Women's Health

Prolapsed Uterus

Exams and Tests

Your health care provider can diagnose uterine prolapse with a medical history and physical examination of the pelvis.

• The doctor may need to examine you in standing position as well as while you are lying down and ask you to cough or strain to increase the pressure in your abdomen.
  
• Specific conditions, such as ureteral obstruction due to complete prolapse, may need an intravenous pyelogram (IVP) or renal sonography. Dye is injected into your vein, and a series of x-rays are taken to view its progress through your bladder.
  
• Ultrasound may be used to rule out other pelvic problems. In this test, a wand is passed over your abdomen or inserted into your vagina to create images with sound waves.

Prolapsed Uterus Treatment

Treatment depends on how weak the supporting structures around your uterus have become.

Self-Care at Home

You can strengthen your pelvic muscles by performing Kegel exercises. You do these by tightening your pelvic muscles, as if trying to stop the flow of urine. This exercise strengthens the pelvic diaphragm and provides some support. Have your health care provider instruct you on the proper ways to isolate and exercise the muscles.

Medications

Estrogen (a hormone) cream or suppository ovules or rings inserted into the vagina help in restoring the strength and vitality of tissues in the vagina. But estrogen is only for use in select postmenopausal women.

Surgery

Depending on your age and whether you wish to become pregnant, surgery can repair the uterus or remove it. When indicated, and in severe cases, your uterus can be removed with a hysterectomy. During the surgery, the surgeon can also correct the sagging of the vaginal walls, urethra, bladder, or rectum. The surgery may be performed by an open abdominal procedure, through the vagina, or through small incisions in the abdomen or vagina with specialized instruments.

Other Therapy

If you do not want surgery or are a poor candidate for surgery, you may decide to wear a supportive device, called a pessary, in your vaginal canal to support the falling uterus. You can use this temporarily or permanently. They come in various shapes and sizes and must be fitted to you. If your prolapse is severe, a pessary may not work. Also, pessaries can be irritating inside your vagina and may cause a foul-smelling discharge.

Next Steps Follow-up

Follow-up depends on how your condition was treated.

• If you had surgery, you need to follow up according to your surgeon's advice.
  
• If you have a pessary inserted in your vagina, it needs to be cleaned and checked by your health care provider for the correct position and fit at regular intervals unless you are instructed on how to remove it and clean it yourself at home.
  
• If you have been told to do Kegel exercises, you should have a regular follow-up visit so that your health care provider can check the progress of your muscle strength.