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.
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.
The risk factors for developing uterine prolapse include:
Mild prolapse may not cause any symptoms. With more severe prolapse, a woman may have:
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.
While uterine prolapse is not always avoidable, some cases can be avoided by:
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:
Uterine prolapse is not contagious, and poses no risk to others.
Treatment for uterine prolapse depends on many things, including:
Treatment options include:
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.
After surgical treatment of a prolapsed uterus, a woman should:
Any new or worsening symptoms should be reported to the healthcare provider.
Author:Eva Martin, MD
Editor:Smith, Mary Ellen, BS
Reviewer:Gail Hendrickson, RN, BS
The Merck Manual of Medical Information, Home edition, 1997
Professional Guide to Diseases, Sixth Edition. Springhouse: Springhouse Corporation, 1998
Tierney, Lawrence, editor, "Current Medical Diagnosis and Treatment, 39th edition", 2000