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Uterine prolapse
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.
The main causes of uterine prolapse
The causes of uterine prolapse in women are complex, with the most common being pregnancy and childbirth, especially multiple childbirths, which can lead to damage to a woman's pelvic floor muscles. Some women experience this during vaginal delivery using instruments such as forceps or vacuum extractors, which can injure the pelvic muscles and lead to uterine prolapse. Some women may engage in heavy physical labor too soon after childbirth before their pelvic floor functions have recovered, affecting the recovery of pelvic tissue tension and leading to uterine prolapse. Additionally, uterine prolapse may also occur in women who are overweight, suffer from internal medical conditions such as chronic cough, ascites, or constipation, which increase the pressure inside the abdominal cavity.
Symptoms of uterine prolapse
The main symptom of uterine prolapse is the protrusion of a mass from the vaginal opening. Uterine prolapse can be divided into three degrees. In the first degree of uterine prolapse, only the cervix is visible at the vaginal opening. At this stage, symptoms are not very pronounced and may include rapid urination or urinary incontinence. In the second degree, the cervix and part of the uterine body protrude from the vaginal opening. This can lead to difficulty walking or abrasion, and bleeding from the vaginal opening may occur. If the entire uterus prolapses, it can lead to an inability to urinate or difficulty defecating. Patients may experience pain in the lower abdomen or difficulties and abrasion while walking, and severe cases can lead to bleeding from the cervix or significant discharge, potentially resulting in infection.
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.
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.
What are the causes of uterine prolapse?
There are many causes of uterine prolapse in women, for instance, the most common one occurs during pregnancy and childbirth, especially when methods such as forceps delivery are used, which may damage the pelvic floor muscles or injure the vaginal wall. This causes damage to the pelvic floor muscles, and if not properly recovered postpartum, it can lead to prolapse. Additionally, some women might suffer from conditions like chronic pharyngitis, chronic bronchitis, long-term coughing, or have liver diseases or malignant tumors leading to a significant build-up of ascites. Frequent heavy physical labor or even simple obesity can increase abdominal pressure, causing uterine prolapse.
Causes of uterine prolapse
The main causes of uterine prolapse include pregnancy, childbirth injury to the pelvic floor muscles, long-term increase in abdominal pressure, such as chronic coughing, habitual constipation, and difficulty defecating. Prolonged heavy lifting. Long periods of squatting or standing, large pelvic tumors causing downward displacement of the uterus, or poor development of pelvic floor tissues and degenerative changes accompanied by prolapse of other organs. In menopausal women, due to the decline in sex hormone levels, the pelvic floor tissues may atrophy and degenerate, which can also lead to uterine prolapse or exacerbate its severity.
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.
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.
Can you get pregnant with uterine prolapse?
When women experience uterine prolapse, if it is only mild or moderate, it usually does not affect their ability to become pregnant normally. In most cases, when the woman lies down, the protruding part of the uterus might naturally retract, or it can be manually pushed back into the vagina. During intercourse, after ejaculation, the cervix may still be immersed in semen, allowing sperm to pass through the cervix smoothly, and the woman can become pregnant normally. However, in cases of severe uterine prolapse, such as when the entire uterus descends outside the vagina, and cannot be repositioned back into the vagina even when lying down, during intercourse, the ejaculated semen may not sufficiently immerse the cervix, and sperm may not be able to normally enter the cervix and uterine cavity. Additionally, many women with severe uterine prolapse might experience cervix erosion, bleeding, and infection due to friction, which can produce inflammatory cells that hinder the normal passage of sperm, leading to difficulties in conception.