Uterine prolapse

Uterine prolapse or hysterocele is the slippage of the uterus into the vagina as a consequence of the weakness of the pelvic floor muscles and ligaments. Pelvic organ prolapse is a highly prevalent pathology, affecting 40% of women after menopause, although most cases are asymptomatic.

The direct cause of uterine prolapse is the weakness of the pelvic floor muscles and ligaments which, as a consequence, do not provide sufficient support to the uterus. Some of the factors that may contribute to this weakening are:

• Vaginal delivery, especially those with difficult or traumatic labor.
• Age of the woman at delivery. Women who give birth at older ages are more predisposed.
• Large babies.
• Overweight and obesity.
• Menopause.
• Chronic constipation or straining to defecate.
• Chronic cough.
• Playing impact sports that involve running or jumping.
• Repeated heavy lifting

Mild uterine prolapse is common, especially after childbirth, and usually causes no symptoms. However, in cases of moderate to severe prolapse, symptoms include the following:

• Lump protruding through the vagina.
• A feeling of heaviness in the pelvis.
• Leakage of urine and a feeling that the bladder does not empty completely when urinating.
• Low back pain.
• Pain during sexual intercourse.

The risk of uterine prolapse and, in general, genital prolapse is reduced by avoiding the risk factors that favor it. Recommended actions include:

• Avoiding constipation by drinking plenty of fluids and favoring the intake of foods rich in fiber. Avoid sitting on the toilet for long periods of time.
• Avoid heavy lifting and, if necessary, have a correct postural hygiene.
• Control chronic cough and avoid smoking.
• Lose weight, if necessary.
• Avoid impact sports and favor others such as swimming or pilates.
• Specific physiotherapy.

The treatment options for uterine prolapse are diverse. If there are no symptoms, it is recommended to control and avoid factors that may aggravate it. In the case of symptoms that limit the quality of life, in addition to self-care measures, there are therapeutic approaches through surgery that are individualized in each case.