Uterine prolapse occurs when the uterus slips out of place and into the vaginal canal. The severity of uterine prolapse is defined as: First degree—the cervix protrudes into the lower part of the vaginaSecond degree—the cervix protrudes past the vaginal openingThird degree—the entire uterus protrudes past the vaginal opening
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The uterus is normally supported by pelvic connective tissue. It is held in position by special ligaments.
Weakening of the tissue causes the uterus to descend into the vaginal canal.
Symptoms may include: Pelvic pressureA feeling of vaginal fullness or heavinessA feeling of pulling in the pelvisVaginal dischargeUrinary urgency and frequencyUrination when laughing, sneezing, coughing, or exercisingProtrusion of pink tissue from the vagina that may be irritated or itchy
You will be asked about your symptoms and medical history. A physical exam will be done. Uterine prolapse without symptoms may be diagnosed during routine examinations. Your doctor may refer you to a gynecologist, who will do a pelvic exam.
Talk with your doctor about the best treatment plan for you. First or second degree prolapse without symptoms may not require treatment. Treatment options include:
involve tensing the muscles around the vagina and anus, holding for several seconds, then releasing. The repetition of this exercise will help to tone pelvic muscles.
Your doctor may recommend estrogen therapy. This may help prevent further weakness of the pelvic floor.
Your doctor may insert a pessary into the upper portion of the vagina. A pessary is a rubbery, doughnut-shaped device. It helps to prop up the uterus and bladder. Pessary placement is more often used in older women.
Surgery may be needed for severe uterine prolapse. These procedures are usually not done until you have finished having children. Options include: Hysterectomy—This is the removal of the uterus. This will permanently resolve uterine prolapse.
Vaginal repair—This is usually done with a hysterectomy. The repair can be done with sutures or with insertion of mesh and slings.Colpocleisis—This involves closing the vagina. It is done only in women who are elderly and who are no longer sexually active.
To help reduce your chance of uterine prolapse:
Maintain a healthy weight.To avoid constipation, eat plenty of fruits, vegetables, and whole grains. Drink plenty of fluids throughout the day.
If you smoke,
talk to your doctor about ways to quit
. Smoking may cause chronic coughing and weakening of connective tissues.
Limit heavy lifting.
Pelvic organ prolapse. International Urogynecological Association website. Available at:
http://c.ymcdn.com/sites/www.iuga.org/resource/resmgr/Brochures/eng_pop.pdf. Published 2011. Accessed March 23, 2016.
Uterine and vaginal prolapse. The Merck Manual Professional Edition. Available at:
Updated December 2013. Accessed March 8, 2016.
Vaginal pessary. Family Doctor—American Academy of Family Physicians website. Available at:
http://familydoctor.org/familydoctor/en/drugs-procedures-devices/procedures-devices/vaginal-pessary.html. Updated May 2015. Accessed March 8, 2016.
10/21/2008 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Shariati A, et al. High-fiber diet for treatment of constipation in women with pelvic floor disorders.
Last reviewed March 2016 by Mike Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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