transvaginal mesh implants, to the Scottish…Dr Wael Agur, consultant gynaecologist and obstetrician, leaves after giving evidence on the risks associated with transvaginal mesh implants, to the…Members and supporters of theScottish Mesh Survivors group listen to evidence on transvaginal mesh implants, on the public benches at the Scottish. ..Olive McIlroy of Scottish Mesh Survivors group gives evidence of her experience of transvaginal mesh implants, to the Scottish Parliament’s Public…Elaine Holmes and Olive McIlroy of Scottish Mesh Survivors group give evidence on their experience of transvaginal mesh implants, to the Scottish…Elaine Holmes and Olive McIlroy of Scottish Mesh Survivors group give evidence on their experience of transvaginal mesh implants, to the Scottish…Elaine Holmes and Olive McIlroy of Scottish Mesh Survivors group give evidence on their experience of transvaginal mesh implants, to the Scottish…Dried Roots Of The Medicinal Plant Thorow-wax. 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A recent…Ammu KANNAMPILLY Nepalese woman Aruna Chaudhary Tharu gestures as she speaks during an interview with AFP in Kathmandu on February 19, 2014. A recent…Ammu KANNAMPILLY In this photograph taken on February 26 Nepalese woman Madhuri Thakuri speaks during an interview with AFP at Malekhu, Dhading…Ammu KANNAMPILLY Nepalese woman Reena Pokharel gestures as she speaks during an interview with AFP in Kathmandu on February 19, 2014. A recent report…Ammu KANNAMPILLY In this photograph taken on February 26 Nepalese woman Madhuri Thakuri speaks during an interview with AFP at Malekhu, Dhading. ..Ammu KANNAMPILLY Nepalese woman Reena Pokharel gestures as she speaks during an interview with AFP in Kathmandu on February 19, 2014. A recent report…Ammu KANNAMPILLY Nepalese woman Aruna Chaudhary Tharu gestures as she speaks during an interview with AFP in Kathmandu on February 19, 2014. 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Omission and prolapse of the uterus: symptoms, causes, diagnosis.

Uterine prolapse

• Description
• Organization of treatment
• Cost of treatment

Description

In some cases, the uterus is practically in its place, and there is a prolapse of the cervix associated with its hypertrophy and elongation. It so happened historically that any prolapse of the patient (sometimes doctors) is called prolapse of the uterus, although, as mentioned above, this is not entirely true.

Symptoms

Signs of uterine prolapse consist of dysfunction of those organs that are involved in the pathological process. By itself, the displacement of the uterus causes:

• foreign body sensation in the vagina
• sexual discomfort
• Pulling sensations in the lower abdomen.

It is important to remember the fact that the uterus lies at the top of the vagina, so its prolapse is inevitably accompanied by prolapse of the anterior / posterior wall of the vagina, and hence the bladder / rectum.

That is why patients with “uterine prolapse” complain:

• for urination disorders (difficulty urinating, feeling of incomplete emptying of the bladder, frequent urination, loss of urine during exertion or against the background of sharp urges, etc.)
• for problems with defecation (difficult defecation, defecation in portions, the need to adjust the prolapse to completely empty the bowel, etc.).

Reasons

The causes of uterine prolapse can be described according to the life path model. At the beginning, a person has one or another predisposition to the development of this pathology. Further, various aggressive factors begin to act on it, which lead to the onset of the disease. At the first stage, the body copes with the damage that has occurred, however, age and the accumulation of breakdowns lead to its manifestation and, in fact, to the complaints that were described above. All pathological factors can be divided into the following:

• Heredity. It has been proven that if the next of kin has the disease, the likelihood of occurrence increases several times. Most often, there is a congenital weakness of the connective tissue, which also affects other body systems, manifesting itself in diseases of the musculoskeletal system, varicose veins, and hemorrhoids. However, heredity is still a predisposition not a sentence, but what makes it a reality are the risk factors, which will be discussed below.
• Childbirth and pregnancy. Perhaps the main factor that leads to changes in the qualitative composition of the supporting apparatus of the pelvic floor and its partial damage. Unfortunately, with severe tissue failure, complete prolapse of the uterus can develop immediately after childbirth. On the other hand, in most parturient women, the prolapse completely regresses within the first year.
• Increased loads. And this is not only hard physical labor, but also chronic constipation, lung diseases, accompanied by a constant and severe cough, obesity. All these factors lead to damage to the ligamentous apparatus of the pelvic organs and their prolapse.
• Age. This factor has a complex effect on all supported structures of the pelvic floor. Firstly, with age, the hormonal background changes, and with it the quality of the connective tissue (it becomes looser and weaker). In some patients, hormonal changes lead to deformation and changes in the cervix, according to the type of its elongation and hypertrophy. Secondly, muscle tone decreases, including that of the pelvic floor. In this regard, once received, injuries of the ligamentous apparatus are deprived of support and become obvious

Diagnosis

Diagnosis of uterine prolapse does not raise questions from specialists. To do this, it is necessary to conduct a standard gynecological examination, on the basis of which the stage of prolapse is set and the vaginal section involved in the pathological process is determined.

Most often, there is damage to all three sections of the pelvic floor: anterior, posterior and apical.

In total, four degrees of uterine prolapse are distinguished: the first (initial), when the patient is practically not bothered by anything, the fourth degree is accompanied by a complete prolapse of the pelvic organs.

The study may be supplemented by a digital rectal examination to rule out rectal prolapse.

As instrumental methods, ultrasound of the pelvic organs is performed, and sometimes MRI.

Treatment

Treatment of uterine prolapse includes surgical and conservative methods of treatment.

Conservative methods include:

• Kegel exercises during uterine prolapse are aimed at increasing the tone of the pelvic floor muscles. Due to this, a base appears in the damaged ligamentous apparatus, which prevents the pelvic organs from dropping excessively. Unfortunately, it is quite difficult to perform these exercises correctly, since it is difficult to train what you cannot see and do not control. To solve this issue, biofeedback devices (BFB-therapy) were developed, which increases the effectiveness of exercises several times. This method will be useful for young patients and women after childbirth.
• Pessaries and bandages are designed to create an obstacle in the way of descending organs. When the uterus is lowered, the pessary is placed in the vagina and serves as a kind of spacer. Unfortunately, the presence of a foreign body inside often causes discomfort, chronic inflammation and, most importantly, requires regular visits to the gynecologist to change it. In the case of bandages, it is just tight underwear that does not allow prolapse to come out of the vagina. Sometimes it is combined with a pessary and works like a “cork”. These methods can be used if the operation cannot be done for some reason. This can be compared with a crutch for a limb injury.

Operation

The main method of treatment is still surgical, since the supporting apparatus of the pelvis is not restored. Unfortunately, the most popular method – removal of the uterus often does not help, since not only the uterus descends, but the pelvic organs (bladder, rectum).

For this reason, this approach leads in 30-50% of cases to the development of vaginal stump prolapse.

Another problem of hysterectomy is post-hysterectomy syndrome, which leads to impaired urination, defecation and decreased sexual function, including due to postoperative shortening of the vagina. The most optimal and proven are reconstructive surgeries performed through the vagina. On the one hand, they allow to achieve a good anatomical result, on the other hand, a good cosmetic effect. One of the most modern techniques is hybrid operations, which allow individualizing the operation for each specific patient, while making the most of his own tissues, and, if necessary, supplementing them with a prosthesis only in the busiest places.

Organization of treatment

Hospitalization for the purpose of surgical treatment is carried out according to the principle “one window” . It is enough for the patient (or the person representing him) to write a letter with the wording of his question. At any time (both before hospitalization and after), you can ask questions of interest to the staff of the department.

CHI and VMP treatment

Citizens of the Russian Federation can receive free treatment under the CHI program for most diseases

No matter where you live

80% of patients come to us from the regions of the Russian Federation and countries of near and far abroad

Many years of experience

Every year more than 3000 operations of any complexity are performed in the Department of Urology

At any time (both before hospitalization and after), you can ask questions of interest to the staff of the department.

1. Online consultation with a specialist

The organization of hospitalization for the purpose of surgical treatment is carried out according to the principle of “one window”. To do this, it is enough for the patient (or the person representing him) to write a letter with the wording of his question.

Write a letter

2. Appointment of the date of hospitalization

After the consultation, our administrator will contact you within a few days to make an appointment for hospitalization.

3. Examination before hospitalization

Preoperative examination should be carried out only after the approval of the date of hospitalization. You can get most of the examinations at the antenatal clinic or polyclinic at the place of residence free of charge, under the CHI policy.

If in your locality there is no opportunity to be adequately examined – do it in the regional center, if everything cannot be done within the framework of compulsory medical insurance (under the policy) – do it in paid laboratories (clinics).

NOT LATE THAN 14 DAYS before hospitalization, you must send SCANS (not photographs) of the test results to the email address: [email protected]

4. Hospitalization in department

10 days before surgery it is NECESSARY to stop drugs that affect blood clotting (aspirin, Plavix, warfarin, etc.) unless otherwise agreed with the attending physicians.

It is highly desirable to arrive for surgical treatment with pre-selected and purchased surgical compression stockings (white stockings, antithrombotic 2nd class of compression or as recommended by the vascular surgeon).

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Prolapse of the uterus: symptoms and treatment

• Home
• Uterine prolapse: symptoms and treatment

08/01/2018

Uterus prolapse is a gynecological problem that can affect not so few women as it might seem at first glance. This disease is characterized by a constant increasing displacement of the pelvic organs downward. The prolapse of the uterus brings a lot of inconvenience and discomfort to a woman’s life, so this problem needs to be solved as soon as possible. In this article, we will try to figure out what this disease is and what methods it is customary to treat.

Symptoms of prolapse of the uterus

Prolapse of the walls of the uterus is characterized by the following symptoms:

• Changes in the normal schedule of menstruation. The menstrual cycle begins to move away, or vice versa, it comes much faster than expected.
• Sensation of a foreign body in the vagina. The woman will feel as if her vagina is filled with something. The sensations themselves can be both constant and periodically disappear.
• Painful intercourse. Having sex during prolapse of the uterus can cause both sharp and not the most severe pain. In any case, discomfort will be present.
• Drawing pains in the lower abdomen. The stomach will hurt: not too sharply, but the attacks of pain themselves will be relatively protracted.
• Drawing pains in the loin and sacrum. The back will also suffer from uterine prolapse, so if such a symptom occurs, uterine prolapse should also be suspected.
• Problems with urination. They can appear in completely different ways. Someone begins too frequent urge to go to the toilet, and someone begins to feel pain when urinating.
• Congestion in the urinary organs. This symptom leads to more serious complications, which are characterized by infection of the lower and upper urinary tract.
• Urinary incontinence. Due to problems with urination, uncontrolled urination may begin. At the same time, it can be either spontaneous, without any urge to urinate, or with a preliminary desire to immediately visit the restroom.
• Proctological problems. With prolapse of the uterus, they occur in almost a third of patients. It can be both incontinence of gas and fecal masses, and constipation and colitis.
• Uterine prolapse. If a woman does not turn to doctors in time to cure the prolapse of the uterus, her prolapse may begin. The uterus begins to protrude from the vagina. Its external can be both matte and shiny, and the surface will be matte and covered with abrasions. Actually, a woman will be able to detect such an education on her own, which most often serves as the reason for contacting a doctor.

Causes of uterine prolapse

There are many reasons why uterine prolapse can begin. So, the most common is the slowdown in collagen production in connective tissues. Because of this, the ligaments begin to stretch, which leads to the prolapse of the pelvic organs – both the uterus and the vagina.

Another common cause of uterine prolapse problems is decreased muscle tone. This process is most often observed in pregnant women or in women who have recently given birth. The fact is that during childbirth, a rather serious load is placed on the body, and it is especially strong on the pelvic organs. If optimal tone is lost, the muscles will not be able to prevent the uterus from moving towards the vagina.

Quite often, such problems arise as a result of birth trauma. Cases when a woman receives injuries to the perineum during childbirth are not at all uncommon. If the birth was especially difficult, the abdominal organs can suffer quite a lot, from which uterine prolapse begins.

Changes with age are another reason for prolapse and even prolapse of the uterus. With age, women begin to reduce the production of estrogen, due to which a gradual loss of muscle tone begins. Especially often the prolapse of the uterus manifests itself during menopause.

Uterine prolapse is a common syndrome in overweight women. So, excess body weight creates an additional load on the internal organs. Moreover, chronic disorders of the digestive system (especially constipation) can cause changes in the normal position of the uterus.

Diagnosis of uterine prolapse

If a problem of this nature is detected at an early stage, there is every chance of avoiding surgery and the appearance of more serious and painful symptoms.

Diagnosis of uterine prolapse is combined from several stages:

1. Complete examination of the patient on the gynecological chair,
2. Diagnosis with special equipment,
3. Delivery of laboratory tests.

If the case caused a lot of additional symptoms, the gynecologist can prescribe additional consultations of the proctologist and urologist.

Treatment of uterine prolapse

Treatment of uterine prolapse is a lengthy and complex procedure. So, if the symptoms themselves are relatively frivolous, it is quite possible to get by with Kegel exercises. They will be individually prescribed by the doctor to each patient with similar problems.

If the problem turned out to be sufficiently neglected, surgical intervention is mandatory.