What is prolapse?

In medical terms, ‘Prolapse’ is a condition where the organs fall down or move out of their original place. Though prolapse is used to refer to conditions when organs fall through vagina or rectum, it can also refer to the valves that gets misaligned in the heart.  Even a slip disc is referred to prolapse.

Types of Prolapse: (Limiting to Gynecology)

  1. Rectocele
  2. Rectal Prolapse
  3. Cystocele
  4. Uterine Prolapse

Uterine Prolapse

Uterus/womb, fallopian tubes, ovaries, the cervix and the vagina – all of these are held together in their respective positions by the muscles, tissues in the pelvis region. When these muscles become weak because of continuous stress, child birth, hereditary reasons etc, these organs tend to fall off from their place and cause the prolapse condition.

Same is the case with Uterus/womb of a woman. When the tissues around the uterus become weak and incapable of holding it in it’s place, this falls down and this falls through the vagina. Such a condition is termed as ‘Uterine Prolapse’. In severe cases, this uterus can come out (protrude) through the vaginal opening. Uterine Prolapse is a very common condition among women above the age of 50 who has a weaker pelvis region. Overweight or obese women are at higher risk of acquiring this condition.

Complete Uterine Prolapse –

This is a severe condition when the prolapsed uterus falls through the vagina and comes out.

Incomplete Uterine Prolapse –

In this case, uterus is displaced from it’s original place but it doesn’t fall through / protrude.

Severity of Uterine Prolapse Condition:

Grade 1 – Uterus descends into upper vagina.-

Grade 2 – Uterus descends into the vagina till the entry/opening

Grade 3 – Cervix (The organ connected to Uterus, located below it) descends out of the vagina.

Grade 4 – Cervix and Uterus descend outside the vagina.

Symptoms of Uterine Prolapse:

  1. Heaviness in the pelvis region with a feeling of something pulling down or sliding.
  2. Increased vaginal discharge or bleeding.
  3. Problem having sex, Urinary leakage, bladder infections
  4. Constipation – problem with bowel movement
  5. Lower back pain
  6. In Grade 3 and Grade 4 cases, one can notice the cervix and/or vagina coming through the vagina
  7. Sometimes, the person may have a feeling of sitting on a ball or balloon.

Diagnosis:

A physical examination will be performed on the patient to assess the severity of the condition. An Ultrasound or MRI may be requested in some cases and appropriate treatment method may be suggested/followed.

How a woman can avoid the risk of Uterine Prolapse:

  1. Work out – especially performing Kegels exercise to strengthen pelvic muscles.
  2. If you have constipation problem, get it treated.
  3. Avoid lifting heavy weights.
  4. If you have severe cough or bronchitis, get it treated immediately.
  5. Maintain weight and keep an eye on what you eat. Weight management is important.
  6. Estrogen replacement therapy in cases where estrogen levels fall below required levels.

Treatment options for Uterine Prolapse at Urogynecology Clinic:

Grade 1, and 2 may be resolved easily. However in cases of Grade 3 and 4, your urogynecologist may have couple of options:

  1. Vaginal Pessary – Vaginal Pessary is a device inserted into the vagina to hold the uterus in it’s place. Utmost care needs to be taken care with insertion, removal of the pessary. If the condition of uterine prolapse becomes severe, this pessary can cause irritation, ulceration and sexual problems.
  2. Surgery – Removal of Uterus may be advised depending on the condition you have and your age and your family plans of bearing children. This procedure may be performed through the Vagina or by hysterectomy.