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What is prolapse of the uterus and vagina and what is the treatment method?

تهبيطة الرحم دكتور قاسم شهاب

Uterine prolapse is a common problem that occurs in women, especially after the age of 50 years (the period of menstrual disorder and menopause). This condition causes a kind of tension and embarrassment and many health complications, so what is this condition, what are its causes and symptoms, and what are they Available treatment methods?

The pelvic organs - the area of ​​the body between the thigh bones - include the vagina, cervix, uterus, bladder, urethra, intestine and rectum.

These organs are held in place by a group of muscles and other tissues.

When this support system becomes extended or torn, it allows the pelvic organs to come out of their normal positions or decline (prolapse)

What is the condition of prolapsed uterus?

The prolapse of the uterus is called many names such as the prolapse or the prolapse of the uterus, or the prolapse of the vagina and others, it is a form of displacement of the genitals from their original position to the bottom, where the uterus descends down to the cervix or the birth canal towards the vagina, the prolapse of the uterus occurs as a result of dilation Weakening of the muscles and ligaments in the pelvic area to become unable to provide adequate support to hold the uterus in place.

What are the types of prolapse of the uterus, vagina and neighboring organs?

  • Prolapse of the uterus: The uterus swells or slips into the vagina , sometimes until it comes out of the vaginal opening.

  • Vaginal vault prolapse: The upper part of the vagina (known as the "vaginal vault") descends into the vaginal canal. This usually occurs in women who have had a hysterectomy (removal of the uterus).

  • Bladder: The bladder drops into the vagina.

  • The urethra: The urethra (the tube that carries urine away from the bladder) bulges into the vagina. It is often found in the bladder and urethra.

  • Rectum: The rectum bulges in or out of the vagina.

  • Intestinal: The small intestine bulges out on the back wall of the vagina . Bowel prolapse and vaginal vaulting often occur together

How common is vaginal and uterine prolapse?

More than a third of women in the United States have pelvic prolapse. Approximately 25% feel some symptoms from the condition. Up to 11% of women require surgery for prolapse at some point in their lives.

Stages of uterine prolapse:

Uterine prolapse occurs gradually through four stages:

  1. The first stage: the prolapse of the cervix towards the vagina.

  2. The second stage: the cervix falls to a level inside the vaginal opening.

  3. The third stage: Part of the cervix prolapses and protrudes outside the vagina.

  4. The fourth stage: the uterus is completely out of its normal position, and this condition is called Procidentia, where severe weakness occurs in all the muscles supporting the uterus.

What are the symptoms of uterine prolapse when married?

The type and severity of symptoms varies from one woman to another, depending on the degree of uterine prolapse. Among the most famous of these symptoms:

  • A feeling of heaviness and a feeling of tension in the pelvic area, such as the feeling of sitting on a ball or the sensation of something falling outside the vagina.

  • lower back pain.

  • Disturbances in bowel movement.

  • Urine leakage, or a bladder infection.

  • Having difficulty establishing a sexual relationship.

  • An increase in the amount of vaginal secretions, or vaginal bleeding.

  • Weakening of vaginal tissue.

  • Uterine protrusion from the vaginal opening .

What are the reasons behind the occurrence of uterine prolapse?

The main reason behind this condition is weak pelvic floor muscles for a number of reasons, the most important of which are:

  • Frequent pregnancy with frequent periods.

  • The birth of babies with relatively large weights .

  • Nature childbirth.

  • Estrogen levels decrease with age and menopause , leading to loss of tissue tone and muscle weakness.

  • Previously pelvic surgery.

  • Genetic factors leading to weak connective tissue in the pelvis.

  • The presence of disturbances in bowel movement such as chronic constipation.

  • Lifting heavy loads the wrong way.

  • Chronic cough, such as a cough associated with bronchitis or an asthma attack.

  • Obesity, as weight gain leads to more pressure on the pelvic area.

  • Smoking.

  • Vigorous physical activity or lifting heavy objects.

What are the symptoms of vaginal and uterine prolapse?

In many cases, a woman will not feel any symptoms indicative of her prolapse and will only discover this during the exam.

In cases where symptoms do occur, the following are the most common:

  1. A feeling of fullness, heaviness, or pain in the pelvic area. This feeling often gets worse over time or gets worse after standing, lifting, or coughing.

  2. lower back pain.

  3. Swelling of the vagina.

  4. Organs slipping out of the vagina.

  5. Urine leakage.

  6. Bladder infections.

  7. Difficulty having a bowel movement or the need to put the organs back in place after a bowel movement.

  8. Problems with sexual intercourse.

  9. Problems inserting tampons.

What are the procedures used to diagnose uterine prolapse?

Uterine prolapse is diagnosed by performing a pelvic exam and evaluating symptoms in general.

The doctor's examination is usually physical, and your doctor may ask you to lie down or stand during this exam.

During a pelvic exam, your doctor will likely ask you to:

  • Tightening the pelvic muscles, like a urethral stopping motion, to check the strength of the muscles.

  • Relax the pelvic muscles as if there is a bowel movement to expel urine, to assess the extent to which the uterus has slipped into the vagina.

How is prolapse treated?

There are many treatments available for uterine prolapse, and the type of treatment used varies from person to person according to the stage of uterine prolapse or the presence of chronic diseases, etc., and what are these treatment procedures:

Treatment for uterine prolapse without surgery:

  • Estrogen

Estrogen is available in many medicinal forms such as topical creams, vaginal suppositories, or vaginal rings (inserted into the vaginal opening) that contain estrogen. Estrogen works to restore the strength and vitality of the vaginal tissues.

  • Vaginal pessary

It is also called the vaginal vulvar, and it is a simple, removable, smooth-touch device that is inserted into the vagina with the aim of supporting the area affected by the lowering of the pelvic organs such as the uterus, the bladder or the rectum, and others, and it can be used in cases of urinary incontinence as well.

Most types of vaginal nipples are made of non-absorbent or harmful silicone, and they come in several forms that may come in the form of a ring (which is the most commonly used type as it can be inserted and removed easily without the help of a doctor), or U-shaped in English, or a cube, or with a small handle.

For more advanced cases of uterine prolapse.

The doctor usually performs the necessary tests to determine if the option to use the vaginal nipple is appropriate, and accordingly the shape and type of the nipple is most appropriate and approximate measurements are taken to ensure that the size of the nipple matches the size of the pelvis and the opening of the vagina, if the vaginal nipple is very small, it may be subject to fall. But if it is very large, the woman may feel a lot of pressure or discomfort.

As for the cleaning method for the vaginal nipple, it varies from one type to another; As there are types that can be taken out easily and cleaned every day or week without the help of a doctor, and other types require insertion, removal or cleaning with the help of the doctor, usually every month to 3 months sometimes.

Treatment of uterine prolapse or vaginal prolapse and surgical procedures:

The doctor’s decision to perform the surgery depends on several factors such as: the woman’s age, the degree of uterine prolapse, the woman’s desire for pregnancy and childbearing, as well as the presence of any other problems in nearby organs such as the urinary bladder or rectum .

The surgery may be performed by opening the abdomen, through the vagina, or through a small incision in the abdomen or vagina with specialized tools such as the use of a speculum.

Among the forms of surgical procedures used in the treatment of uterine prolapse:

  • Weak pelvic floor tissue repair (Sacrohysteropexy)

This procedure is usually performed through the vagina, and in some cases, an incision may be made through the abdomen. This technique consists of placing a network of natural or synthetic tissues on the pelvic floor structure and connecting it to the cervix, to provide the necessary support and lift the uterus and other organs in the pelvic region to its correct place. This option is usually presented when the patient cannot or refuse to have a hysterectomy.

The patient needs a few weeks of rest after the procedure, with the necessity to avoid severe exercises such as racking or straining, and to avoid having sexual intercourse for several weeks after the operation.

Some cases require removing the uterus completely, or part of it, such as removing the upper part only, or removing the lower part with part of the vagina, depending on the degree of development of the prolapse of the uterus, the woman’s age, and her desire for childbearing,

Usually Dr. Qassem Shihab , a consultant specializing in pelvic restoration and ossification, usually resorts to fixing tissues after hysterectomy, in a method known as (sacrospinous fixation)

Dr. Qassem Shehab , consultant of advanced laparoscopic surgery, gynecology and obstetrics. Subspecialty specialization in the treatment of urinary incontinence and gynecological edema

Abdali Hospital, Boulevard, 24th floor

Oman Jourdan

For reservations and inquiries




Does the prolapse of the uterus affect the menstrual cycle?

The contractions and the pain of the period may be more, but the heaviness of the period does not increase

What is the treatment for uterine prolapse or prolapse?

It could be surgical or conservative

What are the symptoms of uterine prolapse?

Usually there are no symptoms, but it may cause difficulty sexual intercourse and heaviness in the pelvis

What are the symptoms of uterine prolapse?

Usually there are no symptoms, but it may cause difficulty sexual intercourse and heaviness in the pelvis

How is prolapse treated at home prolapse?

It is possible for the woman to lie on her back, take a time, then make an appointment with Dr. Qasim Shehab for an examination

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