Prolapsed Uterus

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Medical Author:

Sarah Samreen, MBBS

Coauthor:

George Lazarou, MD, FACOG

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• Prolapsed Uterus Overview
• Prolapsed Uterus Causes
• Prolapsed Uterus Symptoms
• When to Seek Medical Care
• Prolapsed Uterus Diagnosis
• Prolapsed Uterus Treatment
• Prolapsed Uterus Self-Care at Home
• Prolapsed Uterus Medications
• Prolapsed Uterus Surgery
• Prolapsed Uterus Other Therapy
• Prolapsed Uterus Follow-up
• Prolapsed Uterus Prevention
• Prolapsed Uterus Prognosis
• Synonyms and Keywords
• Authors and Editors
• Viewer Comments: Prolapsed Uterus - Causes
• Viewer Comments: Prolapsed Uterus - Symptoms

Prolapsed Uterus Overview

The uterus (womb in which a fetus develops) is normally held in place inside the pelvis with various muscles, tissue, and ligaments. Sometimes, because of childbirth or difficult labor and delivery, these muscles weaken. As a woman ages and with a natural loss of the hormone estrogen, her uterus can collapse into the vaginal canal, causing the condition known as a prolapsed uterus.

Muscle weakness or relaxation may allow the uterus to sag or come completely out of the body to a variable extent. Prolapsed uterus can be described in the following stages:

• First degree: The cervix droops into the vagina.
• Second degree: The cervix sticks to the opening of the vagina.
• Third degree: The cervix is outside the vagina.
• Fourth degree: The entire uterus is outside the vagina. This condition is also called procidentia. This is caused by weakness in all of the supporting muscles.

Other conditions are usually associated with prolapsed uterus. They weaken the muscles that hold the uterus in place:

• Cystocele: A herniation (or bulging) of the upper front vaginal wall where a part of bladder bulges into the vagina, which may lead to urinary frequency, urgency, retention, and incontinence.
• Enterocele: The herniation of the upper rear vaginal wall where a small bowel portion bulges into the vagina. Standing leads to a pulling sensation and backache and is relieved when lying down.
• Rectocele: The herniation of the lower rear vaginal wall where the rectum bulges into the vagina. This makes bowel movements difficult to the point that the woman may need to push on the inside of the vagina to empty the bowel.

Prolapsed Uterus Causes

The following conditions can cause a prolapsed uterus:

• Pregnancy/multiple childbirths with normal delivery through the vagina
• Weakness in the pelvic muscles with advancing age
• Weakening and loss of tissue tone after menopause and loss of natural estrogen
• Conditions leading to increased pressure in the abdomen such as chronic cough (with bronchitis and asthma), straining (with constipation), pelvic tumors (rare), or an accumulation of fluid in the abdomen
• Being overweight or obese and its additional strain on pelvic muscles
• Radical surgery in the pelvic area leading to loss of external support

Other risk factors

• Excess weight lifting
• Caucasian women more commonly affected; African Americans and Asians are affected less often