Uterine prolapse

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Written by Xu Xiao Ming
Obstetrics and Gynecology
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What causes uterine prolapse?

The most common causes of uterine prolapse can be categorized into three types. The first type is childbirth injury, which is the main cause of uterine prolapse. During childbirth, especially with vaginal surgical assistance or prolonged second stage of labor, uterine prolapse can occur. The second cause is long-term increased intra-abdominal pressure, such as chronic coughing, habitual constipation, prolonged standing, or weightlifting. These factors can contribute to uterine prolapse. The third type involves poor development or degenerative changes in the pelvic tissues. This mainly refers to uterine prolapse due to congenital deficiencies in pelvic floor development. Generally, childbirth injuries are the most common cause.

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Written by Liu Jian Wei
Obstetrics and Gynecology
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How to deal with second-degree uterine prolapse?

Once a second-degree uterine prolapse is detected, it is also necessary to determine the treatment plan based on the patient's age and the presence or absence of clinical symptoms. If the patient is young and without apparent clinical symptoms, conservative treatment methods can be chosen. However, if the symptoms are severe and affect the patient's daily life, surgical treatment is needed. The specific surgical treatment plan should also take into account the patient's wishes.

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Written by Du Rui Xia
Obstetrics
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How long after natural childbirth is it easy for uterine prolapse to occur?

In clinical practice, it is common to see cases of uterine prolapse after natural childbirth. This is mainly because during pregnancy, the uterus is prone to various downward pressures. If the body has some imperfections in function, this can lead to uterine prolapse. After childbirth, some women may experience uterine prolapse as soon as one month, or even ten days or eight days postpartum. However, due to the increasing awareness and importance placed on postnatal confinement after natural childbirth, the incidence of uterine prolapse is decreasing. It is advised that women should rest during confinement and avoid heavy physical labor.

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Written by Jia Rui
Obstetrics and Gynecology
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Can uterine prolapse heal itself?

Uterine prolapse is generally difficult to heal completely on its own. Uterine prolapse occurs when the uterus descends from its normal position along the vagina, with the cervical external os reaching below the level of the ischial spine, or even the entire uterus protruding outside the vaginal opening. This condition is difficult to recover from by itself. From the perspective of traditional Chinese medicine, the causes of uterine prolapse are generally attributed to physical weakness or deficiency of Qi and blood. Therefore, it may be appropriate to use some tonic Chinese herbal medicines for treatment. Additionally, comprehensive conditioning through diet and exercise can also be beneficial. Enhancing nutrition by consuming foods such as black chicken, Chinese yam, goji berries, and jujube, which are considered to have tonic effects in traditional Chinese medicine, can strengthen the body and improve conditions like uterine prolapse, providing significant help. If the prolapse is beyond the hymen and symptomatic, surgical treatment should be considered.

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Written by Shen Li Wen
Obstetrics and Gynecology
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The graded treatment for uterine prolapse is what?

According to the severity of female uterine prolapse, it can be categorized into first, second, and third degrees. For first and second degrees, non-surgical treatment methods can be used, such as the commonly practiced anal contraction exercises, which are a type of pelvic floor muscle training. The specific method involves contracting the anus for three seconds, then relaxing, and repeating this action 15 to 30 times per set. Depending on one's physical condition, two to three sets can be done each day. Generally, significant results can be seen after six to eight weeks of consistent practice. Additionally, some women who refuse surgery, such as older women, can also use a uterine pessary. Moreover, for mild or moderate uterine prolapse, treatments such as acupuncture and taking traditional Chinese medicine orally, such as Bu Zhong Yi Qi Tang, can be used. For severe uterine prolapse, surgery is often necessary, but the specific choice depends on various factors such as the woman's age, reproductive needs, and quality of life requirements. For example, older women in their seventies or eighties who might have poor physical condition and possibly no sexual activity might consider undergoing a vaginal closure procedure.

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Written by Shen Li Wen
Obstetrics and Gynecology
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The main causes of uterine prolapse

The causes of uterine prolapse in women are complex, with the most common being pregnancy and childbirth, especially multiple childbirths, which can lead to damage to a woman's pelvic floor muscles. Some women experience this during vaginal delivery using instruments such as forceps or vacuum extractors, which can injure the pelvic muscles and lead to uterine prolapse. Some women may engage in heavy physical labor too soon after childbirth before their pelvic floor functions have recovered, affecting the recovery of pelvic tissue tension and leading to uterine prolapse. Additionally, uterine prolapse may also occur in women who are overweight, suffer from internal medical conditions such as chronic cough, ascites, or constipation, which increase the pressure inside the abdominal cavity.

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Written by Li Shun Hua
Obstetrics and Gynecology
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Symptoms of uterine prolapse

The main symptom of uterine prolapse is the protrusion of a mass from the vaginal opening. Uterine prolapse can be divided into three degrees. In the first degree of uterine prolapse, only the cervix is visible at the vaginal opening. At this stage, symptoms are not very pronounced and may include rapid urination or urinary incontinence. In the second degree, the cervix and part of the uterine body protrude from the vaginal opening. This can lead to difficulty walking or abrasion, and bleeding from the vaginal opening may occur. If the entire uterus prolapses, it can lead to an inability to urinate or difficulty defecating. Patients may experience pain in the lower abdomen or difficulties and abrasion while walking, and severe cases can lead to bleeding from the cervix or significant discharge, potentially resulting in infection.

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Written by Hou Jie
Obstetrics and Gynecology
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What are the symptoms of uterine prolapse?

Mild uterine prolapse may have no clinical symptoms, while severe cases can feel a sense of falling and lower back pain, along with a mass protruding from the vagina. This mass may increase and the sensation of falling becomes more pronounced with long periods of standing, vigorous activity, or increased abdominal pressure. If there is a bulge in the anterior vaginal wall or the bladder, with the urethra and the posterior angle of the bladder becoming sharp, it can lead to difficulty urinating or urinary retention. If a urinary tract infection occurs subsequently, symptoms such as frequent urination, urgency, and painful urination may arise. If the bulge in the bladder coincides with a urethral bulge and a complete protrusion of the anterior vaginal wall, where the posterior angle of the urethra and bladder disappears, urinary leakage can occur during coughing, straining, or other activities that increase abdominal pressure, leading to what is called stress urinary incontinence.

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Written by Liu Jian Wei
Obstetrics and Gynecology
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Uterine prolapse is classified into several degrees.

The current grading of uterine prolapse commonly used in China can be divided into mild, moderate, and severe. The grading is based on the position and severity of the prolapse. Generally, mild indicates that the prolapse of the uterus has not exceeded the external orifice of the vagina. Moderate indicates that part of the uterus has prolapsed beyond the vaginal orifice, and the most severe suggests that the uterus has completely prolapsed to the external orifice of the vagina. Therefore, a gynecological examination is needed in the clinic for assessment.

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Written by Shen Li Wen
Obstetrics and Gynecology
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What are the causes of uterine prolapse?

There are many causes of uterine prolapse in women, for instance, the most common one occurs during pregnancy and childbirth, especially when methods such as forceps delivery are used, which may damage the pelvic floor muscles or injure the vaginal wall. This causes damage to the pelvic floor muscles, and if not properly recovered postpartum, it can lead to prolapse. Additionally, some women might suffer from conditions like chronic pharyngitis, chronic bronchitis, long-term coughing, or have liver diseases or malignant tumors leading to a significant build-up of ascites. Frequent heavy physical labor or even simple obesity can increase abdominal pressure, causing uterine prolapse.