Prolapse Womb

September 22, 2011

Prolapse womb is a serious condition that a woman can get due to loosen of vaginal wall muscles supporting the uterus. Many link this problem with improper care of the vagina after giving birth. But the truth is, uterus and vaginal wall need to be taken care starting at the young age or after puberty.

Prolapse Womb

Normal Womb

You may wonder how serious will the prolapse womb be; well, it will lead to Hysterectomy which is the surgery to remove the uterus. Actually, this prolapse is considered quite common among the women, most notably those who had given birth.

It is estimated about half of those that had given birth will likely to face this issue later on. Many women simply avoid to discuss this problem with their doctor due to embarassment and also because prolapse womb at early stage does not interfere with daily life.

Prolapse womb occurs in situations where the ligaments and muscles in the pelvic (hip) is weakened or damaged and can no longer accommodate the organ at that part. When this happens, the uterus will drop down into the vagina passage, bladder will be against the wall of the vagina and large intestine protruding toward the back of the vagina.

Although this situation is not life-threatening, but it brings discomfort and emotional distress. Sometimes women can get more than just 1 type of prolapse womb.

Types of Prolapse

Type 1 – The top/roof of vagina

If the above are involved, then uterus would fall into the vagina (Uterine prolapsed). This actually consist of 3 grades of severity.

* Grade 1: Womb is lowered slightly. Many women may not realize it. Usually this condition is only known when the inspection carried out by a doctor, such as pap smear

* Grade 2: Womb fell far below and cervix can be seen slightly at the door/opening of the vagina

* Grade 3: Almost the entire uterus fell out of the vagina; can be seen clearly at the vagina door.

Type 2 – The Front of Vagina

Urinary bladder drops down into the vagina (cystocele). It would push the vaginal wall and protrude forward like a lump. In worse scenario, you could actually see the lump at the opening of vagina. Normally, the bladder and urethra will fall together (Cystourethrocele) and the most common in women.

Type 3 – The Back of Vagina

Some of the small intestine that fills the space between the uterus and vagina can fall in the area between the vagina and the last part of the large intestine (rectum). This condition is called enterosele. If the rectum is falling, it will form a large lump on the back of the vagina near the anus. This is called rektosele.
Most likely, both situations can occur simultaneously and should be examined thoroughly. This is important because if not diagnosed, may increase the suffering of patients especially after surgery. This condition is called vault prolapse which occur after hysterectomy.

This condition may take time to occur after the support of the muscles around the vagina and the place of the sutures become weak and fall off. It happens in 15 percent of women who underwent hysterectomy due to this type 3 condition.

Prolapse Womb Causes

There are several factors which cause the pelvic muscles and ligaments to become weak and loose. It maybe due to pregnancy and childbirth, aging and menopause, obesity, tumors such as large fibroids, cough or chronic constipation.

Other factors include heavy lifting, inheritance, such as Marfan syndrome and ethnics, pelvic surgery such as hysterectomy, bladder correction surgery, damage or injury to the spinal cord.

Symptoms and Diagnosis

Women with Prolapse Womb may not know about it at all. They sometimes do not feel any symptoms or discomforts. If dropped bladder or fallen bladder, it may lead to women’s difficulty in controlling urination. She will make more visits to the washroom.

When a small or large intestine that falls, it may cause constipation or discontent bowel, so sometimes may need to insert a finger to remove the droppings.

Uterus that falls will trigger a kind of heavy feeling between the legs. In serious conditions when the uterus falls entirely, it can causes wound, bleeding or even infection.

Prevention

* Avoid standing for too long. This often happened in occupation like nursing, teaching, and many other jobs that require standing or walking too much. Relax yourself by sitting down and rest the foot on the bench.

* Pelvic Exercise is important to all the women disregard of your marital status. It strengthens internal muscles, helps to speed up the recovery process after surgery, regain control of urine and reduce back pain.

* Maintain proper nutrition and fibres to prevent chronic constipation. Eat lots of vegetables, fruits and cereals / grains.

* Wearing a right waist strap / belt can help to support back and pelvic but avoid being too tight

* Quit smoking if you are smoking now. Stay away and avoid inhaling smoke from smokers to avoid chronic cough

* Plan the pregnancy and make sure time between pregnancies are not too close. Try to family planning methods that have a high percentage of success.

* Pap Smear must be done yearly for early detection because this prolapse does not show any symptoms early on

* Traditional use of manjakani or oak gall claimed to help strengthen vagina and maintain womb in great form.

* Massage and toning of womb after childbirth will help to improve the loose muscles.

Treatment

If the prolapse womb is still at an early stage, patients will be referred to a physiotherapist to teach pelvic exercises and techniques. In addition, a form of vaginal pessaries rings / donuts available in various sizes can be used to keep the uterus from falling.

It can be done by women of all ages including menopause and young woman. This is because young woman still want to conceive and bear children and old women are not healthy for surgery. These rings or pessaries must be replaced every three or four months and it must be installed or changed by certified gynecologist.

In general, each individual treatment depends on a variety of conditions such as age, symptoms, types of prolapse, reproductive health, sexual health, vaginal health and impact of a woman’s life (eg. some women cannot accept the fact that they do not have womb, it makes them feel humiliated or not whole).

Surgery

Prolapse Womb

This is the last option if all options were tried but did not work out. Anterior colporrhaphy is the surgical repair, performed from the front of the vagina without the incision in the abdomen or stomach.
It is used to correct fallen bladder and can be done with full anesthesia or partial anesthesia .

Complications may occur (but rarely) is pain during sexual intercourse, bladder will become too sensitive or difficult urination. Similarly, the posterior surgery to repair the vagina from the rear with a more or less the same complications with anterior repair.

Surgery for ‘dropped uterus’ is by removing the uterus from the reproduction system is called vaginal hysterectomy.

Normally, all three of the procedures above are done simultaneously because prolapse womb involving the front, back and uterus at once. This is because if anyone of the problem not resolved will require vault prolapse surgery which will complicate the matter.

Post Surgery

Hysterectomy took three months to heal completely. Sexual intercourse can be started again six weeks after surgery. However, it must be consulted with doctor about your plan to go back to your sexual life.

Most importantly, do not feel embarrassed to see a doctor and tell about all the problems that is affecting your private parts. Perform annual inspection and Pap smear.

In conclusion, prolapse womb is a serious condition that needs to be taken care immediately to prevent surgery. Start to work on the recommended actions to prevent prolapse womb now.