Uterine Prolapse

uterine-prolapse

Heart care

When the muscles and ligaments of the pelvis become weak and can no longer support your organs in their normal position a uterine prolapse may occur. This condition, also known as pelvic organ prolapse, is a type of disorder in which the uterus or parts of the vagina drops from its normal position.The pelvic muscles become weak for a variety of reasons, including a loss of oestrogen, damage during pregnancy and delivery, or simply several years of stress and gravity. Multiple births, giving birth to a large baby, chronic coughing, repetitive heavy lifting, or previous pelvic surgeries can also increase your risk of a uterine prolapse.

Along with the uterus, the surrounding organs may also be affected by a prolapse.

  • Vaginal vault prolapses – The top of the vagina may prolapse in women who have had a hysterectomy
  • Cystocele – Prolapse of the front wall of the vagina and the bladder
  • Rectocele – Prolapse of the back wall of the vagina and the rectum
  • Enterocele – Prolapse of the pocket of tissue between the back wall of the uterus and the rectum, usually involving part of the small intestine

While a mild case of uterine prolapse may not present with any symptoms, a severe prolapse might cause:

  • Bulging or protrusion at the vaginal opening and/or ulcers on the protruding tissue
  • Pain or discomfort during sex
  • Full, heavy, pulling, or aching feeling in the pelvis
  • Difficult urination or bowel movements

The abnormal tissue must be removed right away. Although most of these growths are benign, they can sometimes become harmful tumours.If some molar tissue still remains even after removal, it may continue to grow and become cancerous. This complication occurs in about one out of five molar pregnancies.The fertilised egg triggers a pregnancy response in your body, which starts producing hormones to prepare for pregnancy. If in anscreenination we detect elevated levels of human chorionic gonadotropic (HCG) in your blood, it might indicate that you still have some molar tissue growing in your uterus.

This is known as persistent gestational trophoblastic disease (GTD) & may require treatment.

Mild uterine prolapses that cause no symptoms may not need treatment. For more serious prolapses, we will discuss both surgical and non-surgical options.

Non-Surgical Treatment for Uterine Prolapse Non-surgical options includethe insertion of a pessary which is a removable device that is inserted into the vagina to support the prolapsing muscles and organs.

Types of pessaries:

  • Inflatable
  • Doughnut
  • Gellhorn

Your London Obs & Gynae consultant will recommend the correct type of pessary for you and can insert it whilst you are at our Clinic.

Your doctor may also recommend Kegel exercises. These are exercises designed to strengthen your pelvic floor muscles and can be performed easily anywhere – at home, while watching TV, in the car, or even at the office.

Lastly, women who are overweight or obese might find relief from their symptoms if they lose some excess weight. Weight loss can reduce pressure in the pelvis and relieve strain on their pelvic muscles.

Before having surgery to treat your prolapse we will discuss the implications and risks of this type of surgical treatment which you will certainly want to consider if you have future plans for pregnancy.

Carrying a baby puts a lot of strain on your uterine muscles. If you have corrective surgery and then become pregnant, you may risk another prolapse after childbirth.

You’ll also want to consider your age. Recurring prolapse is not uncommon even after surgery, so young women may want to consider if they are willing to risk more surgery in the future.

Older women, women with health problems, and women who have had previous pelvic surgeries may have special circumstances that the Consultant will need to work around to have a successful procedure.

Some women, especially elderly women, may elect to have obliterative surgery to treat uterine prolapse. This procedure permanently closes off the vaginal canal in order to keep prolapse organs from descending. The procedure is very effective at treating uterine prolapse and is less risky than reconstructive surgery, but it prohibits sexual intercourse.

Obliterative surgery is only recommended for women who no longer desire sexual intercourse.

As with any medical procedure, reconstructive surgery for uterine prolapse carries some risk for certain complications, including painful intercourse, chronic pelvic pain, and urinary incontinence.

There are several different types of reconstructive surgery for the treatment of uterine prolapse. Basically, reconstructive surgery aims to correct the muscles, tissues, and ligaments to lift your pelvic organs back into their natural positions. Surgery may be performed through the vaginal opening or through an incision in the abdomen. The surgeon may or may not use a laparoscope (a thin, flexible, lighted camera) to guide the procedure. Depending on your condition, your surgeon may graft your own tissue onto the weakened areas, use tissue from a donor, or replace your tissue with synthetic mesh.

Reconstructive surgery is a very intensive procedure.

We recommend you will require up to 2-4 weeks off work post-surgery to rest& recover, during this period avoid heavy lifting, exercise, or sexual activity for 6-8 weeks after surgery.

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