Uterine prolapse


Uterine prolapse is treated in the Department of Gynecology.
Uterine prolapse requires registration with the gynecology department as it is a type of gynecological disease. There are many causes of uterine prolapse, including pregnancy and childbirth. Particularly, vaginal delivery before childbirth or difficult deliveries involving suction can weaken the supporting strength of the pelvic fascia, ligaments, and muscles due to excessive stretching, leading to uterine prolapse. Additionally, aging, especially post-menopause, can cause an atrophy of the supporting structures, also leading to uterine prolapse. Other causes include chronic cough, abdominal effusion, and obesity, which can all lead to uterine prolapse. Therefore, once uterine prolapse occurs, it is necessary to promptly visit a hospital for examination to determine the extent of the prolapse, and treatment should be conducted according to the examination results.


Does uterine prolapse affect pregnancy?
Under normal circumstances, it is still necessary to determine the degree of uterine prolapse to understand whether it affects pregnancy. If the degree of uterine prolapse is mild, and it is just the cervix bulging into the vaginal wall, it generally does not have a significant impact on a normal pregnancy. If the uterine prolapse is more severe, and part of the cervix or part of the uterus has prolapsed beyond the hymen, this condition is considered to be within a mild range of 2nd to 3rd degree of prolapse. This severity of uterine prolapse can greatly impact pregnancy, and it is very easy to lead to miscarriage after becoming pregnant. Therefore, it is still necessary to undergo surgical repair before attempting to conceive.


What are the symptoms of uterine prolapse?
Patients with mild uterine prolapse generally do not exhibit symptoms. Severe prolapse can cause pulling on the ligaments and fasciae, resulting in pelvic congestion, with patients experiencing varying degrees of soreness in the lower back or a sensation of heaviness. Symptoms become noticeable after standing for extended periods or after fatigue but significantly lessen after resting in bed. It is crucial for patients experiencing uterine prolapse to seek timely medical examination at a hospital to determine the severity of the condition. Patients with mild uterine prolapse can also use traditional Chinese medicine or acupuncture and other physical therapies to promote the recovery of pelvic floor muscle tension and relieve local symptoms. If the prolapse is severe, surgical treatment may be necessary, and it is generally advised to avoid cold and fatigue.


Does postpartum constipation cause uterine prolapse?
Postpartum constipation generally does not lead to uterine prolapse. Uterine prolapse is mainly associated with women engaging in heavy physical labor, standing for long periods, or performing strenuous activities too soon after childbirth. Additionally, prolonged coughing after childbirth or severe constipation can increase abdominal pressure, which may lead to uterine prolapse. Furthermore, multiple pregnancies or improper handling during childbirth, especially in cases of difficult labor, can easily cause damage to the tissues around the uterus, including tears, which can result in uterine prolapse.


Will sexual intercourse cause bleeding in cases of uterine prolapse?
When women suffer from uterine prolapse, bleeding usually does not occur during intercourse. Bleeding only occurs in certain special circumstances, such as when a woman suffers from severe cervical erosion or acute cervical inflammation, where the cervical surface exhibits congestion and edema. Furthermore, some women with severe symptoms of uterine prolapse might have the cervix protruding outside the vaginal opening; the friction between the cervix and undergarments can lead to local ulcers, and even infections. In such cases, intercourse might cause bleeding from cervical trauma. Generally, the amount of bleeding is relatively small, which may manifest as blood streaks in vaginal discharge.


What should I do if I have uterine prolapse during menstruation?
The normal position of the uterus is within the female pelvis. When a prolapse occurs, the uterus gradually descends downwards. In cases of mild to moderate uterine prolapse, since the majority of the uterus remains inside the vagina, there is no particular need for special attention during menstruation—regular care will suffice. In severe cases of uterine prolapse, the uterus might completely protrude outside the vaginal opening. In such circumstances, extra care may be needed during menstruation to prevent menstrual blood from staining undergarments. You might need to use larger sanitary pads; other than that, there is nothing particularly different that needs attention. Additionally, remember to change sanitary pads and underwear regularly to avoid potential infections.


How to check for uterine prolapse after childbirth
During routine postnatal checks after natural childbirth, it is important to evaluate the recovery of pelvic floor function, including checking for the presence and severity of uterine prolapse. Uterine prolapse can be assessed in the following ways: First, a gynecological examination can be conducted. Through this examination, the condition of the uterine prolapse and the position of the cervix can be clearly identified and staged. Second, performing a perineal ultrasound can generally assess the condition of uterine prolapse and the state of pelvic floor function. Third, in cases of severe uterine prolapse, it is also necessary to perform a urinary system examination, such as urodynamic testing, because uterine prolapse often occurs simultaneously with bladder prolapse.


Does uterine prolapse affect pregnancy?
Uterine prolapse, as long as it does not affect sexual intercourse, generally does not impact the ability to conceive. Uterine prolapse can be classified into three degrees. First-degree uterine prolapse does not affect pregnancy since it allows for normal sexual activity. However, in the case of third-degree uterine prolapse, the uterus has prolapsed out of the vagina and sometimes cannot be repositioned, thus interfering with sexual activity and affecting the ability to conceive. Therefore, whether uterine prolapse impacts pregnancy depends on the patient's condition, as well as whether they have normal menstruation or normal endocrine function.


How to treat uterine prolapse and urinary incontinence?
Uterine prolapse is mostly caused by childbirth injuries, long-term increase in abdominal pressure, or the degenerative changes and poor development of pelvic floor tissues. Mild uterine prolapse generally does not have noticeable symptoms. Severe uterine prolapse often accompanies anterior vaginal wall prolapse, which can lead to urinary retention and stress urinary incontinence, commonly referred to as leakage of urine. In cases of uterine prolapse with urine leakage, treatment requires enhanced nutrition, appropriate arrangement of rest and work, avoidance of heavy physical labor, and maintaining smooth bowel movements. Active treatment of chronic negative pressure increase diseases, such as constipation and chronic cough, is necessary. When uterine prolapse results in urine leakage, surgical treatment is generally required. Pelvic floor tissue repair is done, and in severe cases, hysterectomy is necessary along with the repair of the anterior and posterior vaginal walls for effective treatment.


Can postpartum constipation cause uterine prolapse?
If there is severe constipation after childbirth, and it is not corrected in time, long-term constipation can lead to uterine prolapse in women. Postpartum constipation increases abdominal pressure, which affects the recovery of pelvic floor muscles, causing the loss of support in the pelvic floor muscles and thus leading to uterine prolapse. However, the main factor contributing to uterine prolapse is not constipation but the damage caused by childbirth, which is the primary cause. After childbirth, the pelvic floor muscles are weakened. Whether standing, bearing weight, or holding breath for a long period, thereby increasing abdominal pressure, can lead to the inability of the pelvic floor tissues to support and stabilize the internal organs of the pelvis, resulting in a prolapse.