Causes of uterine prolapse

Written by Li Lin
Obstetrics and Gynecology
Updated on September 22, 2024
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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.

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Can a uterine prolapse be detected with an ultrasound?

Uterine prolapse is generally not diagnosed through ultrasound, as the standard for diagnosing uterine prolapse is a gynecological exam. During the gynecological examination, the level to which the cervix has descended is observed, whether it is in the middle of the vagina or has reached the vaginal opening, and in severe cases of uterine prolapse, the cervix can protrude out of the vaginal opening. Of course, if there is uterine prolapse, it can also be detected during an ultrasound, where the significantly lower position of the uterus is evident. However, in reality, to diagnose uterine prolapse, an ultrasound is not strictly necessary; a simple gynecological exam can suffice for diagnosis.

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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.

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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.

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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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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.