HomeHealthHealthUterine prolapse: what is it, symptoms, degrees and treatment

Uterine prolapse: what is it, symptoms, degrees and treatment

Uterine prolapse, also popularly known as a low or fallen uterus, is the descent of the uterus into the vagina caused by the weakening of the muscles and ligaments that keep the uterus inside the pelvis in the correct position. It can occur at any age, before menopause. or during pregnancy. However, it is more common in post-menopausal women or in women who have had multiple vaginal births.

There are various degrees of uterine prolapse that vary according to the level of descent of the uterus, which may not present symptoms in the lower degrees, or cause sexual dysfunction or urinary incontinence, for example, decreasing the quality of life, in the higher degrees.

The treatment of uterine prolapse is done by the gynecologist who may indicate exercises to strengthen the pelvis muscles or surgery to repair or remove the uterus, depending on the degree of descent of the uterus.

Main symptoms

The main symptoms of uterine prolapse are:

  • Stomach ache;
  • Vaginal discharge;
  • Sensation of something coming out of the vagina;
  • Urinary incontinence;
  • Difficulty evacuating;
  • Pain during sexual intercourse.

When uterine prolapse is less severe, symptoms may not be seen. However, when signs and symptoms indicative of uterine prolapse are identified, it is important to consult a gynecologist so that the diagnosis can be confirmed and treatment initiated.

uterine prolapse degrees

Uterine prolapse can be classified according to the level of descent of the uterus through the vagina into:

  • Grade 1 uterine prolapse, in which the uterus descends but the cervix does not appear on the vulva;
  • Grade 2 uterine prolapse, in which the uterus descends and the cervix appears along with the anterior and posterior wall of the vagina;
  • Grade 3 uterine prolapse, in which the uterus is up to 1 cm outside the vulva;
  • Grade 4 uterine prolapse, in which the uterus protrudes more than 1 cm.

Other organs in the pelvis region such as the walls of the vagina, bladder and rectum may also suffer this displacement due to the weakening of the supporting muscles of the pelvis.

Possible causes

The most common cause of uterine prolapse is muscle weakness in the pelvis due to aging. However, other causes that contribute to the occurrence of prolapse can be:

  • Multiple births;
  • Menopause due to reduced estrogen hormone;
  • Sequelae from previous infections in the pelvis region;
  • Obesity;
  • Excessive lifting of weights.

In addition to these causes, chronic cough, constipation, pelvic tumors, and accumulation of fluid in the abdomen cause increased pressure in the abdomen and pelvis and, therefore, can also cause uterine prolapse.

Uterine Prolapse in Pregnancy

Uterine prolapse in pregnancy is very rare and can occur before or during pregnancy. In addition, prolapsed uterus in pregnancy can lead to cervical infection, urinary retention, miscarriage, and premature labor. Therefore, all the obstetrician’s guidelines must be followed to reduce the risk of complications.

How to confirm the diagnosis

The diagnosis of uterine prolapse is made by the gynecologist through the symptoms presented, and through the pelvic exam, in which the doctor performs a visual analysis of the interior of the vagina and examines the vaginal canal and uterus. See which are the main exams requested by the gynecologist.

How is the treatment done

The treatment of uterine prolapse is done by the gynecologist according to the degree of descent of the uterus and symptoms, and exercises to strengthen the pelvic muscles, which are the Kegel exercises, may be indicated.

1. Pelvic exercises

Pelvic exercises can be indicated by the gynecologist in the case of uterine prolapse that presents little or no symptoms, with the objective of strengthening the pelvic muscles and preventing the uterus from descending further. Kegel exercises or pelvic physiotherapy are the most indicated. See how to do Kegel exercises.

2. Pessary

A pessary is a plastic or silicone device that provides support for the uterus, relieves symptoms of prolapsed uterus such as urinary incontinence, or prevents the uterus from descending further.

This device is inserted into the vagina by the gynecologist, being indicated when you want to avoid or postpone surgery, or the woman has health problems making surgery risky.

3. Surgery

Surgery for uterine prolapse is safe and effective, being indicated when recovery does not respond to other forms of treatment.

According to the doctor’s indication, the surgery can be performed in order to:

  • Repair the uterus: in this case, the surgeon will place the uterus back in its normal position, keeping it inside the pelvis, by repairing the muscles and ligaments that keep the uterus in place;
  • Remove the uterus: this surgery involves partial or total removal of the uterus and is usually performed in women who are in menopause, or when the prolapse is very severe. Hysterectomy is effective in curing prolapsed uterus, but it can trigger immediate menopause if the ovaries are also removed. See what else can happen after the uterus is removed.

Recovery from uterine prolapse surgery varies according to the type of surgery performed, however, the average recovery time is approximately 6 weeks. Find out about recovery from surgery for prolapsed uterus.

Possible complications

Uterine prolapse can have complications when the weakening of the muscles and ligaments of the pelvis is severe, it can also lead to the descent of the bladder into the vagina, called a cystocele, or even causing the intestine to exit through the vaginal canal.

In addition, displacement of the vagina can occur, causing the birth canal to protrude out of the body in a situation called vaginal prolapse. Understand better what vaginal prolapse is.

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