Uterine prolapse

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Female reproductive anatomy

Uterus

Pelvic relaxation; Pelvic floor hernia

Uterine prolapse can be treated with a vaginal pessary or surgery.

A vaginal pessary is an object inserted into the vagina to hold the uterus in place. It may be used as a temporary or permanent form of treatment. Vaginal pessaries are fitted for each individual woman.

Pessaries may cause an irritating and abnormal smelling discharge, and they require periodic cleaning, usually done by the physician. In some women they rub on and irritate the vaginal mucosa, and in some cases may erode and cause ulcerations. Some types of pessaries may interfere with normal sexual intercourse by limiting the depth of penetration.

If the woman is obese, attaining and maintaining optimal weight is recommended. Heavy lifting or straining should be avoided.

There are some surgical procedures that can be done without removing the uterus, such as a sacral colpopexy. This procedure involves the use of surgical mesh for supporting the uterus.

Most surgery should be deferred until symptoms are significant enough to outweigh the risks. The surgical approach depends on:

• The woman's age and general health
• Desire for future pregnancies
• Preservation of vaginal function
• Degree of prolapse
• Associated conditions

When indicated, a vaginal hysterectomy is performed. Any sagging of the vaginal walls, urethra, bladder, or rectum can be surgically corrected at the same time.

With proper precautions (periodic check-ups and cleaning) vaginal pessaries can be effective for many women with uterine prolapse. Surgery, if done, usually provides excellent results, however, some women may require treatment again in the future for recurrent prolapse of the vaginal walls.

Urinary tract infections and other urinary symptoms may occur due to the frequently associated cystocele. Constipation and hemorrhoids may also occur as a result of the associated rectocele. Ulceration and infection may occur in more severe cases of prolapse.

Call for an appointment with your health care provider if symptoms of uterine prolapse occur.

Review Date: 06/06/2006
Reviewed By: Audra Robertson, MD, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.