How to treat uterine prolapse

We all know that the female uterus is a place where new life is nurtured, so the health of the uterus is also very important for women. During the menstrual period, the inner wall of the uterus will fall off every month, and then a new layer of inner wall of the uterus will be formed. This is actually a protective process for the uterus. However, some women feel abdominal pain and go to the hospital for examination to find that the uterus is prolapsed. So how should uterine prolapse be treated?

Uterine prolapse refers to the descent of the uterus from its normal position along the vagina, with the external cervical opening reaching below the level of the ischial spine, or even the entire uterus protruding out of the vaginal opening, often accompanied by bulging of the anterior and/or posterior vaginal wall. The anterior and posterior walls of the vagina are adjacent to the bladder and rectum, so uterine prolapse may also be accompanied by bladder urethra and rectal prolapse. Uterine prolapse is related to the relaxation of the ligaments supporting the uterus and the weakening of the pelvic floor support. It is more common in women who have given birth multiple times, are malnourished, or do physical labor. The incidence rate is 1% to 4%.

Causes

1. Delivery injury

It is the main cause of uterine prolapse. Childbirth, especially difficult labor, prolonged second stage of labor or vaginal operative delivery, can easily cause damage to the cervix, cardinal cervical ligament, uterosacral ligament and pelvic floor muscles. If the supporting tissue fails to return to normal after childbirth, uterine prolapse is likely to occur.

2. Increased abdominal pressure

Most mothers in the postpartum period like to lie on their backs and are prone to chronic urinary retention. The uterus is prone to become posterior, with the axis of the uterus in the same direction as the axis of the vagina. When the abdominal pressure increases, the uterus will descend along the direction of the vagina and prolapse will occur. Chronic constipation and cough, ascites or abdominal obesity can increase abdominal pressure and cause uterine prolapse.

3. Congenital developmental abnormalities

Uterine prolapse in nulliparous women is caused by poor development of the supporting tissues of the reproductive organs.

4. Malnutrition

Severe nutritional deficiencies can lead to muscle atrophy, relaxation of the pelvic fascia, and loss of support for the uterus. Uterine prolapse caused by malnutrition is often accompanied by symptoms such as gastroptosis and abdominal wall relaxation.

5. Aging

Ovarian dysfunction leads to a decrease in estrogen secretion, which makes the pelvic floor support tissue weak and loose, making uterine prolapse more likely to occur or worsening the original prolapse.

Clinical manifestations

The patient feels that his abdomen is falling, and the pain is more obvious when he walks or squats. In cases of mild prolapse, the prolapsed material in the vagina can be returned to its original position after lying down and resting. In severe cases, the prolapsed material cannot be returned to its original position, which affects movement. Due to long-term exposure to the outside, the cervix may develop thickening and keratinization of the mucosal surface or erosion and ulceration. Patients experience increased leucorrhea, which is sometimes pus-like or bloody. Some also experience menstrual disorders and excessive menstrual bleeding. When accompanied by cystocele, dysuria, urinary retention, stress urinary incontinence, etc. may occur.

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