Uterovaginal Prolapse

Definition - What does Uterovaginal Prolapse mean?

Uterovaginal (UV) prolapse is the descent of the uterus, cervix, and vagina due to weakened pelvic supports. The condition is most common in women during their menopausal years that have completed their family, but can also affect younger women during their reproductive years. The UV prolapse can also affect the organs located in close proximity to the uterus. The urinary bladder that sits in front of the vagina but below the uterus may also be displaced resulting in a cystocele. Alternatively, the rectum located behind the uterus may also undergo prolapse, and is termed as a rectocele.

FertilitySmarts explains Uterovaginal Prolapse

The uterus, cervix, and vagina are held in position by the uterine supports such as ligaments or muscles. If these supports become weak due to factors such as childbirth injury, they are no longer able to support these pelvic structures.

The symptoms of a uterovaginal prolapse depend on the severity of the prolapse and the organs involved. Women with a minor degree of prolapse may not experience any symptoms whereas women with a more advanced prolapse may report the following symptoms:

  • Dragging sensation or feeling that something is coming down or coming out of the vagina - these symptoms are most noticeable during sneezing, coughing, or physical exertion, or after standing for prolonged periods
  • Aching sensation in the pelvic region or a dull back pain
  • Seeing a noticeable lump or bulge in the vagina with a third-degree uterine prolapse
  • Increased vaginal discharge
  • Difficulty during sexual intercourse
  • Urinary problems such as leaking of urine when coughing, sneezing, or laughing due to stress incontinence, frequent urge to urinate and feeling of incomplete emptying of the bladder are additional urinary problems

The condition is suspected in a woman who presents with the aforementioned features and confirmed by physical examination.

Treatment differs with the degree of prolapse, for instance, minor degrees can be addressed with the following strategies:

  • Doing Kegel exercises, which help reinforce the pelvic floor muscles and organs
  • Using a vaginal pessary, which is a device that fits into the vagina and helps stabilize the uterus and cervix
  • Losing weight to take some strain off of the pelvic organs
  • Avoiding heavy weight lifting
  • Taking estrogen replacement therapy

Surgical therapies include uterine suspension or hysterectomy. During a uterine suspension, the uterus is placed back into its original position by reconnecting the pelvic ligaments. With a hysterectomy, the surgeon removes the entire uterus.

UV prolapse does not usually cause infertility. However, in cases where infertility has no obvious cause, concurrent uterine prolapse may be the culprit. This happens rarely though. In such cases, traditional surgery of the prolapse using sling supports eases the symptoms and may also help achieve pregnancy with successful results.

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