Natural childbirth uterine prolapse manifestations

Written by Shen Li Wen
Obstetrics and Gynecology
Updated on September 03, 2024
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After vaginal childbirth, women may experience uterine prolapse due to being over-fatigued or engaging in physical labor too soon. Most women with mild symptoms show no clinical signs. As the symptoms worsen, some women may feel a sense of heaviness in the lower abdomen, and this sensation intensifies when squatting or using the restroom, with a feeling of heaviness in the vulva. Some women may feel something protruding from the vagina, which can be retracted back into the vagina when lying flat; this is uterine prolapse after childbirth. Typically, this condition can be improved by performing anal contraction exercises.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Does uterine prolapse affect menstruation?

In most cases, uterine prolapse does not affect the normal menstrual cycle in women. However, in very rare instances where the symptoms of uterine prolapse are severe, part of the uterus may prolapse outside the vagina, such as external cervical protrusion. This can cause the cervical tissue to rub against the underwear, leading to local ulcers and even infections. At this point, this can result in the presence of purulent vaginal discharge or bleeding in women. If a woman's immune resistance decreases, the infection can ascend, causing inflammation of the uterine lining. This condition can affect the menstrual cycle, with some women experiencing increased menstrual flow. Additionally, some women may exhibit irregular cycles, irregular vaginal bleeding, and abdominal pain.

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Written by Shen Li Wen
Obstetrics and Gynecology
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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.

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Written by Sun Shan Shan
Obstetrics and Gynecology
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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.

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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 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.