Uterine Prolapse

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Introduction

What is uterine prolapse?

Uterine prolapse occurs when the uterus drops down (prolapses) into the vagina. It is caused by weakened pelvic muscles and ligaments that fail to hold the uterus in place. There may be full collapse of the uterus into the vagina or only a partial descent of the uterus. Uterine prolapse is a common condition that affects approximately 50% of postmenopausal women who have given birth. It occurs more frequently in women who had multiple births by vaginal delivery, but it can also develop in women who did not bear children.

The most common cause of uterine prolapse is damage to the pelvic floor during pregnancy and childbirth. Normal aging and a decrease in estrogen levels may also contribute to the prolapse. Other conditions that strain the muscles and ligaments of the pelvic floor include obesity, chronic constipation, and abdominal gas.

The symptoms of uterine prolapse may occur frequently or only occasionally. The condition varies among individuals. Many women with uterine prolapse have no symptoms at all, while others may have back pain, abnormal pelvic pressure, or pain during sexual intercourse. In some cases, uterine prolapse is severe enough to interfere with bladder or bowel function.

Treatment options that relieve symptoms or repair the prolapse include exercises and surgical procedures.

In some cases, uterine prolapse can significantly interfere with bladder or bowel function, which can cause serious complications. Seek immediate medical care (call 911) if you experience inability to urinate or have a bowel movement, severe abdominal pain, or uncontrollable vomiting.

Seek prompt medical care if you are being treated for uterine prolapse but mild symptoms recur or are persistent.

Symptoms

What are the symptoms of uterine prolapse?

The symptoms of uterine prolapse vary among individuals.

Common symptoms of uterine prolapse

You may experience symptoms of uterine prolapse daily or only occasionally. Any of these symptoms can be severe:

  • Abdominal, pelvic, or lower back pain
  • Bulging sensation at the vagina
  • Difficulty urinating (dysuria) and urinary retention
  • Loss of bladder or bowel control
  • Loss of tone in the vagina
  • Pain or discomfort during sexual intercourse
  • Pelvic discomfort, including pressure or pulling
  • Protrusion of organs through the vaginal opening
  • Vaginal bleeding (mucosal irritation)

Serious symptoms that might indicate a life-threatening condition

In some cases, uterine prolapse can significantly interfere with bladder or bowl function, which can lead to serious complications that can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these symptoms:

  • Inability to have a bowel movement
  • Inability to urinate
  • Severe abdominal pain
  • Uncontrollable vomiting

Causes

What causes uterine prolapse?

Uterine prolapse occurs when the muscles and ligaments of the pelvic region lose the ability to support the uterus, and the uterus descends into the vagina. The prolapse can be caused by stress on the muscles and ligaments during pregnancy and vaginal childbirth, by normal aging and a decrease in estrogen levels, or by other conditions that put strain on the pelvic floor, such as prolonged standing, obesity, chronic constipation, abdominal gas, or chronic coughing.

What are the risk factors for uterine prolapse?

A number of factors increase the risk of developing uterine prolapse. Not all people with risk factors will develop uterine prolapse. Risk factors include:

  • Aging
  • Chronic abdominal gas
  • Chronic constipation
  • Chronic coughing such as from lung disease
  • Estrogen-deficient state (not receiving HRT)
  • Family history
  • Frequent straining during bowel movements
  • Lifting heavy objects frequently
  • Menopause
  • Pregnancy history (multiparity)
  • Tobacco use
  • Vaginal childbirth

Reducing your risk of uterine prolapse

You may be able to lower your risk of uterine prolapse if you:

  • Avoiding lifting heavy objects
  • Avoid prolonged periods of standing
  • Maintaining a healthy weight
  • Practicing daily Kegel exercises (contracting the muscle used to stop urine flow)

Treatments

How is uterine prolapse treated?

Treatment for uterine prolapse begins with seeking medical care from your health care provider. Some people with uterine prolapse may never have any symptoms. When symptoms do occur, however, several treatment options can reduce or relieve the symptoms. Your health care provider will determine the best treatment options for you based on your age, the severity of your symptoms, and whether or not you plan to have children.

Uterine prolapse treatment options

A number of treatment options may be suggested for uterine prolapse, depending upon your age and overall health, as well as the severity of the condition. Examples include:

  • Daily Kegel exercises to strengthen the pelvic floor
  • Dietary changes to maintain a healthy body weight
  • Stool softeners or laxatives to decrease constipation and gas symptoms
  • Surgical procedure to repair the pelvic floor
  • Vaginal pessary (a device inserted into vagina to support the uterus)

What are the potential complications of uterine prolapse?

You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of uterine prolapse include:

  • Adverse effects of treatment
  • Decreased sexual activity
  • Bowel obstruction
  • Prolapse of other pelvic organs, such as bladder, rectum or bowel
  • Reoccurrence of the prolapse
  • Urethral obstruction
  • Urinary tract infections
  • Vaginal ulcers
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 5
  1. Uterine prolapse. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002477/.
  2. Pelvic support problems. ACOG American Congress of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq012.pdf?dmc=1&ts=20140530T1130431181.
  3. Smith FJ, Holman CD, Moorin RE, Tsokos N. Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol 2010; 116:1096.
  4. Jelovsek JE, Maher C, Barber MD. Pelvic organ prolapse. Lancet 2007; 369:1027.
  5. Culligan PJ. Nonsurgical management of pelvic organ prolapse. Obstet Gynecol 2012; 119:852.
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