Prolapsed uterus refers to the sliding or the falling of the uterus from its normal position in the pelvic cavity into the vaginal canal.
The uterus in normal conditions is held in its position by the pelvic muscles, ligaments and other tissues. The falling of the uterus in the vaginal canal takes place when these muscles and other supporting tissues weaken. This is generally seen in women who have had one or more vaginal births.
– Prolapsed uterus can happen as a normal ageing process or after menopause due to lack of estrogen hormone.
– Conditions like obesity or chronic cough also increase the chances of developing a prolapsed uterus as these conditions increase the pressure on the pelvic floor.
-This can also occur due to a tumor of the pelvis.
Condition like chronic constipation causes a constant pressure on the uterus which will worsen the condition.
-lower back pain
-pain during intercourse
-repeated bladder infections
-pulling sensation in the pelvis
-sudden urge to empty the bladder
-protruding uterus from the cervix of the vagina
-increased vaginal discharge
These symptoms worsen on sitting for a long time or standing.
A pelvic examination is performed. Prolapsed uterus can either be mild or moderate. It is considered mild when the uterus drops in the lower part of the vagina and is moderate when it drops out of the vaginal opening. A pelvic examination also shows that the cystocele and the retrocele which are the front n the back wall of the vagina respectively, are entering the vaginal area. Even the bladder is seen to be positioned lower than normal.
Prolapsed uterus can be treated either by surgery or vaginal pessary. Treatment for the prolapsed uterus is generally not necessary unless the symptoms get bothersome for the patient.
Surgery is done in severe cases. The type of surgery depends on the following things like:
-desire for future pregnancy
-degree of prolapse
-general health condition of the women
-other medical conditions
Surgical procedures like vaginal hysterectomy or sacrospinous fixation can be done without the removal of the uterus.
Vaginal pessary is a form of permanent or a temporary treatment. In this procedure a donut shaped rubber or a plastic device is inserted into the vagina to hold the uterus correctly in place. These are fitted individually for each woman. They are taught how to insert, clean and wear this device. There might be some amount of pain and discomfort to the vaginal mucosa which may cause damage in certain cases also an abnormal smelling discharge from the vagina is sometimes seen, which might need cleaning from a doctor or the nurse.
Vaginal pessary has shown excellent results in most women. For women who have had a surgery also show good results but may require some treatment in the future.
Certain lifestyle changes are recommended in women with prolapsed uterus like:
-weight loss in obese women
-coughing can worsen the symptoms so preventive measures should be taken for chronic cough.
-activities like lifting or straining should be avoided as they worsen the symptoms.
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