Uterine prolapse

Overview

Uterine prolapse is when the uterus drops toward or into the vagina.  It happens when the pelvic floor muscles and ligaments become weak and cannot hold the uterus in its natural anatomical location.

The pelvic floor muscles support the uterus, rectum, vagina, bladder, and other pelvic organs. Commonly, this area weakens due to age and vaginal birth. Uterine prolapse mostly affects women after menopause.

Uterine prolapse is categorize into two: incomplete and complete. Incomplete uterine prolapse occurs when the uterus partially descends in the vagina but has not protruded yet.  Whereas, complete prolapse happens when the uterus falls far enough that it protrudes outside the vagina.
Uterine prolapse is also classified according to its severity. Stage I is when the uterus slips in the upper vaginal area. Stage II is when it falls in the lower vaginal area. In Stage III, the uterus protrudes out of the vagina. In Stage IV, the uterus is fully out of the vagina.

In most cases, uterine prolapse is mild with no symptoms. However, the condition may change overtime and may affect a person’s daily activities.  In severe cases, treatments may be necessary to restore quality of life.

Symptoms

Symptoms of uterine prolapse varies in the severity of condition. Typically, prolapse from childbirth is mild and has no symptoms. If a prolapse develops and worsen, common symptoms include:

• Bulging in the vagina
• Feeling of sitting on a small ball
• Feeling of heaviness and pulling in the pelvis
• Leaking of urine or incontinence
• Difficulty having bowel movement
• Inability to completely empty the bladder
• Pelvis and lower back pain
• Sensation that the vaginal tissue is rubbing on clothing
• Discomfort or pain during sexual intercourse

Moderate to severe cases of uterine prolapse can cause discomfort. If the person experiences any symptoms, visit a healthcare provider for proper diagnosis. Several treatments are available depending on the severity of the condition.

Causes

Pelvic floor muscles and ligaments supports the uterus. Uterine prolapse happens when the connective tissue is damaged or weakened. The pelvic muscles can deteriorate due to several reasons, such as:

• Vaginal childbirth, having many vaginal delivery
• Delivering a large baby
• First delivery age (increased risk for older women)
• Trauma or difficulty during childbirth
• Obesity
• Lower estrogen level due to menopause
• Long-term constipation, straining of bowel movement
• Chronic coughing or straining
• Repeated heavy lifting

Risk factors

Risk factors of uterine prolapse include:

• Multiple vaginal delivery
• Having first baby at an older age
• Giving birth to a large baby
• Age
• Obesity
• History of pelvic surgery
• Genetics (family history of weak connective tissue)
• Ethnicity, being Hispanic or white
• Increased abdominal pressure (cough, chronic constipation, heavy lifting)