What causes uterine prolapse?

Written by Xu Xiao Ming

Obstetrics and Gynecology

Updated on December 15, 2024

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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 Liu Jian Wei

Obstetrics and Gynecology

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Can pelvic organ prolapse be detected by ultrasound?

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 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 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

47sec

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Natural childbirth uterine prolapse manifestations

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 Jia Rui

Obstetrics and Gynecology

1min 9sec

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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.