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Understanding Uterine Prolapse: Causes, Symptoms, and Treatment

Elica Ong, Physiotherapist

Uterine prolapse

Uterine prolapse occurs when the pelvic floor muscles and ligaments weaken, losing their ability to support the uterus properly. As a result, the uterus shifts from its original position and may slip into or protrude out of the vagina. This condition is most common in older individuals or those who have experienced multiple vaginal deliveries. Treatment becomes necessary when the prolapse causes discomfort or interferes with daily life.


Symptoms of Uterine Prolapse

The symptoms of uterine prolapse can vary widely from person to person. Some individuals may experience one or more of the following:

  • Heaviness or pressure in the pelvic region

  • A noticeable lump or bulge in the vagina

  • A bulge protruding from the vagina

  • Pain or discomfort during sexual intercourse

  • Difficulty or frequent urination, or the feeling of not fully emptying the bladder

  • Urgency to urinate

  • Urinary incontinence

  • Low back pain

  • Vaginal bleeding

  • Constipation

It’s important to note that the severity of symptoms doesn’t necessarily correlate with the degree of prolapse. If you experience any of these symptoms, it’s crucial to seek medical attention to determine the stage of the prolapse and begin treatment promptly.


Stages of Uterine Prolapse

The severity of uterine prolapse is classified into four stages based on how far the uterus has descended. In some cases, other pelvic organs, such as the bladder or bowel, may also prolapse. According to Better Health Channel (Australia, 2021), the stages are as follows:

  • Stage I: The uterus is in the upper half of the vagina.

  • Stage II: The uterus has descended near the opening of the vagina.

  • Stage III: The uterus protrudes out of the vagina.

  • Stage IV: The uterus is completely outside the vagina.


Treatment Options for Uterine Prolapse

The prognosis for uterine prolapse is generally positive, especially if treated early. Non-invasive treatments are preferred to avoid the need for surgery.


Non-Surgical Treatment Options

  1. Women’s Health Physiotherapy:

    A physiotherapist specializing in women's health will assess your symptoms, lifestyle, and obstetric history. They may perform a pelvic floor muscle exam to determine the strength of your pelvic muscles. A tailored pelvic floor exercise regimen will be recommended to strengthen these muscles, which helps support the uterus and other pelvic organs.


  2. Vaginal Pessary:

    A pessary is a device made of rubber or plastic that fits around the cervix, helping to prop up the uterus and hold it in place. This can be a temporary or long-term solution.


  3. Diet and Lifestyle Changes:

    Incorporating more fiber into your diet can help prevent straining during bowel movements. Maintaining a healthy weight also reduces pressure on the pelvic floor, while regular physical activity helps overall muscle strength.


Surgical Treatment Options

  1. Prolapse Repair with Hysterectomy:

    In more severe cases, a hysterectomy (removal of the uterus) may be necessary as part of the prolapse repair procedure.


  2. Prolapse Repair without Hysterectomy:

    If removal of the uterus is not required, the uterus may be repositioned, and pelvic ligaments may be reattached to support the uterus in its correct place.


Preventing Uterine Prolapse

While factors such as multiple deliveries, menopause, and aging are unavoidable, there are ways to reduce the risk of developing prolapse:

  • Maintain a healthy body weight

  • Perform pelvic floor muscle training regularly

  • Use proper lifting techniques

  • Prevent constipation

  • Follow a balanced diet to support overall health and prevent illnesses like the flu or persistent cough


Conclusion

If you're experiencing any symptoms of uterine prolapse, it’s essential to seek medical advice as soon as possible. Early intervention can significantly improve your quality of life. Start by visiting your gynecologist for a diagnosis. If your condition is in its early stages, a women’s health physiotherapist can provide guidance to support your recovery.

Pelvic floor health is often a neglected topic due to societal taboos surrounding private matters. However, it’s important to remember that talking to a healthcare professional about your symptoms is not only okay—it’s vital. No matter which part of your health it pertains to, your health matters.


Thank you for reading.


Elica Ong

Physiotherapist


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Editor
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Lian Yun-Perng  

UK Qualified Physiotherapist
Bachelor of Physiotherapy

Keele University, United Kingdom
Diploma in Physiotherapy

AIMST University, Malaysia

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