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Uterine prolapse
How to check for uterine prolapse after childbirth
During routine postnatal checks after natural childbirth, it is important to evaluate the recovery of pelvic floor function, including checking for the presence and severity of uterine prolapse. Uterine prolapse can be assessed in the following ways: First, a gynecological examination can be conducted. Through this examination, the condition of the uterine prolapse and the position of the cervix can be clearly identified and staged. Second, performing a perineal ultrasound can generally assess the condition of uterine prolapse and the state of pelvic floor function. Third, in cases of severe uterine prolapse, it is also necessary to perform a urinary system examination, such as urodynamic testing, because uterine prolapse often occurs simultaneously with bladder prolapse.
Does uterine prolapse affect pregnancy?
Uterine prolapse, as long as it does not affect sexual intercourse, generally does not impact the ability to conceive. Uterine prolapse can be classified into three degrees. First-degree uterine prolapse does not affect pregnancy since it allows for normal sexual activity. However, in the case of third-degree uterine prolapse, the uterus has prolapsed out of the vagina and sometimes cannot be repositioned, thus interfering with sexual activity and affecting the ability to conceive. Therefore, whether uterine prolapse impacts pregnancy depends on the patient's condition, as well as whether they have normal menstruation or normal endocrine function.
How to treat uterine prolapse and urinary incontinence?
Uterine prolapse is mostly caused by childbirth injuries, long-term increase in abdominal pressure, or the degenerative changes and poor development of pelvic floor tissues. Mild uterine prolapse generally does not have noticeable symptoms. Severe uterine prolapse often accompanies anterior vaginal wall prolapse, which can lead to urinary retention and stress urinary incontinence, commonly referred to as leakage of urine. In cases of uterine prolapse with urine leakage, treatment requires enhanced nutrition, appropriate arrangement of rest and work, avoidance of heavy physical labor, and maintaining smooth bowel movements. Active treatment of chronic negative pressure increase diseases, such as constipation and chronic cough, is necessary. When uterine prolapse results in urine leakage, surgical treatment is generally required. Pelvic floor tissue repair is done, and in severe cases, hysterectomy is necessary along with the repair of the anterior and posterior vaginal walls for effective treatment.
Can postpartum constipation cause uterine prolapse?
If there is severe constipation after childbirth, and it is not corrected in time, long-term constipation can lead to uterine prolapse in women. Postpartum constipation increases abdominal pressure, which affects the recovery of pelvic floor muscles, causing the loss of support in the pelvic floor muscles and thus leading to uterine prolapse. However, the main factor contributing to uterine prolapse is not constipation but the damage caused by childbirth, which is the primary cause. After childbirth, the pelvic floor muscles are weakened. Whether standing, bearing weight, or holding breath for a long period, thereby increasing abdominal pressure, can lead to the inability of the pelvic floor tissues to support and stabilize the internal organs of the pelvis, resulting in a prolapse.
Does cesarean delivery easily cause uterine prolapse?
After a cesarean section, there is also a certain chance of uterine prolapse occurring. The occurrence of uterine prolapse is mainly related to the number of childbirths, the size of the fetus during childbirth, and factors such as whether there were difficulties during delivery or the use of vaginal delivery assistance. Cesarean section can to some extent reduce the incidence of uterine prolapse. Cesarean delivery can improve or avoid conditions such as uterine prolapse and bladder protrusion, and other pelvic organ prolapse diseases. However, this practice is not advocated and should only be performed in necessary cases. Natural childbirth is still recommended as the best method. If pelvic floor dysfunction occurs, repair can be conducted after childbirth.
Can an ultrasound detect uterine prolapse?
Uterine prolapse cannot be detected through an ultrasound, because during the ultrasound when it is necessary to hold urine, the uterus is lifted, so the degree and severity of uterine prolapse cannot be determined by this method. Uterine prolapse can be diagnosed by a gynecologist's examination, which can also determine the severity of the prolapse. Treatment methods should be determined based on the severity of the prolapse and the symptoms of the patient. Mild uterine prolapse might recover through treating the underlying disease and exercising. However, uterine prolapse of second degree or higher must be treated surgically to be restored to the normal position.
Can a belly band be used for uterine prolapse?
For patients with uterine prolapse, the initial treatment adopted is pelvic floor exercises. The use of abdominal binders is less common clinically, as abdominal binders can only tighten the lower abdomen and have no significant effect on uterine prolapse. If the patient's symptoms of uterine prolapse are severe, it is recommended that the patient seeks medical evaluation at a local hospital. If necessary, surgical repair treatment may be required.
Can you still have children with uterine prolapse?
Most women with uterine prolapse are not affected in their ability to become pregnant and give birth normally. However, in rare cases, symptoms can be severe when women suffer from uterine prolapse, with part of the uterus protruding outside the vagina. This may cause friction with the underwear, leading to localized ulcers or even infections, causing purulent vaginal discharge or bleeding. This can affect the normal passage of sperm and impact normal pregnancy. For these women, anti-inflammatory treatment can be administered first. After healing, it generally does not affect normal conception. After conception, as the size of the uterus increases and moves from the pelvic cavity into the abdominal cavity, the symptoms of uterine prolapse tend to decrease.
What does a uterine prolapse feel like to the touch?
Under normal circumstances, the uterus of a woman is located deep in the pelvic cavity and is usually not palpable through the abdomen. When a woman has a mild uterine prolapse, the body of the uterus cannot be felt at the vulva either. It is only when a woman experiences moderate to severe uterine prolapse, with part or the entire body of the uterus protruding outside the vagina, that it becomes palpable to the touch. The exposed part can cause local hyperplasia, ulceration and other phenomena due to friction with undergarments, giving a feeling of enlargement upon touch. During gynecological examinations, it can be observed that most women with uterine prolapse have relatively lax vaginal walls. When these women cough, there is a noticeable downward movement of the cervix, which impacts the finger, and the entire cervix may appear enlarged and thickened.
How to check for uterine prolapse?
Uterine prolapse can be assessed through a vaginal examination to determine the degree of prolapse. Uterine prolapse can be divided into three grades: First-degree mild, where the external os of the cervix is less than 4 cm from the hymenal ring and has not yet reached the hymenal ring; first-degree severe, where the cervix has reached the hymenal ring, and the cervix can be seen at the vaginal opening, which constitutes the first degree. Second-degree mild occurs when the cervix prolapses out of the vaginal opening, but the uterus remains inside the vagina, while in severe cases, part of the uterus prolapses out of the vaginal opening. Third-degree prolapse involves both the cervix and the uterus protruding completely outside the vaginal opening. Once uterine prolapse occurs, it is necessary to seek timely medical treatment at a hospital.