Uterine Prolapse

• Incomplete prolapse: In an incomplete prolapse, the uterus is partially displaced into the vagina, but does not protrude. 
• Complete prolapse: Incomplete prolapse, the uterus falls far down and some portion of it protrudes outside of the vagina.

• 1st grade: The uterus has descended to the upper half of the vagina.
• 2nd grade: The uterus has descended close to the opening of the vagina.
• 3rd grade: The cervix has descended outside the vagina.

• Bearing down as if having a bowel movement. This helps the doctor assess how far the uterus has slipped into the vagina.
• Tightening the pelvic muscles as if halting a stream of urine. This helps to determine the strength of the pelvic muscles.
• An ultrasound or MRI may also be requested to assess the severity of the prolapse.

• Repair of weakened pelvic floor tissues: This surgery is usually approached through the vagina but sometimes it is approached through the abdomen. The patient’s tissue, donor tissue, or a synthetic material might be grafted onto weakened pelvic floor structures to support the pelvic organs.

Symptoms

Mild cases of uterine prolapse generally doesn't cause symptoms. Moderate to severe uterine prolapse symptoms include:

• A sensation of heaviness or pulling in the pelvis.
• Tissue protrusion from the vagina.
• Urinary problems; for instance, urine leakage, urine retention or bladder infections.
• Trouble with bowel movement.
• Feeling like you're sitting on a small ball or that something is falling out of your vagina.
• Vaginal bleeding or an increased vaginal discharge. 
• Lower back pain.
• Weakened vaginal tissue.
• Problems with having sex.

Causes

Uterine prolapse is as a results of weakened pelvic muscles and supportive tissues, which could be due to:

• Pregnancy.
• Difficult labour and delivery, or trauma during childbirth.
• Delivering a large baby.
• Overweight or obesity.
• Low oestrogen level after menopause.
• Chronic constipation or strained bowel movements.
• Chronic cough or bronchitis.
• Frequent heavy lifting.
• Normal aging.
• Pelvic tumour (in rare cases though).
• Fibroids.

FAQ

What are the possible risk factors for uterine prolapse? 

The following are factors that can increase the risk of uterine prolapse;

• One or more pregnancies and vaginal births.
• Birth of a large baby.
• Aging.
• Obesity.
• Previous pelvic surgery.
• Chronic constipation or repeated straining in the course of bowel movements.
• Family history of weakness in connective tissues.
• Being Hispanic or white.
• Chronic cough.

Are there any complications from uterine prolapse? 

Uterine prolapse is commonly associated with prolapse of other pelvic organs. Therefore, those with uterine prolapse might experience:

• Anterior prolapse (cystocele): Weakness of the connective tissue that separates the bladder and the vagina may cause the bladder to protrude into the vagina. This is also known as prolapsed bladder.
• Posterior vaginal prolapse (rectocele): Weakness of the connective tissue that separates the rectum and the vagina may cause the rectum to protrude into the vagina. This may lead to difficulty with bowel movements.
• In severe cases of uterine prolapse part of the vaginal lining can be displaced, causing it to protrude outside the body. When the vaginal tissue rubs against clothing, it may lead to vaginal sores (ulcers). The sores, though rarely, can become infected.

How can I prevent a uterine prolapse? 

To reduce the risk and prevent the occurrence of uterine prolapse, the following may be useful:

• Perform Kegel exercises regularly. This strengthens the pelvic floor.
• Treat and prevent constipation.
• Avoid heavy lifting and lift correctly. 
• Control coughing. 
• Quit smoking.
• Avoid weight gain or obesity by all means.

Who is likely to have uterine prolapse?

Uterine prolapse is most likely to occur in:

• Women who have had one or more vaginal deliveries.
• Post-menopausal women.
• Women with family members who have had prolapse.