Uterine Prolapse: From Prevention to Management

Uterine prolapse is a condition where the pelvic muscles and tissues supporting the uterus weaken, causing it to drop into the vagina. It affects those assigned female at birth, particularly after menopause or multiple vaginal deliveries.

Pelvic floor muscles support the uterus, rectum, bladder, and vagina.

What is Uterine Prolapse?

Uterine Prolapse occurs when these muscles weaken, unable to support organs, leading them to descend into the vagina.

The severity of a prolapse varies: mild cases show the uterus partly in the vagina, forming a lump; severe cases result in complete prolapse, where the uterus protrudes from the vagina. 

What are the Types of Uterine Prolapse?

Uterine prolapse is categorised into four stages based on severity:

• Grade 1 (Mild): Uterus begins descending into the vagina.
• Grade 2 (Moderate): Uterus descends further but doesn’t protrude outside.
• Grade 3 (Severe): Uterus protection rudes outside the vaginal opening during activities.
• Grade 4 (Complete): The uterus is completely outside the vagina, visible as a bulge.

What are the Symptoms of Uterine Prolapse?

Having a mild case of uterine prolapse may not initially present obvious signs/symptoms, but as it progresses, symptoms can become more noticeable, including:

•  A sensation of heaviness, fullness, or pressure in the pelvis.
•   Pelvic, abdominal, or lower back pain.
• Uterine tissue protrudes through the vaginal opening.
• Difficulty inserting tampons or other vaginal applicators.
• Constipation.
• Urination issues such as leakage (incontinence), frequent urination, or sudden urges to urinate.

These symptoms often worsen with prolonged standing or walking and during coughing or sneezing due to increased pressure on pelvic muscles caused by gravity. Getting medical guidance is essential for managing a condition appropriately.

What are the Causes of Uterine Prolapse?

The position of your uterus in the pelvis is maintained by a network of muscles and ligaments known as pelvic floor muscles. If these structures weaken, they may no longer adequately support the uterus, causing it to droop or sag. Various factors can contribute to the weakening of pelvic muscles, including:

• Decreased muscle tone due to menopause.
• Pregnancy.
• Vaginal childbirth, particularly after multiple or large babies (over 9 pounds).
• Obesity.
• Persistent coughing or straining.
• Chronic constipation.
• Regularly lifting heavy objects.
• Prolapse Grading

Based on findings, prolapse severity is categorised (Stage 0 to III) to guide treatment decisions:

• Pelvic Ultrasound:Offers detailed images of pelvic organs to assess prolapse extent.
• Cystoscopy: Examines the bladder and urethra for abnormalities.
• MRI or CT scan: Provides in-depth pelvic anatomy visualisation for complex cases.

FAQ’s About Uterine Prolapse

Can Uterine Prolapse be Reversed Without Surgery?

Mild cases of uterine prolapse may improve with pelvic floor exercises (Kegels), lifestyle changes, and the use of pessaries. Severe cases often require surgical intervention for full reversal.

Are there any Exercises to Avoid with Uterine Prolapse?

Avoid high-impact exercises like jumping, heavy lifting, or exercises that strain the pelvic floor, such as certain yoga poses or sit-ups. Focus on low-impact activities and pelvic floor exercises instead.

How Long does Recovery take After Uterine Prolapse Surgery?

Recovery after uterine prolapse surgery varies but typically takes 4-6 weeks for physical healing. Full recovery may take several months, including pelvic floor rehabilitation and a gradual return to normal activities.