Uterine Prolapse Treatment
What is Uterine Prolapse ?
Uterine Prolapse is a medical condition where a patient’s uterus sags or slips out of its normal position. A group of muscles and ligaments are responsible to hold the uterus in place. This group of muscles and ligaments are weakened by the following factors:
- Loss of muscle tone as women age
- An injury caused during childbirth, particularly, women who have had many or large babies
- Chronic coughing
- Chronic constipation
- Added stress or tension on the pelvic muscles.
Prolapsed Uterus Symptoms
Patients with mild cases of Uterine Prolapse usually don’t exhibit any symptoms. However, patients with severe cases exhibit symptoms that interfere with bowel, bladder and sexual functions. Some of the prolapsed uterus symptoms are:
- Heavy Sensation or pulling of the pelvis
- Tissue protruding from the vagina
- Urinary issues, like leakage or retention of urine
- Problem during the bowel movement
- Patient might feel like sitting on a small ball or as if something is falling out of the vagina
- Vaginal bleeding
- Increased discharge
Diagnosis and Management
The doctor usually diagnoses this condition though pelvic examination by asking the patient to:
- Bear down during the bowel movement. This will help in the assessment of the distance the uterus had slipped into the vagina.
- Tightening of the pelvic muscles as if stopping a stream of urine. This is to check the pelvic muscle strength.
The doctor will recommend the following options for uterine prolapse treatment :
- Pelvic Floor Exercises : Stage I and II Uterine Prolapses can be helped by pelvic floor muscle exercises, but they need to be done correctly and practised long enough to strengthen the muscles.
- Vaginal Pessary : A pessary is a flexible device that can be fitted into the vagina to support the uterus. Pessary comes in different shapes and sizes. They are usually prescribed and fitted by a trained medical professional. The patient can also be taught to remove and re-insert it. Once the pessary is inserted into the patient’s vagina, it needs to be cleaned and checked by a doctor or a trained medical professional for the correct position.
- Vaginal Surgery : In cases of moderate to severe severity, the prolapse may have to be surgically repaired. The position of the uterus is corrected and reattached to its supporting ligaments. There is a chance of the surgery failing if the original cause of the prolapse, like obesity, coughing or straining, is not rectified.
- Uterine Suspension : In this treatment option, the surgeon will lift the uterus using a mesh material attaching the uterus to the pelvis. This procedure is called a sacral colpohysteropexy. In some cases, the surgery is done to shorten stretched-out ligaments that support the uterus.
The surgeons usually perform this treatment using laparoscopy.
In this procedure, a thin, flexible instrument called a laparoscope is used, with a small camera at one end that will transmit images pictures of the inside of the patient’s body to a video screen.
The surgeon will first create a couple of tiny incisions in the lower abdomen. Then, the laparoscope and tiny specialised surgical instruments are inserted through these incisions to perform the surgery.
Due to the latest technological advances, some surgeons might also use a surgical robotic system for the laparoscopic uterine prolapse surgery. Here, the surgeon will direct a robotic device from a computer to perform the different steps of the surgery.
Why is Laparoscopy preferred?
Minimal invasive surgery usually allows the patient to recover quickly and cause lesser pain than open surgery. This is due to:
- Lesser trauma inflicted on the tissues and organs
- Smaller incisions are created instead of larger ones that are used in open surgery
- Surgical tools used in this procedure are usually threaded around the muscles and tissues instead of cutting through or displacing them, like in an open surgery.
Prolapsed Uterus can be prevented to a great extent by performing the following measures:
Authored By Dr. Sunil Eshwar
Medical disclaimer: For information purposes only
- Perform Kegel exercises regularly
- Treat and prevent constipation
- Avoid heavy lifting and lift correctly
- Avoid weight gain