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Last Updated: Oct 23, 2019
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Causes, Symptoms And Diagnosis Of Uterine Prolapse

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Dr. Tripti RahejaGynaecologist • 28 Years Exp.M.R.C.O.G. (LONDON) Gold Medalist, MD - Obstetrics & Gynaecology , MBBS
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The uterus or womb, is a muscular structure and is held in place by ligaments and pelvic muscles. If these muscles or tendons become weak, they cause prolapse and are no longer able to hold the uterus in its place.

Uterine prolapse happens when the uterus falls or slips from its ordinary position and into the vagina or birth waterway. It could be complete prolapse or even incomplete at times. A incomplete prolapse happens when the uterus is just hanging into the vagina. A complete prolapse depicts a circumstance in which the uterus falls so far down that some tissue rests outside of the vagina. Likewise, as a lady ages and with a loss of the hormone estrogen, her uterus can drop into the vaginal canal. This condition is known as a prolapsed uterus.

Causes of Prolapse: The risks of this condition are many and have been enumerated as follows:

  1. Complicated delivery during pregnancy
  2. Weak pelvic muscle
  3. Loss of tissue after menopause and loss of common estrogen
  4. Expanded weight in the stomach area, for example, endless cough, constipation, pelvic tumors or accumulation of liquid in the guts
  5. Being overweight
  6. Obesity causing extra strain on the muscles
  7. Real surgery in the pelvic zone
  8. Smoking

Symptoms: Some of the most common symptoms of prolapse involve:

  1. Feeling of sitting on a ball
  2. Abnormal vaginal bleeding
  3. Increase in discharge
  4. Problems while performing sexual intercourse
  5. Seeing the uterus coming out of the vagina
  6. A pulling or full feeling in the pelvis
  7. Constipation
  8. Bladder infections

Nonsurgical medications include:

  1. Losing weight and getting in shape to take stress off of pelvic structures
  2. Maintaining a distance from truly difficult work
  3. Doing Kegel workouts, which are pelvic floor practices that strengthen the vaginal muscles. This can be done at any time, even while sitting down at a desk.
  4. Taking estrogen treatment especially during menopause
  5. Wearing a pessary, which is a gadget embedded into the vagina that fits under the cervix and pushes up to settle the uterus and cervix
  6. Indulging in normal physical activity

Some specialists use the following methods to diagnose the problem:

  1. The specialist will examine you in standing position keeping in mind you are resting and request that you to cough or strain to build the weight in your abdomen.
  2. Particular conditions, for example, ureteral block because of complete prolapse, may require an intravenous pyelogram (IVP) or renal sonography. Color is infused into your vein, and an X-ray is used to view the flow of color through your urinary bladder.
  3. An ultrasound might be utilised to rule out any other existing pelvic issues. In this test, a wand is used on your stomach area or embedded into your vagina to create images of the internal organ with sound waves.

Treatment

If you have mild uterine prolapse, either without symptoms or with symptoms that don't bother you, you probably don't need treatment. However, your pelvic floor may continue to lose tone, making uterine prolapse more severe as time goes on. Check with your doctor to monitor the extent of your prolapse and review your symptoms.

For advanced cases of uterine prolapse, treatment options include:

  1. Vaginal pessary. This device fits inside your vagina and holds your uterus in place. Used as temporary or permanent treatment, vaginal pessaries come in many shapes and sizes. Your doctor measures and fits you for the proper device. You'll learn how to insert, remove and clean the pessary. A pessary also can irritate vaginal tissues, possibly to the point of causing sores (ulcers) on vaginal tissues, and it may interfere with sexual intercourse.
  2. Surgery. To repair damaged or weakened pelvic floor tissues, your surgeon may perform the procedure through your vagina, although sometimes an abdominal surgery is needed. Surgical repair of your prolapse may involve grafting your own tissue, donor tissue or some synthetic material onto weakened pelvic floor structures to support your pelvic organs. Your surgeon may recommend a hysterectomy, which removes your uterus. In some cases, minimally invasive (laparoscopic) surgery is a possibility. This procedure involves smaller abdominal incisions, special surgical instruments and a lighted camera-type device (laparoscope) to guide the surgeon. Which surgery and surgical approach the doctor recommends depends on your individual needs and circumstances. Each procedure has pros and cons that you'll need to discuss with your surgeon.

If you plan future pregnancies, you might not be a good candidate for surgery to repair uterine prolapse. Pregnancy and delivery of a baby put strain on the supportive tissues of the uterus and can undo the benefits of surgical repair. Also, for women with major medical problems, the causes of surgery might outweigh the benefits. In these instances, pessary use may be your best treatment choice for bothersome symptoms. If you wish to discuss about any specific problem, you can consult a gynaecologist.

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