The Symptoms of Uterine Prolapse
By Kristi Patrice Carter
Uterine prolapse, a condition in which the uterus (womb) is weakened and eventually collapses into the vaginal canal, is usually the result of difficult or multiple childbirths. During pregnancy, the ligaments and muscles that hold the womb in place become stretched or slack, which causes the uterus to sag or droop.
Obesity, chronic coughing, and abdominal or pelvic tumors can also cause a prolapsed uterus or pelvic relaxation, conditions which rarely affect younger women. The severity of a prolapsed uterus is much more likely to progress over time following the post-reproductive years, and may be caused by multiple or difficult pregnancies. The deprivation of estrogen that occurs after menopause may also contribute to the weakening of the pelvic muscles.
The classic symptoms of a prolapsed uterus include:
- Difficulty having bowel movements
- Difficulty walking
- Difficulty urinating
- Pain in the lower back area
- Pain during sexual intercourse
- Pressure in the pelvis or a feeling of fullness
- The sensation that something is about to fall out of the vagina
Symptoms that require immediate medical attention include:
- Bowel obstructions
- Continual, worsening back pain
- Increasing difficulty walking or standing
- Rectal urgency, a continual sensation or urge to have a bowel movement
- The ability to feel the cervix pressing against the vaginal canal
- Uterine prolapse, the uterus has actually completely come out of the vagina
There are other medical conditions that cause a weakening of the muscles that hold the uterus in its proper place and may possibly lead to uterine prolapse. These conditions include:
- Cystocele: A cystocele is a herniation of the vaginal wall caused by a part of the bladder that is pressing into the vagina. This herniation causes a bulge in the walls of the vagina and may lead to symptoms such as incontinence, urinary frequency, and urgency.
- Enterocele: An enterocele is a herniation of the upper, rear vaginal wall. A small section of the bowel pushes, or bulges into the vagina causing a distinct pulling sensation, and backaches while standing. Symptoms of an enterocele are usually relieved from lying down.
- Rectocele: A rectocele is a herniation of the lower, rear vaginal wall. A portion of the rectum bulges or pushes into the vagina making bowel movement increasingly difficult. In severe cases, pressure needs to be applied to the inside of the vagina in order to facilitate a bowel movement.
The evidence of classic symptoms along with the patient’s history are usually enough to suggest the presence of a prolapsed uterus. However, to accurately diagnose the condition, a complete medical history along with a physical examination of the pelvic region will be necessary. In many instances it is necessary to perform multiple examinations to determine the extent of the condition, and to determine which organs may be involved.
Other tests to detect specific conditions or to rule out underlying causes may be necessary to diagnose uterine prolapse, including a renal sonogram, and an ultrasound, which are imaging tests that create pictures of the internal organs using sound waves.