Can pelvic organ prolapse be detected by ultrasound?

Written by Liu Jian Wei
Obstetrics and Gynecology
Updated on September 14, 2024
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For uterine prolapse, ultrasound examination mostly cannot detect it. The preferred method of examination for uterine prolapse is gynecological examination. Gynecological examination can observe the position of the vaginal cervix, effectively assess uterine prolapse, and determine its grade. This helps to clarify whether it is a prolapse of the anterior uterine wall, the posterior uterine wall, or the uterus itself. Based on the results of the examination, the next step in the treatment plan can be formulated. In cases of severe uterovaginal prolapse, surgical treatment may be necessary when required.

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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 Du Rui Xia
Obstetrics
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Symptoms of postpartum uterine prolapse

When postpartum women experience uterine prolapse, they often feel a sensation of heaviness in the abdomen, noticing a swollen mass protruding from the vulva. Postpartum uterine prolapse can be categorized into mild, moderate, and severe prolapse. In mild cases, there is generally just a sensation of heaviness, while moderate to severe prolapse can cause difficulties in urinating and urinary incontinence. Additionally, during a gynecological examination, a protruding cervix can be detected near the entrance of the vagina, and when this condition occurs, timely rehabilitative treatment is necessary.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Can you have sexual intercourse with uterine prolapse?

When a woman experiences uterine prolapse, it generally does not affect normal sexual activity, as symptoms might improve in a supine position, regardless of the type of prolapse. For instance, with moderate uterine prolapse, where the cervix protrudes beyond the vaginal opening, it might retract back into place when lying down. However, during sexual activity, cleanliness and hygiene should be considered. When uterine prolapse is severe, part of the uterus may be exposed at or outside the vaginal opening. Prolonged walking or other activities can cause friction, leading to possible cervical erosion and infections. Therefore, during intercourse, actions should not be too rough as it may exacerbate erosions or cause bleeding.

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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 Du Rui Xia
Obstetrics
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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.