Guide to Advanced Surgery for Women's Health
Why Choose Cedars-Sinai Marina del Rey Hospital for Uterine Prolapse Treatment?
In order to choose the most suitable treatment for uterine prolapse, a series of important factors, such as age and the woman’s desire for future pregnancy, need to be taken into consideration. The specialists and surgeons at Cedars-Sinai Marina del Rey Hospital provide the patients diagnosed with this condition various treatment approaches, carefully assessing their health and personal options, as well as the severity of the prolapse.
Uterine prolapse is a condition in which the muscles and ligaments that keep your uterus in place weaken and stretch, resulting in the uterus slipping from its normal position, and protruding into the vagina.
There are two types of uterine prolapses: complete uterine prolapse - the uterus descends so low that some tissues protrude outside the vagina and incomplete uterine prolapse - the uterus will partly sag into the vagina.
Uterine prolapse can affect women of any age, however, it is more often seen in women who have crossed the menopause stage and have had one or more vaginal deliveries in their lifetime. Pelvic muscles and ligaments tend to become weak because of the following conditions:
- Pregnancy or childbirth can weaken or damage the muscles
- Normal aging
- Effects of gravity
- Lack of estrogen hormone
- Continuous stress on the pelvic muscles due to chronic coughing, constipation, and obesity
There are many options available to treat uterine prolapse; the choice of these treatments depends on the severity of the prolapse, its symptoms, the woman’s desire for future pregnancy and retaining vaginal functionality, age, health and other medical complications.
Surgical Procedures for Uterine Prolapse Performed at Cedars-Sinai Marina del Rey Hospital
Surgery is considered to provide better results. The type of surgery depends on the medical condition and the patient’s preferences. A discussion with the gynecologist will let you know the right surgical treatment, risks involved, potential side effects and the recovery time for the chosen surgical procedure.
In surgical treatment, an apical suspension procedure is followed, with or without the removal of the uterus. The surgeries can be performed through a cut made in the abdomen, through a laparoscopic method or by using the vaginal approach.
Surgical approaches generally followed for treatment of uterine prolapse are:
- Sacrospinous fixation: In this surgical procedure performed through a cut in the vagina, stitches are placed into a strong sacrospinous ligament in the pelvic area and the cervix. This procedure provides extra support for the uterus to stay in the correct position.
- Abdominal Sacrocolpopexy: In this procedure, with a help of a polypropylene mesh, the cervix, uterus, and sacrum are sutured to keep the upper vagina in its normal axis and the uterus in its place.
- Hysterectomy: When there is a heavy bleeding and when the woman is close to menopause or has crossed menopause, gynecologists suggest this surgical method. In this method, the whole uterus or a part of the uterus is removed. After this procedure, women will never be able to bear children.
Types of hysterectomy:
- Partial hysterectomy: In this procedure, only a part of the uterus is removed.
- Total hysterectomy: Complete uterus, cervix, and sometimes ovaries and fallopian tubes may also be removed.
- Radical hysterectomy: In this procedure, the uterus, the tissue on both sides of the cervix, and the upper part of the vagina are removed.
Other surgical approaches are:
Drugs and Other Treatment Needed for Uterine Prolapse
The treatment of uterine prolapse using medication involves hormonal drugs, which change the hormonal levels in the body. These are usually given orally, in the form of injections or through an intra-uterine device.
Kegel exercise »
physical therapy »
Vaginal Devices »
Uterine Prolapse is generally classified based on the degree of descent:
Second Degree Uterine Prolapse »
Fourth Degree Uterine Prolapse »
First Degree Uterine Prolapse »
Third Degree Uterine Prolapse »
Symptoms of Uterine Prolapse
The most common symptoms of uterine prolapse include:
- Involuntary leakage of urine and inability to hold back urine in the bladder. This is because the voluntary control over the urinary sphincter is lost or possibly weakened
- Constant pressure or heaviness felt in the pelvis or vagina
- Problems with sexual intercourse
- Increased vaginal bleeding or discharge
- Uterus or cervix protruding out of the vagina
- Recurrent urinary bladder infections
Diagnosis of Uterine Prolapse
Uterine prolapse can be diagnosed by evaluation of the symptoms and by performing a pelvic examination. The doctor will insert a device called speculum through which the vaginal canal and uterus can be examined.
Risk Factors for Uterine Prolapse
The risk factors associated with uterine prolapse increases as women grow older, and it could be due to a decrease in levels of estrogen hormone. The estrogen hormone maintains the pelvic muscles and tissues surrounding it strong.
Other factors that can influence this disorder are:
Menopause: Uterine prolapse is more common among women nearing menopause and those who have attained menopause.
Vaginal birth: Uterine prolapse is more commonly seen in women who have had more than one vaginal birth. This is due to damage to the pelvic muscles and tissues during vaginal childbirth.
Physical stress: Physical pressure on the pelvic muscles increases the risk of uterine prolapse.
Obesity: Being obese and excess belly fat can lead to this disorder.
Chronic cough: A continuous cough exerts a lot of stress on the muscles of the abdomen and pelvic muscles, thus straining and weakening, leading to uterine prolapse.
Constipation: Chronic constipation may lead to constant straining and pressure on the abdominal and pelvic muscles, which can cause uterine prolapse.
Pelvic tumor: Tumor in the pelvis can damage or weaken the muscles, which may enhance the risk of uterine prolapse.
Family history: If your first degree relatives, for instance, your mother or sister have had uterine prolapse, you are at a higher risk of developing uterine prolapse.
Surgery: Pelvic surgery in the past may increase your risk of uterine prolapse.
Collagen diseases: Disease such as Marfan's syndrome and Ehlers-Danlos syndrome can cause weakness of the pelvic muscles.
Causes of Uterine Prolapse
Uterine prolapse happens when the muscles, ligaments, tissues and other structures holding the uterus in the pelvic region become weak and stretched. In this condition, the uterus moves away from its original location and descends down due to gravity, leading to uterine prolapse. At times, it may protrude out of the vagina.
Other attributes that can cause uterine prolapse are listed below:
- Lack of estrogen hormone after menopause
- Normal effects of aging
- Continuous pressure on the pelvic muscles because of chronic constipation, coughing, and obesity.
Fasting with only fruit diet: Fasting may be suggested for 3- 5 days, but you can drink only fruit juices. Fasting can relieve pressure from the abdominal region and spare the pelvic muscles from carrying an additional burden. The pelvic muscles get revitalized and fasting also helps in detoxifying your body. Avoid fruits that are known to inhibit production of estrogen. Fruits and foods such as apples, cherries, pomegranates, papaya, beetroot, eggplant, alfalfa, flaxseeds, aniseed, baker’s yeast, parsley, barley, pepper, split peas, black- eyed peas, cucumber, dates, fennel, licorice, oats, green peas, plums, red beans, sesame seeds and sunflower seeds can be considered.
Epsom salt bath: Epsom salt has a high amount of magnesium and sulfates. Magnesium helps in easing the tension of the muscles, regulates the enzymes of the body and prevents tissue hardening. Sulfates in Epsom salt help in the absorption of vital nutrients, flushes the toxic radicals out of the body, and is effective in revitalizing the pelvic muscles.
Hip or Sitz Bath: This bath has shown positive effects in the treatment and cure of uterine prolapse. In this, the water level in the tub is maintained up to the navel region of the patient. The abdomen and other parts immersed in the water are rubbed vigorously. After coming out of the tub, the wet pelvic area is rubbed with a rough towel.
Olive oil massage on abdomen: Olive oils are rich in estrogen and compensate for the loss of estrogen, thereby, helping in the treatment of uterine prolapse. Application and massage with olive oil can improve blood circulation and help in revitalizing the pelvic tissues.
Physical exercises: Regular physical exercise controls hormonal imbalances and obesity, which in turn decreases your chances of developing uterine prolapse.
Kegel exercises: Kegel exercise helps in strengthening your pelvic floor muscles, which support the uterus, urinary bladder, and the bowel. Maintaining a strong pelvic floor muscle provides good support for the pelvic organs and relieves from uterine prolapse and its symptoms. Kegel exercises can be done anytime, whenever the patient is sitting at her desk, or while relaxing on a couch. Biofeedback mechanism can be used to make sure this procedure is done correctly.
Manage your body weight: Maintaining the correct body weight will reduce the possibilities of uterine prolapse since obese women are more prone to have this disorder.
Avoid heavy lifting: Use proper lifting technique while lifting heavy objects that includes using your legs instead of your waist or back.
Treat a chronic cough: Get appropriate treatment for your chronic cough or bronchitis, and avoid smoking.
Diet: Consume foods high in zinc, magnesium, and calcium such as green leafy vegetables; drinking green tea regularly may be beneficial. Avoid intake of fatty foods, these can cause obesity and also foods that inhibit estrogen.
Prevent constipation: Drink lots of fluids and eat foods rich in fiber such as fruits, vegetables, and whole-grain cereals.
Other precautions to be considered to avoid uterine prolapse:
- Women who have crossed 55 years of age, with a concern of uterine prolapse can consider estrogen replacement therapy (ERT).
- Perform household chores in sitting position.
- You may lie down with a pillow under the buttock for some time after having food.
- Avoid smoking as it can aggravate the symptoms of uterine prolapse.
- Undergo regular physical pelvic examination by consulting a medical practitioner.
Are you suffering from vaginal bleeding, recurrent bladder infections, or pelvic discomfort? For any questions, information or guidance related to uterine prolapse, consult our specialty-trained, skilled gynecologist at Cedars-Sinai Marina del Rey Hospital.