Summary about Disease
Uterovaginal prolapse occurs when the uterus and/or vaginal walls descend from their normal position in the pelvis. This happens when the pelvic floor muscles and ligaments that support these organs weaken or become damaged. The prolapse can range in severity from a mild descent to a complete protrusion of the uterus or vagina outside of the vaginal opening. The condition can affect quality of life and daily activities.
Symptoms
Symptoms of uterovaginal prolapse can include:
A feeling of heaviness or pressure in the pelvis or vagina
A sensation of "something falling out" of the vagina
Difficulty with urination (e.g., urinary frequency, urgency, incomplete emptying, urinary retention)
Difficulty with bowel movements (e.g., constipation, feeling of incomplete evacuation)
Lower back pain
Painful intercourse
Vaginal bleeding or spotting
Difficulty walking or sitting comfortably
Recurrent bladder infections
Causes
Factors that can weaken pelvic floor muscles and increase the risk of uterovaginal prolapse include:
Pregnancy and childbirth (especially multiple vaginal deliveries or large babies)
Aging (leading to natural loss of muscle strength and elasticity)
Obesity
Chronic coughing (e.g., from smoking or chronic lung disease)
Chronic constipation and straining during bowel movements
Heavy lifting
Family history of prolapse
Prior pelvic surgery
Estrogen deficiency after menopause
Medicine Used
Treatment options and medications may include:
Pessaries: These are supportive devices inserted into the vagina to help support the prolapsed organs.
Estrogen Therapy: Vaginal estrogen creams or tablets can help strengthen vaginal tissues, especially in postmenopausal women.
Pain Relievers: Over-the-counter or prescription pain medications may be used to manage pain.
Surgery: Surgical options may include:
Uterine-sparing procedures: Procedures to restore the uterus to its proper position.
Hysterectomy: Removal of the uterus, often combined with vaginal wall repair.
Vaginal wall repair: Procedures to tighten the vaginal walls.
Is Communicable
Uterovaginal prolapse is not a communicable disease. It is not caused by an infection and cannot be spread from person to person.
Precautions
Precautions and lifestyle modifications that can help prevent or manage uterovaginal prolapse include:
Performing Kegel exercises to strengthen pelvic floor muscles
Maintaining a healthy weight
Avoiding heavy lifting
Treating chronic cough and constipation
Using proper lifting techniques
Estrogen replacement therapy (if appropriate for postmenopausal women, after consulting with a healthcare provider)
How long does an outbreak last?
Uterovaginal prolapse is not an "outbreak" type of condition. It is a chronic condition that can gradually worsen over time if left untreated. Symptoms can fluctuate depending on activity level and other factors.
How is it diagnosed?
Uterovaginal prolapse is typically diagnosed through a:
Pelvic examination: A physical exam to assess the position of the uterus and vaginal walls. This is often performed while the patient is bearing down (straining) to accentuate the prolapse.
Medical history: Discussion of symptoms, risk factors, and past medical conditions.
Possible additional tests: In some cases, imaging studies (such as ultrasound or MRI) or urodynamic testing (to assess bladder function) may be recommended.
Timeline of Symptoms
The development of symptoms can vary. Some women may experience a gradual onset of symptoms over years, while others may experience a more rapid progression.
Early Stages: Mild pelvic pressure or heaviness, sometimes noticed only after prolonged standing or activity.
Progressive Stages: Increased pelvic pressure, sensation of a bulge in the vagina, urinary or bowel symptoms may develop or worsen.
Advanced Stages: Protrusion of the uterus or vagina outside of the vaginal opening, significant impact on daily activities.
Important Considerations
Uterovaginal prolapse can significantly impact a woman's quality of life.
Treatment should be individualized based on the severity of the prolapse, the woman's age, overall health, and personal preferences.
It is crucial to seek medical attention if you suspect you have uterovaginal prolapse.
Pelvic floor physical therapy can be a beneficial non-surgical treatment option.
Open communication with your healthcare provider is important for determining the best course of management.