Uterine prolapse and urinary incontinence

Uterine prolapse occurs when pelvic floor muscles and ligaments stretch and weaken, providing inadequate support for the uterus. The uterus then slips down into or protrudes out of the vagina. Uterine prolapse can happen to women of any age, but it often affects postmenopausal women.

Uterine prolapse varies in severity. If you have moderate to severe uterine prolapse, you may experience:

• Sensation of heaviness or dragging sensation in your pelvis
• Tissue protruding from your vagina
• Urinary problems, such as urine leakage or urine retention
• Trouble having a bowel movement
• Low back pain
• Sexual concerns, such as a sensation of looseness in the tone of your vaginal tissue
• In severe cases, part of the vaginal lining may be displaced by the fallen uterus and protrude outside your body, rubbing on underwear. The friction may lead to vaginal sores (ulcers).

Treatment

For mild uterine prolapsed, pelvic floor exercise would be advised to strengthen your pelvic muscles. We also advise you to maintain a healthy weight and avoid heavy lifting which may help reduce pressure on supportive pelvic structures.

For more severe cases of uterine prolapse, treatment options include:

• Vaginal pessary. This device fits inside your vagina and holds your uterus in place. Vaginal pessaries come in many shapes and sizes. Your doctor measures and fits you for the proper device.
• Surgery. There are operations to repair damaged or weakened pelvic floor tissues. Surgical repair of your prolapse may involve grafting your own tissue, donor tissue or some synthetic material onto weakened pelvic floor structures to support your pelvic organs. If there is urinary stress incontinence, incontinence surgery can be performed.

Talk with your doctor to learn your options, including the benefits and risks.