Uterine prolapse


Uterine prolapse

Description, Causes and Risk Factors:

Uterine prolapse

Uterine prolapse is the protrusion of the body and/or one or both horns of the uterus through the cervix and vulva. Although relatively uncommon, this complication can occur while the cervix is dilated during or after the delivery of pups or abortion of a litter.

The causes of uterine prolapse are many, some obvious and some not.

    Excessive straining while trying to pass an abnormally large body or retained placenta or fetus would be the most common.

  • Weakening and loss of tissue tone after menopause and loss of natural estrogen.

  • Conditions leading to increased pressure in the abdomen such as chronic cough, straining, pelvic tumors, accumulation of fluid in the abdomen.

  • Being overweight.

  • Radical surgeries in the pelvic area leading to loss of external support.

The exact prevalence of uterine prolapse is difficult to determine. However, it is estimated that the lifetime risk of requiring at least 1 operation to correct incontinence or prolapse is approximately 11-12%.

Preventive measures:

    Reduce weight.

  • Avoid constipation by eating a high-fiber diet.

  • Do Kegel exercises to strengthen the pelvic muscles.

  • Avoid heavy lifting or straining.

Symptoms:

Symptoms may include,

    Difficult or painful sexual intercourse.

  • Frequent urination or a sudden urge to empty the bladder.

  • Low backache.

  • Uterus and cervix that stick out through the vaginal opening.

  • Repeated bladder infections.

  • Feeling of heaviness or pulling in the pelvis.

  • Vaginal bleeding.

  • Increased vaginal discharge.

Diagnosis:

The healthcare professional can diagnose uterine prolapse with a medical history and complete physical examination of the pelvis.

    The doctor may need to examine the patient in standing position as well as while she is lying down and ask her to cough or strain to increase the pressure in the abdomen.

  • Specific conditions, such as ureteral obstruction due to complete prolapse, may need an intravenous pyelogram (IVP) or renal sonography. In an IVP, dye is injected into a vein, and a series of X-rays are taken to view its progress through the urinary tract.

  • Ultrasound may be used to rule out other pelvic problems. In this test, a sensor device is passed over the abdomen or inserted into the vagina to create images with sound waves.

  • Sometimes, other imaging tests such as MRI (magnetic resonance imaging) may be used to accurately image the pelvis.

Treatment:

Treatment is not necessary unless the symptoms bother you. Many women seek treatment by the time the uterus drops to the opening of the vagina.

Treatment options:

LIFESTYLE CHANGES

    Weight loss is recommended in obese women with uterine prolapse.

  • Heavy lifting or straining should be avoided, because they can worsen symptoms.

  • Coughing can also make symptoms worse. If you a chronic cough, ask your doctor how to prevent or treat it. If you smoke, try to quit. Smoking can cause a chronic cough.

VAGINAL PESSARY

    Your doctor may recommend placing a rubber or plastic donut-shaped device, called a pessary, into the vagina. This device hold the uterus in place. It may be temporary or permanent. Vaginal pessaries are fitted for each individual woman. Some are similar to a diaphragm used for birth control.

  • Pessaries must be cleaned from time to time, sometimes by the doctor or nurse. Many women can be taught how to insert, clean, and remove the pessary herself.

Side effects of pessaries include:

    Foul smelling discharge from the vagina.

  • Irritation of the lining of the vagina.

  • Ulcers in the vagina.

  • Problems with normal sexual intercourse and penetration.

SURGERY

Surgery should not be done until the prolapse symptoms are worse than the risks of having surgery. The specific type of surgery depends on:

    Degree of prolapse.

  • Desire for future pregnancies.

  • Other medical conditions.

  • The women's desire to retain vaginal function.

  • The woman's age and general health.

Often, a vaginal hysterectomy is used to correct uterine prolapse. Any sagging of the vaginal walls, urethra, bladder, or rectum can be surgically corrected at the same time. There are some surgical procedures that can be done without removing the uterus, such as a sacrospinous fixation. This procedure involves using nearby ligaments to support the uterus.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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