Anatomy and Diagnosis of Uterine Prolapse
Although more common in postmenopausal women, uterine prolapse may occur at any age. In most cases, uterine prolapse occurs in women who have had multiple vaginal deliveries. Furthermore, the condition may be the result of trauma to the pelvic muscles, the additional pull of gravity on muscular and connective tissues, reduced estrogen levels, and additional straining of the pelvic muscles.
When the pelvic tissues become unable to support the weight of pelvic organs, especially the uterus, the uterus will slip through the muscular sling of connective tissue. Unfortunately, the severity of uterine prolapse varies from woman to woman. In mild cases, symptoms may be absent. However, moderate to severe cases, reports MedlinePlus, may result in the following symptoms:
- Sensation of pulling in the pelvis.
- Abnormal tissue in the vagina or protruding from the vagina.
- Problems maintaining urinary retention.
- Pain in the lower abdomen or back.
- Pain during urination.
- Constipation or difficulty having a bowel movement.
- Urinary urgency without other medical explanation.
- Pain or discomfort during sexual intercourse.
- Gradual worsening of discomfort from morning to evening.
These symptoms lack clarity when compared to other potent women’s health problems. As a result, it’s important for women to obtain a thorough, accurate women’s health examination. Since vaginal tissue may obscure the uterine tissues, excessive lateral wall tissue will need to be addressed with a vaginal wall retractor. This allows the obstetrician to gain an unobstructed view of the cervix. Furthermore, an LED vaginal illuminator may be used to ensure fibroids are not present out the visible part of a prolapsed uterus.
Risk Factors For Uterine Prolapse
In addition to multiple, vaginal births, certain women may be at a greater risk for uterine prolapse. Some of these risk factors include the following:
- Giving birth to a large baby.
- Increasing age, especially after reaching menopause.
- Frequent lifting of heavy objects.
- Chronic coughing.
- Previous surgery in the pelvic region.
- Genetic predispositions to uterine prolapse.
- Hispanic and white women.
- Morbid obesity.
- COPD (Chronic Obstructive Pulmonary Disease).
Treatment of Uterine Prolapse
Depending on the severity of uterine prolapse, treatment may vary from no treatment to surgery. Some common treatments include the following:
- Medications – Estrogen medication treatment may prevent the weakening of muscles in the pelvic floor.
- Physical therapy – Physical therapy or Kegel Exercises, as defined by the American Urogynecologic Society, to increase the muscle tone of pelvic connective tissue.
- Pessaries – These silicone devices are non-surgically inserted into the vagina daily to help prevent further descent of the uterus and internal organs.
- Surgery – Surgical options vary and depend on the overall health and type of uterine prolapse.
A Caveat to Surgical Repairs
After a comprehensive examination with a vaginal wall retractor, women should be thoroughly informed of their surgical options. However, the Food and Drug Administration (FDA) has released extensive warnings on the use of certain surgical materials, such as vaginal mesh, which may pose serious complications. As a result, women must take great care in researching and understanding how treatment for uterine prolapse will affect their bodies.
Preventing uterine prolapse follows a pattern similar to the importance of routine examinations to prevent cervical cancer. By receiving a diagnosis and undergoing treatment for uterine prolapse early, women can attempt to evade progression of severity to the point of surgery.
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