Uterine Prolapse – Diagnosis and Treatment
Diagnosis
Doctors usually find uterine prolapse or pelvic organ prolapse during a pelvic exam. During the exam, the provider may ask the patient to bear down as if trying to have a bowel movement.
This helps the provider see if the uterus or other organs, like the bladder (cystocele) or bowel (rectocele or enterocele), move toward the vaginal opening. A provider may also ask the person to tighten pelvic muscles as if stopping urine.
This checks the strength of the pelvic floor. Sometimes, the provider gives a questionnaire to see how symptoms such as urinary incontinence, pain during sex, bulging, or urinary tract infections affect daily life.
If there are bladder problems or incontinence, the provider may order extra tests, such as urodynamics or an MRI, to learn more about bladder and bowel function before planning treatment.
Treatment
Surgical Procedures
Doctors offer surgical options to people with troubling symptoms from uterine prolapse, especially if other treatments do not help.
They may recommend different surgeries depending on symptoms, plans for future pregnancies, and the presence of other pelvic organ problems.
Types of Surgeries:
| Surgery Type | Description | Key Details |
|---|---|---|
| Hysterectomy | Removal of the uterus | Often suggested for serious uterine prolapse |
| Uterus-sparing procedure | Secures uterus in place | Option for those wishing to have children |
| Pelvic floor repair | Uses stitches to support weak pelvic tissues | Helps maintain vaginal shape and sexual function |
| Colpocleisis | Closes the vaginal opening | For people who do not want vaginal intercourse |
| Mesh support | Mesh attaches tissues to the tailbone | Provides extra support with synthetic material |
Surgery Details:
- Doctors may use minimally invasive techniques like laparoscopy or perform surgery through the vagina.
- If a person has both uterine prolapse and other pelvic organ prolapse, the surgeon may do extra repairs.
- For people who no longer plan for sexual activity, doctors may offer surgery to close the vaginal canal.
Risks to Consider:
Surgical procedures can have risks, such as:
- Heavy bleeding
- Blood clots form in the legs or lungs
- Infection
- Injury to other organs such as the bladder, ureters, or bowel
- Urinary incontinence
- Anesthesia reactions
- Prolapse coming back
Other Treatment Options
Doctors may recommend a vaginal pessary—a silicone device inserted into the vagina to help keep organs lifted. The pessary needs regular cleaning and checkups by a doctor.
For those with mild symptoms, Kegel exercises, maintaining a healthy weight, and managing constipation can help relieve symptoms and prevent worsening.
Everyday Habits and At-Home Tips
Exercises for Pelvic Strength
Doing special exercises can help make the muscles at the bottom of the pelvis stronger.
These are called Kegel exercises, and they help people with pelvic floor weakness, such as those who have a uterine prolapse or urinary incontinence. A stronger pelvic floor helps organs stay in place and supports better bladder control.
Steps for Doing Pelvic Muscle Exercises:
- Tighten the muscles you would use to stop passing gas.
- Hold the squeeze for five seconds, then relax for five seconds. If this is too hard at first, start with two seconds of squeezing and three seconds of rest.
- Repeat the squeeze and rest. Try to do up to three rounds of ten each day.
- Work up over time to holding each squeeze for ten seconds.
Tip: You can do Kegel exercises almost anywhere—while watching TV, sitting at work, or riding in a car.
Sometimes, working with a physical therapist or using feedback tools can help you find the right muscles and do the exercises correctly. These steps help make the pelvic floor muscles more supportive and can reduce the feeling of heaviness.
Regular practice gives the best results.
| Benefit | Description |
|---|---|
| Better support | Strong pelvic muscles offer more organ support. |
| Leak prevention | May improve bladder control. |
| Privacy | Exercises can be done quietly, anytime. |
Getting Ready for Your Visit
Steps You Can Take Beforehand
Preparing for a medical appointment is important. Patients should gather important details to help the doctor understand their condition.
It can help to make a list of:
- All current symptoms, including when they started.
- Any medicines, vitamins, or supplements, with the exact doses.
- Past health problems and recent changes in health or life.
- Questions to ask the provider.
Some helpful questions for the doctor can include:
| Question Ideas |
|---|
| What can I do at home to help with symptoms? |
| If left untreated, will this condition get worse? |
| What treatment does the doctor suggest? |
| Could this issue return after surgery? |
| What are the possible risks of having surgery? |
Writing these items down ahead of time can help make the visit go smoothly. Patients should also bring any medical records or documents that may be useful.
Common Topics Your Doctor Might Discuss
During the appointment, your health care provider will likely ask questions to better understand your symptoms and medical history.
Some questions they may ask include:
Have your symptoms changed or become worse over time?
Do you have any pelvic pain or discomfort?
Do you experience urine leakage?
Do you have a frequent or severe cough?
Does your job or routine involve heavy lifting?
Do you often need to strain during bowel movements?
Is there a family history of pelvic health problems?
How many children have you given birth to? Were these births vaginal?
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Do you plan on having children in the future?
