Causes of uterine prolapse

Written by Liu Jian Wei
Obstetrics and Gynecology
Updated on September 03, 2024
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Uterine prolapse is a common gynecological condition, primarily caused by damage to the pelvic floor tissues during childbirth. As the fetus descends during labor, it can damage the pelvic floor muscles and fascia, leading to a reduction in their supportive strength, which in turn causes the prolapse of the uterus and vagina. Additionally, aging is another main cause of uterine prolapse. As age increases, relaxation of the cervix, various uterine ligaments, and pelvic floor fascial muscles also contribute significantly to uterine prolapse.

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

When women experience uterine prolapse, the clinical symptoms vary depending on the severity of the condition. For instance, mild uterine prolapse often does not cause any discomfort. Severe uterine prolapse, however, may be due to the pulling of the uterus, leading to a reflex tension in the surrounding ligaments and causing congestion in the pelvic area. Women may feel pain in their sacral or lower abdominal area, which intensifies with excessive fatigue or prolonged standing. Some women may also experience stress urinary incontinence or changes in bowel behavior, such as constipation.

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What should I do if I have uterine prolapse?

The treatment of uterine prolapse needs to be determined based on the degree of prolapse and whether the patient has any clinical symptoms. If the prolapse is mild and the patient does not display obvious clinical symptoms, conservative treatment is recommended. Conservative treatment mainly involves pelvic floor muscle training to strengthen the pelvic floor support and facilitate the repair of the prolapsed uterus. If the prolapse is severe and is accompanied by serious clinical manifestations, surgical treatment may be considered.

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Written by Li Lin
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Can uterine prolapse be seen with the naked eye?

Uterine prolapse occurs when the uterus descends from its normal position, falling along the vaginal opening and moving out of its normal location, with the cervix or the entire uterus reaching or completely coming out of the vaginal opening. The main causes of uterine prolapse are childbirth injuries, prolonged increased abdominal pressure, and poor development of pelvic floor tissues. In mild cases of uterine prolapse, patients mostly do not have any symptoms and the condition is only identified during a gynecological examination. However, in severe cases of uterine prolapse, patients feel a mass coming out of the vaginal opening while walking, working, or squatting, and in serious cases, the entire uterus can completely prolapse out of the vaginal opening, becoming visible to the naked eye.

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How to recover from uterine prolapse?

Uterine prolapse can be classified into first-degree, second-degree, and third-degree prolapse. Typically, first-degree prolapse is considered mild and can generally be managed with a pessary or by performing exercises to strengthen the anal levator muscles and pelvic floor rehabilitation movements, which usually achieve the treatment purpose for mild uterine prolapse. Moderate or severe uterine prolapse must be treated according to the specific condition. In cases of severe prolapse, surgical options can be considered. Common procedures include uterine ligament suspension or vaginal hysterectomy. The treatment for uterine prolapse generally depends on age. For older individuals with severe prolapse, vaginal hysterectomy is often recommended. For younger patients with severe prolapse who wish to return to normal, uterine ligament suspension surgery is generally an option.

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Can you have intercourse with uterine prolapse?

Generally, it is possible, but it specifically depends on the condition of the disease. In severe cases of uterine prolapse, the entire uterus can protrude outside the vaginal opening, obstructing the passage for intercourse, making intercourse impossible. In mild cases of uterine prolapse or bulging, although it does not significantly affect intercourse, it can affect the quality of intercourse and cause abnormal sensations. Uterine prolapse is classified into three grades: first grade where the cervix is just above the hymen, second grade where both the cervix and part of the uterine body prolapse outside the vagina, and third grade where the entire uterine body is prolapsed outside the vagina. If suffering from uterine prolapse, it is recommended to seek active treatment, as early-stage uterine prolapse can be improved through physical therapy and exercise.