What are the symptoms of uterine prolapse?

Written by Hou Jie
Obstetrics and Gynecology
Updated on September 24, 2024
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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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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 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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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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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 Zhang Xiu Rong
Obstetrics and Gynecology
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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.