Does uterine prolapse require removal of the uterus?

Written by Shen Li Wen
Obstetrics and Gynecology
Updated on July 02, 2025
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When women experience uterine prolapse, it is not always necessary to remove the uterus. For instance, in cases of mild to moderate uterine prolapse, conservative treatment methods can be adopted, such as pelvic floor exercises. A common exercise is the anal contraction exercise, which involves contracting the anus for 3 seconds and then repeating this action for 15-30 times per set, with 2-3 sets a day depending on one’s physical condition. Most people will see significant improvement in symptoms of uterine prolapse after 6-8 weeks of exercise. For severe uterine prolapse, treatment should be tailored to the specific conditions of the woman. For example, elderly women in their seventies or eighties, who may not be in good physical condition and are not suitable for extensive surgery and who may not have significant sexual needs, may undergo vaginal closure surgery. On the other hand, women who place a high value on quality of life and do not wish to have their uterus removed can opt for a total pelvic reconstruction surgery.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Will intercourse worsen uterine prolapse?

Uterine prolapse in women can be categorized into mild, moderate, and severe based on the symptoms. It occurs due to damage to the pelvic floor muscles, causing the uterus to descend from its original position and protrude through the vagina. Normal sexual activity does not affect the function of the pelvic floor muscles nor exacerbate the symptoms of uterine prolapse. However, in certain cases, such as severe prolapse where part of the uterus extends beyond the vaginal opening, like when the cervix is exposed outside the vagina, friction between the cervix and underwear might occur during normal walking or activities. This friction can cause small ulcers that may bleed or become infected, producing purulent discharge during sexual intercourse.

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Written by Li Lin
Obstetrics and Gynecology
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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.

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Written by Li Shun Hua
Obstetrics and Gynecology
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Can an ultrasound detect uterine prolapse?

Uterine prolapse cannot be detected through an ultrasound, because during the ultrasound when it is necessary to hold urine, the uterus is lifted, so the degree and severity of uterine prolapse cannot be determined by this method. Uterine prolapse can be diagnosed by a gynecologist's examination, which can also determine the severity of the prolapse. Treatment methods should be determined based on the severity of the prolapse and the symptoms of the patient. Mild uterine prolapse might recover through treating the underlying disease and exercising. However, uterine prolapse of second degree or higher must be treated surgically to be restored to the normal position.

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Written by Xu Xiao Ming
Obstetrics and Gynecology
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Postoperative sequelae of uterine prolapse surgery

After undergoing a hysterectomy for uterine prolapse, the patient will be missing an organ, as the uterus is removed, and possibly the cervix as well, and part of the vagina may also be removed. Therefore, patients who have had this surgery may experience some difficulties during sexual activity. It is advised that such patients should rest more and avoid vigorous sexual activity. Additionally, after the removal of the uterus due to uterine prolapse, the patient will no longer menstruate and will not have reproductive capabilities. Therefore, it is suggested that patients consider carefully the postoperative conditions before undergoing the surgery.

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Written by Wang Jing Hua
Obstetrics and Gynecology
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Uterine prolapse bleeding, what's going on?

Uterine prolapse and vaginal bleeding typically occur due to infections related to the prolapse. Bleeding can also stem from precancerous lesions of the cervix, cervical inflammation, and other issues. Some cases involve bleeding from within the uterine cavity, which necessitates diagnostic examinations. Firstly, an examination of secretions is required, followed by an examination of the cervix to check for precancerous changes, cervical polyps, or severe cervical inflammation. Other potential causes include inflammation of the uterus, polyps of the endometrium, complications from intrauterine devices, or abnormal proliferation of the endometrium, among others.