Uterine prolapse occurs when the pelvic floor muscles and ligaments stretch and weaken and no longer support the uterus. As a result, the uterus slips into the vagina or protrudes through it.

Uterine prolapse often affects postmenopausal women who have one or more normal vaginal deliveries, but it can occur in women at any age.

Mild uterine prolapse does not require treatment, but if it makes you uncomfortable or disrupts your normal life, you may benefit from treatment.

Symptoms

In general, mild uterine prolapse does not cause signs or symptoms. Signs and symptoms of moderate or severe uterine prolapse include:

Feeling of heaviness or pulling in the pelvis
Tissue protruding from the vagina
Urinary problems, such as urine leakage or urinary retention
Difficulty defecating
Feeling that you are sitting on a small ball or as if something is falling out of your vagina
Sexual problems, such as a feeling of looseness in the vaginal tissue

Causes

Uterine prolapse occurs when the pelvic muscles and supporting tissues are weakened. Causes of weakened pelvic and tissue muscles include:

Pregnancy
Difficult labor and delivery or trauma during childbirth
Delivery of a large child
Being overweight or obese
Decreased estrogen levels after menopause
Chronic constipation
Rectal fullness or pressure
Bronchitis and acute cough
Heavy lifting

Treatment

Treatment depends on the severity of the uterus prolapse. Your doctor may recommend:

Self-care measures:

If your uterine prolapse causes few or no symptoms, simple self-care measures may provide relief or help prevent the condition from worsening. Self-care measures include Kegel exercises to strengthen the pelvic muscles, losing weight, and treating constipation.

The vaginal pessary is a plastic or rubber ring inserted into the vagina to support the protruding tissue. A pessary should be removed regularly to be cleaned.

Surgery

Your doctor may recommend surgery to repair uterine prolapse. Minimally invasive (laparoscopic) or vaginal surgery may be an available option.

Surgery may include:

Repair weakened pelvic floor tissue:

This surgery is usually performed vaginally, but sometimes it is performed through the abdomen. The surgeon might graft your own tissue, donor tissue, or synthetic material to patch the weakened pelvic floor structure to support the pelvic organs.

Removal of the uterus (hysterectomy):

Hysterectomy may be recommended to treat uterine prolapse in specific cases. Generally, a hysterectomy is very safe, but any surgery carries the risk of complications.

Talk to your doctor about all treatment options available to make sure you understand their risks and benefits, so you can choose the best one for you.

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