What is Uterine Prolapse? What are the Diagnosis, Symptoms and Treatment?

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What is Uterine Prolapse?

Uterine prolapse occurs in women who have had a large number of pregnancies and have had trouble at birth. Symptoms of uterine prolapse are swelling in the vagina.

As a result of the weakening of the pelvic floor muscles and the ligaments that keep the uterus stable, the uterus becomes prominent in the vagina or comes out of the uterus. Although it is seen at all ages, it is generally seen in postmenopausal women who have given more than one birth.

What Causes Uterine Prolapse?

Sagging occurs due to the weakening of the ligament ducus that holds the bladder, uterus and intestines in place. As with all diseases, genetic factors are effective here.

However, multiple births, being overweight, chronic lung diseases that increase intra-abdominal pressure, constipation, and heavy lifting are risk factors.

What are the Symptoms of Uterine Prolapse?

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There are symptoms such as the feeling of swelling out of the vagina, the feeling of pulling towards the lower part of the vagina and waist, inability to discharge urine comfortably, incontinence with cough sneezing, inability to fully empty the intestines and the need to push the swelling in the vagina to empty it, difficulty in sexual intercourse.

 

How Is Uterine Prolapse Treated?

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The degree of uterine prolapse is important. In addition, since it is not a life-threatening situation, it is also important whether the patient complains about it.

In mild cases without serious complaints, no treatment may be required. However, if there is a cough, it should be relieved, avoiding situations that increase intra-abdominal pressure, and exercising should be recommended.

If the sagging is more serious, especially if there is sagging, placing a pessary ring can be applied to elderly patients who cannot afford the surgery or those who want to have children.

If the uterine prolapse of the patient is serious and requires treatment, surgical treatment is the most successful method. Surgical treatment is performed in two ways: vaginal and abdominal approach.

In the vaginal approach, the outgoing organ is pushed to its place, separated from the surrounding tissues and placed in its original place by strengthening.

The abdominal approach is performed using open, laparoscopic or robot-assisted laparoscopic methods.

In all, hanging organs are hung on the bone called sacrum with the help of mesh and fixed with stitches. This operation, which we call Sacro colpopexy, is 90-95% successful.

Which Treatment Is Suitable for Me?

The treatment decision should be made by mutual discussion after the communication between the patient and the physician.

If you want to have children in the next period, the choice of follow-up or pessary ring will be more appropriate.

The type of surgical approach varies from patient to patient. Laparoscopic or robotic approach can be preferred for those who have aesthetic concerns.

With open surgery, it can be successfully treated without any contamination of the abdominal organs (retroperitoneal approach).

Prof. Dr. Abdullah ArmağanUrology Specialist

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