Prolapsed Uterus

Prolapsed Uterus Overview

Your uterus (womb in which a fetus develops) is normally held in place inside your pelvis with various muscles, tissue, and ligaments. Sometimes-because of childbirth or difficult labor and delivery-these muscles weaken. As a woman ages and with a natural loss of the hormone estrogen, her uterus can collapse into the vaginal canal, causing the condition known as a prolapsed uterus.

• Muscle weakness or relaxation may allow your uterus to sag or come completely out of your body in various stages:
  
  
  • First degree: The cervix droops into the vagina.
    
    
  • Second degree: The cervix sticks to the opening of the vagina.
    
    
  • Third degree: The cervix is outside the vagina.
    
    
  • Fourth degree: The entire uterus is outside the vagina. This condition is also called procidentia. This is caused by weakness in all of the supporting muscles.
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• Other conditions are usually associated with prolapsed uterus. They weaken the muscles that hold the uterus in place:
  
  
  • Cystocele: A herniation (or bulging) of the upper front vaginal wall where a part of bladder bulges into the vagina, which may lead to urinary frequency, urgency, retention, and incontinence.
    
    
  • Enterocele: The herniation of the upper rear vaginal wall where a small bowel portion bulges into the vagina. Standing leads to a pulling sensation and backache and is relieved when you lie down.
    
    
  • Rectocele: The herniation of the lower rear vaginal wall where the rectum bulges into the vagina. This makes bowel movements difficult to the point that you may need to push on the inside of your vagina to empty your bowel.

Prolapsed Uterus Causes

The following conditions can cause a prolapsed uterus:

• Pregnancy/multiple childbirths with normal delivery through the vagina
  
  
• Weakness in the pelvic muscles with advancing age
  
  
• Weakening and loss of tissue tone after menopause and loss of natural estrogen
  
  
• Conditions leading to increased pressure in the abdomen such as chronic cough (with bronchitis and asthma), straining (with constipation), pelvic tumors (rare), or an accumulation of fluid in the abdomen
  
  
• Being overweight or obese and its additional strain on pelvic muscles
  
  
• Radical surgery in the pelvic area leading to loss of external support

Other risk factors

• Excess weight lifting
  
  
• Caucasian women more commonly affected; African Americans and Asians affected less often

Prolapsed Uterus Symptoms

• A feeling of fullness or pressure in your pelvis (you may describe it as a feeling of sitting on a small ball)
  
  
• Low back pain
  
  
• Feeling that something is coming out of your vagina
  
  
• Painful sexual intercourse
  
  
• Difficulty with urination or moving your bowels
  
  
• Difficulty walking

When to Seek Medical Care

Notify your health care provider if you experience any of the following symptoms:

• You feel the cervix near the opening of the vaginal canal. Or you suffer persistent discomfort from urinary dribbling or the urge to have a bowel movement (rectal urgency).
  
  
• You may not feel the cervix but just pressure in your vaginal canal and the feeling of something coming out of your vagina.
  
  
• You have continuing low back pain with difficulty in walking, urination, and defecation.

Seek medical care immediately if you experience the following:

• Obstruction or difficulty in urination and/or defecation
  
  
• Complete uterine prolapse (your uterus comes out of your vagina)