Uterine prolapse is a condition that occurs when the pelvic floor muscles and ligaments stretch and weaken. Due to inadequate support the uterus then slips down into or protrudes out of the vagina.
Uterine prolapse often affects postmenopausal women who have had one or more vaginal deliveries, but it can happen to women of any age. Uterine prolapse can be caused by damage to supportive tissues during pregnancy and childbirth, loss of estrogen, repeated stain over the period of several years, or even the effects of gravity.
For mild cases of uterine prolapse, treatment is usually not necessary. Regular checkups with a doctor to keep track of the condition are recommended. However, if uterine prolapse creates too much discomfort and disrupts normal life, treatment can be beneficial.
Simple self-care measures, such as exercises like Kegels, may provide relief as the pelvic muscles are strengthened. Avoiding heavy lifting and maintaining a healthy weight can also reduce pressure on supportive tissues in the pelvis.
- Vaginal pessary is a device placed inside the vagina. It holds the uterus in place and can be used temporarily or permanently. Vaginal pessaries come in a variety of shapes and sizes. You will be trained to insert, remove and clean the pessary. Some pessaries are made to be taken out overnight and reinserted daily, while others can be left in place for longer periods of time.
- A vaginal pessary is not effective for severe uterine prolapse cases. In addition, a pessary can irritate vaginal tissues, to the point of causing sores, and may interfere with sexual intercourse.
- Surgery is another option and is used to repair damaged or weakened pelvic floor tissues. Surgery may be possible through the vagina, although in some cases an abdominal surgery is required. Surgical repair of the prolapse may involve grafting tissue or some synthetic material onto the weakened pelvic structures to support the pelvic organs. In some cases, a hysterectomy may be the best option.
- Minimally invasive surgery may also be possible. In laparoscopic surgery, a small camera and slender instruments are inserted through small incisions in the abdomen avoiding any need for larger incisions.
- The best surgery technique and surgical approach depends on your individual needs and circumstances. Each procedure has pros and cons that should be discussed and considered.
- For women who want to have become pregnant in the future, surgery to repair uterine prolapse may not be the best option. Pregnancy and delivering a baby puts excessive strain on the supportive tissues of the uterus and can undo the benefits of surgical repair. The risks of surgery might also outweigh the benefits for women with major medical problems. In these instances, using a pessary may be the best option.
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