Heard of Uterine Prolapse?

As we close in on Mother’s Day, here’s learning more about a condition called uterine prolapse, and what’s in store for women after they hit menopause

KOCHI:  Women live one third of their lives after menopause. We ignore it. And what is her most productive span of life, professionally socially and economically? Obviously, it comes after menopause. Most of them withdraw themselves thinking that quality life is lost during this phase due to a number of health issues.

Problems like stress, urinary incontinence (leakage of urine while coughing sneezing or lifting weight), and pelvic organ prolapse aggravates in this period due to laxity of muscles and facia, a direct result of decreased estrogen levels after menopause. 

It is estimated that roughly one third of women are affected by one or more forms of pelvic organ prolapse over their lifetime.

Detected at early stages, progression of prolapse can be stopped or delayed with specific exercises and hormone replacement. Even the most difficult case may need simple corrective surgery.   

Pelvic organ prolapse refers to slipping down of pelvic floor organs like uterus, urinary bladder, large intestine and rectum through vagina.

The condition that affects most women is uterine prolapse. Uterus is supported and held in place inside the pelvis by various pelvic floor muscles, ligaments and fascia. When these muscles and ligaments weaken and fail to support the uterus, it drops down and comes out in various degrees.

Dr Urmila Soman

First degree: The cervix (lower end of uterus) drops into vagina.
Second degree: The cervix drops till the opening of the vagina.
Third degree: The cervix protrudes out of the vagina.
Fourth degree or complete prolapse: All supporting muscles fail and the entire uterus comes out through the vagina.

Causes, incidence and symptoms
Pelvic muscles can weaken due to one or more vaginal deliveries. Supportive tissues may damage during pregnancy and childbirth.  Uterine prolapse often affects sixty per cent of postmenopausal women due to hormonal changes. Loss of estrogen and straining over the years escalate it. 

Chronic cough associated with bronchitis and asthma, extra strain on pelvic muscles due to obesity, excess weight lifting, excessive weight of child in the womb and increased pressure in the abdomen can lead to pelvic organ prolapse. A prolapsed uterus would show symptoms including vaginal bulge, bleeding, stress urinary incontinence, constipation and the need to manually assist in reducing prolapse, often to defecate or relieve oneself.

Minimal invasive surgery:
When uterine prolapse disrupts daily life, women tend to withdraw from work and social life. The illness is largely suppressed fearing a surgical removal of the uterus. Such anxieties are now misplaced. Womb and other pelvic organs can be restored with minimally invasive laparoscopic or robotic-assisted surgery.

Widespread use of laparoscopic techniques in treating gynecological problems has made surgery easier. Obviously, no major incision is needed here. The procedures to correct uterine prolapse bring the highest level of precision in treatment giving excellent results and speedy recovery.