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==What causes Uterine prolapse?==
==What causes Uterine prolapse?==
The uterus is held in position in the pelvis by muscles, special ligaments, and other tissue,. The uterus drops into the vaginal canal (prolapses) when these muscles and connective tissues weaken.


==Who is at highest risk?==
==Who is at highest risk?==
*Uterine prolapse usually happens in women who have had one or more vaginal births.
*Normal aging and lack of estrogen hormone after menopause may also cause uterine prolapse
*Chronic cough and obesity increase the pressure on the pelvic floor and may contribute to the prolapse.
*Uterine prolapse can also be caused by a pelvic tumor, although this is rare.
*Chronic constipation and the pushing associated with it can worsen uterine prolapse.


==When to seek urgent medical care?==
==When to seek urgent medical care?==
Call for an appointment with your health care provider if you have symptoms of uterine prolapse.


==Diagnosis==
==Diagnosis==
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*  Degree of prolapse
*  Degree of prolapse
*   Desire for future pregnancies
* Desire for future pregnancies
*  Other medical conditions
*  Other medical conditions
*  The women's desire to retain vaginal function
*  The women's desire to retain vaginal function
Line 75: Line 82:


==Possible complications==
==Possible complications==
Ulceration and infection of the cervix and vaginal walls may occur in severe cases of uterine prolapse.
[[Urinary tract infections]] and other urinary symptoms may occur because of a cystocele. [[Constipation]] and [[Hemorrhoids (patient information)|hemorrhoids]] may occur because of a [[rectocele]].


==Prevention==
==Prevention==
Tightening the pelvic floor muscles using [[Kegel exercises]] helps to strengthen the muscles and reduces the risk of uterine prolapse.
Estrogen therapy, either vaginal or oral, in postmenopausal women may help maintain connective tissue and muscle tone.


==Sources==
==Sources==
http://www.nlm.nih.gov/medlineplus/ency/article/001508.htm


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Revision as of 19:34, 10 August 2011

Uterine prolapse

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

When to seek urgent medical care?

Diagnosis

Treatment options

Where to find medical care for Uterine prolapse?

What to expect (Outlook/Prognosis)?

Possible complications

Prevention

Uterine prolapse On the Web

Ongoing Trials at Clinical Trials.gov

Images of Uterine prolapse

Videos on Uterine prolapse

FDA on Uterine prolapse

CDC on Uterine prolapse

Uterine prolapse in the news

Blogs on Uterine prolapse

Directions to Hospitals Treating Uterine prolapse

Risk calculators and risk factors for Uterine prolapse

For the WikiDoc page for this topic, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S.

Overview

Uterine prolapse is falling or sliding of the uterus from its normal position in the pelvic cavity into the vaginal canal.

What are the symptoms of Uterine prolapse?

  • A feeling as if sitting on a small ball
  • Difficult or painful sexual intercourse
  • Frequent urination or a sudden, urgent need to empty the bladder
  • Low backache
  • Pain during intercouse
  • Protruding of the uterus and cervix through the vaginal opening
  • Repeated bladder infections
  • Sensation of heaviness or pulling in the pelvis
  • Vaginal bleeding or increased vaginal discharge

Many of the symptoms are worse when standing or sitting for long periods of time.

What causes Uterine prolapse?

The uterus is held in position in the pelvis by muscles, special ligaments, and other tissue,. The uterus drops into the vaginal canal (prolapses) when these muscles and connective tissues weaken.

Who is at highest risk?

  • Uterine prolapse usually happens in women who have had one or more vaginal births.
  • Normal aging and lack of estrogen hormone after menopause may also cause uterine prolapse
  • Chronic cough and obesity increase the pressure on the pelvic floor and may contribute to the prolapse.
  • Uterine prolapse can also be caused by a pelvic tumor, although this is rare.
  • Chronic constipation and the pushing associated with it can worsen uterine prolapse.

When to seek urgent medical care?

Call for an appointment with your health care provider if you have symptoms of uterine prolapse.

Diagnosis

A pelvic examination performed while the woman is bearing down (as if trying to push out a baby) will show how far the uterus comes down.

  • Uterine prolapse is mild when the cervix drops into the lower part of the vagina.
  • Uterine prolapse is moderate when the cervix drops out of the vaginal opening.

The pelvic exam may reveal that the bladder, front wall of the vagina (cystocele), or rectum and back wall of the vagina (rectocele) are entering the vaginal area. The urethra and bladder may also be positioned lower in the pelvis than usual.

A mass may be noted on pelvic exam if a tumor is causing the prolapse (this is rare).

Treatment options

Treatment is not necessary unless the symptoms are bothersome. Most women seek treatment by the time the uterus drops to the opening of the vagina.

Uterine prolapse can be treated with a vaginal pessary or surgery.

Vaginal Pessary

A vaginal pessary is a rubber or plastic donut-shaped device that is inserted into the vagina to hold the uterus in place. It may be a temporary or permanent form of treatment. Vaginal pessaries are fitted for each individual woman. Some pessaries are similar to a diaphragm device used for birth control. Many women can be taught how to insert, clean, and remove the pessary herself.

Pessaries may cause an irritating and abnormal smelling discharge, and they require periodic cleaning, sometimes done by the doctor or nurse. In some women, the pessary may rub on and irritate the vaginal wall ( mucosa), and in some cases may damage the vagina. Some pessaries may interfere with normal sexual intercourse by limiting the depth of penetration.

Lifestyle Changes

Weight loss is recommended in women with uterine prolapse who are obese.

Heavy lifting or straining should be avoided, because they can worsen symptoms.

Coughing can also make symptoms worse. Measures to treat and prevent chronic cough should be tried. If the cough is due to smoking, smoking cessation techniques are recommended.

Surgery

Surgery should not be done until the prolapse symptoms are worse than the risks of having surgery. The specific type of surgery depends on:

  • Degree of prolapse
  • Desire for future pregnancies
  • Other medical conditions
  • The women's desire to retain vaginal function
  • The woman's age and general health

There are some surgical procedures that can be done without removing the uterus, such as a sacrospinous fixation . This procedure involves using nearby ligaments to support the uterus. Other procedures are available.

Often, a vaginal hysterectomy is used to correct uterine prolapse. Any sagging of the vaginal walls, urethra, bladder, or rectum can be surgically corrected at the same time.

Where to find medical care for Uterine prolapse?

Directions to Hospitals Treating Uterine prolapse

What to expect (Outlook/Prognosis)?

Possible complications

Ulceration and infection of the cervix and vaginal walls may occur in severe cases of uterine prolapse.

Urinary tract infections and other urinary symptoms may occur because of a cystocele. Constipation and hemorrhoids may occur because of a rectocele.

Prevention

Tightening the pelvic floor muscles using Kegel exercises helps to strengthen the muscles and reduces the risk of uterine prolapse.

Estrogen therapy, either vaginal or oral, in postmenopausal women may help maintain connective tissue and muscle tone.

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/001508.htm

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