Dr. Lata M. Dandekar

Your uterus is held in place by ligaments, tissues and pelvic muscles. The prolapse occurs when the ligaments or muscles weaken, and thus they can no longer support the uterus. The uterus slips or sags from its usual position into the birth canal (vagina).

Uterine prolapse could be complete or incomplete:

• If the uterus partly sags into the vagina, the prolapse is incomplete.
• If the uterus falls, and tissues are found to be resting in the vagina's exterior, the prolapse is termed 'complete'

Type of Prolapse:

1. Cystocele: It is characterized by the herniation (bulging) of the vaginal wall caused by the bladder; it leads to urination problems
2. Enterocele: It is characterized by the bulging on the vaginal wall caused by the bowel; it leads to backache
3. Rectocele: If the rectum pushes into the vaginal wall, it makes movement in bowels difficult

Causes:
Uterine prolapse can be caused by any of the following factors:

• Normal childbirth through the vagina weakens muscles
• Pelvic muscles weaken with age
• Tissues weaken after menopause and oestrogen loss
• Chronic cough, constipation, pelvic tumours or abdominal fluid accumulation puts a lot of pressure on the abdomen leading to prolapse
• Pelvic muscles are stressed if you are obese or overweight
• Major pelvic (or areas around it) surgery leads to loss of muscular support
• Smoking
• Excessive weight lifting causes weakening of muscles

Symptoms:
Symptoms of uterine prolapse depend on its severity. There are no symptoms or signs if you have mild uterine prolapse. But if you have moderate to severe uterine prolapse, you might experience the following symptoms:

1. Sensation of pulling or heaviness in the pelvis
2. Tissue bulges out of your vagina
3. Urinary problems like urine retention or urine leakage
4. Bowel movement difficulties
5. Pain in lower back
6. Sexual problems such as vaginal tissues feeling loose

Symptoms might feel less distressing during the morning, but they worsen at night. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

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