Uterıne Prolapse Treatment
What is Uterine Prolapse Treatment?
Uterine prolapse treatment refers to the correction of issues caused by the uterus slipping into the vagina due to the weakening of pelvic floor muscles and connective tissues. Pelvic floor exercises strengthen these muscles and support the uterus. Kegel exercises, especially when done regularly, can prevent prolapse and alleviate symptoms. These devices are inserted into the vagina and control prolapse without requiring surgical intervention. Hormone therapy may be recommended for postmenopausal women, as declining estrogen levels can weaken vaginal tissues. This treatment helps strengthen vaginal tissues.
Generally, as uterine prolapse progresses, uterine prolapse treatment may be necessary. These procedures include sling surgeries to support the uterus or hysterectomy, which involves complete removal of the uterus. Lifestyle changes are also essential for prevention or symptom relief. Reducing pressure on the pelvic floor can be achieved by losing excess weight, avoiding heavy lifting, and managing chronic cough. A fiber-rich diet can prevent constipation and relieve the pelvic floor muscles.
What is Uterine Prolapse?
Uterine prolapse refers to the condition where the uterus moves downward from its normal position in the pelvis. The uterus is usually held in place by various muscles, ligaments, and supportive tissues. However, in some cases, these supportive structures weaken or loosen, causing the uterus to descend or prolapse. Uterine prolapse is often associated with aging, childbirth, excessive weight, chronic constipation, or heavy lifting. Symptoms may include a feeling of pelvic pressure, urinary incontinence, pain during intercourse, and a noticeable bulge in the pelvic organs. Treatment options include pelvic floor exercises, supportive devices, hormone therapy, or surgical intervention.
What Causes Uterine Prolapse?
The causes of uterine prolapse, where the uterus descends into or out of the vagina, include a history of vaginal childbirth, delivering a large baby, and multiple pregnancies. Prolapse may occur immediately after childbirth or develop over the years. One-third of women who have given birth vaginally experience some degree of uterine prolapse. Women who frequently lift heavy objects for work, suffer from chronic coughing due to allergies or other medical conditions, or experience persistent constipation are also at risk of developing uterine prolapse.
Additionally, women with estrogen deficiency, those who have undergone vaginal surgery, those with lung disease, obesity, advanced age, menopause, or excessive body weight have a higher risk of uterine prolapse. Certain medical conditions can also contribute to uterine prolapse. Diseases that affect connective tissue, such as Ehlers-Danlos and Marfan syndromes, can increase the likelihood of prolapse. Women with these conditions are genetically predisposed to developing uterine prolapse.
Symptoms Requiring Uterine Prolapse Treatment
Uterine prolapse is generally classified into three levels based on severity: mild, moderate, and severe. Mild prolapse does not usually cause significant discomfort and may not require treatment. However, when the prolapse starts interfering with daily activities—progressing to a moderate or severe stage—it may cause various discomforts or complications. These symptoms are often more noticeable as the day progresses. While uterine prolapse is more common in postmenopausal women and those who have had multiple vaginal births, it can also occur in younger women.
Some of the symptoms include:
- A feeling of heaviness in the pelvic area or a bulging sensation inside or outside the vagina
- A pulling sensation in the vagina or lower abdomen
- Tissue protruding from the vagina
- Vaginal bleeding or increased discharge
- Frequent urination
- A feeling of incomplete bladder emptying
- Slowed urine flow
- Recurring bladder infections
- Urine leakage during sneezing or coughing
- Difficulty in bowel movements
- Discomfort or pain during sexual intercourse
How is Uterine Prolapse Treated?
Depending on the patient’s condition and the severity of prolapse, various treatment methods can be used. The first recommendation is Kegel exercises to strengthen the pelvic floor muscles. These exercises, which involve contracting and relaxing the pelvic floor muscles, can slow or alleviate uterine prolapse.
Vaginal pessaries may also be used. Pessaries are silicone devices inserted into the vagina to help keep the uterus in place. Many patients prefer this method as it does not require surgical intervention. Regular cleaning and maintenance of pessaries are necessary to reduce the risk of infection.
Due to declining estrogen levels after menopause, vaginal tissues may weaken, making hormone therapy an option. Local estrogen therapy, applied in the form of vaginal rings or creams, can strengthen tissues and alleviate prolapse symptoms.
In more advanced cases of uterine prolapse, surgical intervention may be required. Surgical treatment options include sling procedures to support the uterus or hysterectomy, which involves the complete removal of the uterus. Sling procedures use the patient’s own tissues or synthetic materials to reinforce the pelvic floor muscles and ligaments. Hysterectomy is typically considered in severe cases of uterine prolapse.
Lastly, lifestyle modifications are crucial in preventing uterine prolapse. Reducing pressure on the pelvic floor by losing excess weight, avoiding heavy lifting, and managing chronic cough can help. A fiber-rich diet can prevent constipation and relieve strain on the pelvic floor muscles.
How is Uterine Prolapse Diagnosed?
Several symptoms can help identify uterine prolapse. The most common initial sign is a sensation of pressure or heaviness in the vaginal area. Women often feel this pressure more while sitting or standing.
A noticeable bulge or protrusion from the vagina is another common symptom. Some women can feel this bulge themselves or notice it while moving. In severe cases, the uterus may protrude from the vagina.
Urinary issues such as incontinence or difficulty urinating may also occur. The displacement of the bladder from its normal position can cause frequent urges to urinate, difficulty urinating, or an inability to completely empty the bladder. Similarly, digestive issues such as constipation or difficulty emptying the bowels may arise.
Another symptom is discomfort or pain during sexual intercourse. Weak pelvic floor muscles can cause pain during sex, increasing the likelihood of uterine prolapse.
Exercises for Uterine Prolapse
Exercises that strengthen the pelvic floor muscles are highly effective in preventing and treating uterine prolapse. These simple exercises involve contracting and relaxing the pelvic muscles. When performed regularly, they can stop or alleviate prolapse. Recommended exercises for uterine prolapse include:
Kegel Exercises
- Identify the right muscles by stopping urination midstream.
- Contract the muscles for 5 seconds, then relax for 5 seconds. Repeat this process ten times.
- Perform this exercise three times a day to strengthen the muscles.
Pelvic Tilt Exercises
- Lie on your back with your knees bent and feet flat on the floor.
- Gently lift your pelvis off the ground, hold for a few seconds, then lower it back down.
- Repeat this exercise ten times, three times a day.
Is Uterine Prolapse Surgery Difficult?
Surgical procedures for uterine prolapse vary based on the patient’s condition and the severity of prolapse. These surgeries are generally not considered highly complex, but, like any surgical intervention, they carry some risks. Most modern techniques are minimally invasive, allowing for a shorter recovery time.
In severe cases, a hysterectomy may be required, which can have a longer recovery period. Postoperative care is crucial for a successful recovery, including avoiding heavy lifting and strenuous activities.
Using Vaginal Pessaries for Uterine Prolapse
Vaginal pessaries are silicone devices used to keep the uterus in place without surgery. They must be cleaned and maintained regularly. This method is ideal for patients who are not suitable for surgery or wish to delay the procedure.