Uterine prolapse is the protrusion of the uterus (womb) into the vagina, and at times outside the vagina, due to loss of support from the muscles and ligaments surrounding the uterus. Uterine prolapse is one form of pelvic organ prolapse. The bladder, rectum, or small bowel can also protrude into the vagina in related disorders. Uterine prolapse has been reported to occur in approximately 14% of women. Several factors may increase a woman's risk of uterine prolapse, including her number of vaginal deliveries, delivery of a large infant, increasing age, and frequent heavy lifting. A number of conditions, including chronic obstructive lung disease, chronic constipation, and obesity, may also contribute to the development of uterine prolapse.

SYMPTOMS

The symptoms associated with uterine prolapse vary depending on the degree of prolapse. In severe cases, the uterus may be easily felt or be visible to the woman, while in other cases there may be no symptoms.

·         Sensation of vaginal or pelvic fullness

·         Urinary complaints including urinary incontinence (involuntary urination), frequency, orurgency (the sensation of the immediate need to urinate)

·         Bowel symptoms, including pain with defecation, constipation, or incontinence

·         Sexual complaints, including pain with intercourse

DIAGNOSIS

In addition to a complete medical history and physical examination, your doctor will perform a complete pelvic examination to look for signs of prolapse. He or she may also order an imaging study (ultrasound or MRI) of your pelvis to better delineate the prolapse. Your doctor may refer you to a gynecologist (a doctor with specialized training in diseases of the female reproductive tract) for more specialized testing and evaluation for treatment.

TREATMENT

·         In cases where the prolapse is minor or not bothersome to the patient, no treatment may be necessary.

·         Pelvic floor muscle exercises (Kegel exercises) strengthen the pelvic floor muscles that support the uterus and may be helpful for some patients.

·         Pessaries (devices that can be inserted into the vagina to support the uterus) may be effective for some patients. A variety of these devices are available and your doctor can help you determine which one would be most appropriate.

·         A number of surgical treatment options are available