Procidentia - Uterine Prolapse

Uterine prolapse is the "dropping" of the uterus from its normal position at the top of the vagina. It drops to a lower part of the vagina and may even drop outside the vagina. This is caused by a relaxation of the ligaments that support the uterus within the abdominal walls.

What is going on in the body?

Uterine prolapse occurs more commonly in white women, and in women who:

These things may have caused injury to the pelvic ligaments and muscles. Symptoms may not occur until many years after women have given birth. This suggests that aging and shrinkage of these muscles also adds to the problem.

Uterine prolapse sometimes occurs in women who have never given birth. In these cases, the condition is due to a family tendency to have weak muscles that hold the uterus in place.

Some women have what is known as a "tipped uterus." This type of uterus is especially at risk to prolapse. This is due to its alignment along the same line as the vagina. It may be subject to a "piston-like effect." This happens when a woman uses her abdominal muscles, which push the uterus down into the vagina.

There are many different degrees of prolapse. Incomplete prolapse occurs when the uterus drops only partway into the vagina. Complete prolapse occurs when the uterus and cervix protrude out of the vagina and the vagina becomes inverted. Along with uterine prolapse there may be relaxation of the front and back portions of the vagina. This can cause a part of the bladder or rectum to protrude into the vagina.

What are the causes and risks of the condition?

The risk factors for developing uterine prolapse include:

What are the signs and symptoms of the condition?

Mild prolapse may not cause any symptoms. With more severe prolapse, a woman may have:

How is the condition diagnosed?

A healthcare provider can tell during a pelvic exam if the cervix is in a lowered position in the vagina. The pelvic exam may also show a part of the bladder or rectum protruding into the vagina.

What can be done to prevent the condition?

While uterine prolapse is not always avoidable, some cases can be avoided by:

What are the long-term effects of the condition?

The long-term effects of uterine prolapse depend on how severe it is and how long a woman has had the condition. Some long-term effects include:

What are the risks to others?

Uterine prolapse is not contagious, and poses no risk to others.

What are the treatments for the condition?

Treatment for uterine prolapse depends on many things, including:

Treatment options include:

What are the side effects of the treatments?

The side effects depend on the treatment. The use of hormone replacement therapy may cause nausea, weight gain, abdominal bloating, increased vaginal discharge, and breast tenderness. After a hysterectomy a woman will need 6 to 8 weeks to recuperate. There are possible side effects with any surgery. These include bleeding, infection, and allergic reactions to anesthesia.

What happens after treatment for the condition?

After surgical treatment of a prolapsed uterus, a woman should:

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

Author:Eva Martin, MD
Date Written:
Editor:Smith, Mary Ellen, BS
Edit Date:07/19/00
Reviewer:Gail Hendrickson, RN, BS
Date Reviewed:04/09/01

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