Uterine Prolapse: Symptoms, Causes, Treatment
هبوط الرحم
Uterine prolapse is descent of the uterus into the vagina when pelvic support weakens. Management may involve observation, physiotherapy, a vaginal pessary or surgery according to symptoms and the patient’s preferences.
What is Uterine Prolapse?
It is one form of pelvic organ prolapse and may coexist with vaginal wall prolapse involving the bladder or rectum. Not every prolapse is painful or needs surgery. Its effect on urination, bowel function, activity and sexual comfort guides decisions.
Related reading: Does frequent urination mean you have diabetes?.
Symptoms
Symptoms may include vaginal heaviness or a bulge, pelvic pressure and difficulty emptying the bladder or bowel. Some women have urine leakage or discomfort during intercourse, while others have no symptoms. Assessment clarifies which problems are related to prolapse.
Causes
Weak pelvic muscles and connective tissues reduce support. Pregnancy, childbirth, ageing and repeated pressure from constipation, chronic cough or heavy lifting can contribute. It is usually not possible to attribute prolapse to a single movement.
Risk factors
Previous childbirth, increasing age, obesity, chronic constipation and connective-tissue disorders may increase risk. Future pregnancy plans, prior operations and general health influence treatment selection rather than automatically determining one particular approach.
Diagnosis
A pelvic examination identifies the affected structures and degree of descent, sometimes while lying down or standing and bearing down. Bladder and bowel symptoms are assessed, with additional tests only when indicated. You can request an explanation and a suitable chaperone.
Treatment
Options include observation for non-bothersome prolapse, supervised exercises and a fitted pessary with follow-up. Vaginal oestrogen may help appropriate menopause-related symptoms. Surgery is considered when needed, including uterus-preserving approaches; hysterectomy is not compulsory for every patient.
Complications
Exposed tissue may become irritated or ulcerated, and bladder emptying, activity or intimacy may be affected. Pessaries and surgery have their own risks and follow-up needs. Prolapse may recur, so discuss benefits, adverse effects and alternatives before an operation.
Prevention
Managing constipation, cough and excess weight can reduce strain. Adapt activities that aggravate pelvic symptoms and learn suitable exercises rather than avoiding all movement. These measures cannot guarantee prevention but may support treatment and symptom control.
When to see a doctor
Seek assessment for a vaginal bulge or new bladder or bowel symptoms. Inability to urinate or severe pain needs urgent attention. New vaginal bleeding, especially after menopause, should not simply be attributed to prolapse or a pessary without assessment.