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Overview Uterus Prolapse

Female reproductive system is the organ called the uterus (womb). The uterus contains ovaries that produce eggs, which travel through the fallopian tubes. Once the egg leaves the ovary it can be fertilized and implant itself in the lining of the uterus. The function of the uterus is to nourish the developing fetus prior to birth.

The uterus is located inside the pelvis and shaped liked an upside down pear. Containing inside this organ, bladder and bowl are supported by a various muscles slung between the tailbone (coccyx) and the pubic bone. These muscles are known as the pelvic floor or the levator ani muscles. Also, anchoring the uterus is ligaments and connective tissue. The uterus can slip into the vagina (In a female, the tublar tract leading from the uterus to the exterior of the body. The vagina function allows for the flow of menstrual blood, sexual intercourse, and the passage through which a baby is born), if these tissues are weakened or damaged. This called uterine prolapse (Also known as pudendal hernia, pelvic floor hernia (prolapse), uterus prolapse, pelvic relaxation or falling of the womb)), commonly caused during childbirth (Prolong labor or large babies cause muscle weakness.) or multiple childbirth’s, obesity, chronic constipation (Pressure from behind from an over filled colon), wearing tight clothing including tight corsets, and age related changes after menopause, surgical injuries, and lack of exercise and bodily weakness. Also, women smoker’s cough is more likely to develop prolapse especially being overweight. A study published in the The Journal of Investigative Dermatology, suggests the women with stretch marks are more prone to be diagnosed with pelvic prolapse. A uterus that is tilted toward the back of the body is called retro – verted uterus. More than sixty-five percent of women diagnosed with uterus prolapse are under 55 years old. Also, most commonly observed in Caucasian women, and women that had one or more vaginal births. Treatment includes muscle strengthening exercises and surgery (severe cases).

Symptoms and causes related to uterus prolapse include feeling that something is coming down through the vagina, sense of fullness in the region of the bladder and rectum, dragging discomfort in the lower abdomen, low backache, diabetes, constant coughing attributed to conditions that include chronic bronchitis or asthma, experiencing painful intercourse, and heavy menses (blood products that pass out of the vagina during the culmination of menstruation.) frequent urination (difficulty emptying the bladder), burning sensation due to infection, difficulty being able to completely pass stools, and sometimes sterility. In rare cases, caused by a pelvic tumor.

Common observed when uterus prolapse is diagnose through a pelvic examination, the ovaries (one produces eggs and the other functions to secret hormones) become located lower than normal inside the pelvis. The severity of this problem, consist of one of three degrees. First degree (mild): The part of the uterus neck (cervix) protrudes into the lowest third of the vagina. Second degree (moderate): The cervix protrudes to the opening of the vagina. Third degree (severe): The entire uterus protrudes out of the vagina.

Treating for uterus prolapse or displaced womb depends on, how weak the ligaments have become, woman’s age, health and decision to become pregnant in the future. Beginning with proper dieting, exercise and, and precautionary steps, before considering surgery, unless that is the only option available. Also, avoid constant stooping and lifting any heavy objects. Dieting should start with eating only fruits for the first five days. Daily recommend a warm water enema, which cleanses the bowl. After the initial five days of dieting, a combination of seeds, nuts, grains, vegetables and fruits are recommended. Avoid caffeine and diuretics (reduces the amount of water in the body). Exercise to strength the pelvic area. Example: From a half hour to an hour, two or three times daily, lying on a couch with your legs raised higher then the rest of the body. The feet should be raised about eighteen inches by placing cushions under them. Alternatively, sitting on a chair with feet on another chair. The more times this exercise can be performed than recommended will greatly increase correcting this displacement. Additionally, performing other types of exercise that will aim to strengthen the abdominal muscles. An intrusive exercise, performed in privacy, for women that are knowledgeable of the muscles of the vagina, would insert one to two fingers and squeeze them. For the urethra (The tube that drains urine from the bladder to the outside of the body) certain times during urination but not all the time, hold for a few seconds in midstream and then release the flow of urine. This is called Kegel Exercise, which tightens the pelvic muscles. A device called a vaginal pessary, shaped like a doughnut (A rubber diaphragm like device), may be inserted into the vagina (filled with air or water) and positioned to prop the cervix and uterus. This device is available in many different shapes and sizes (40 to 120 mm), which is fitted for each woman individually. It is used temporarily or permanent form of treatment. Side effects using this device includes, irritating discharge, interfere with intercourse and an increase risk of ulceration. The vaginal pessary must be removed regularly for cleaning. Preventing uterus prolapes by spacing out the time between getting pregnant or delivery times. This will help genital tissues to regain their strength and vitality, which prevents this problem. Applying estrogen creams to increase flagging hormone levels. A physiotherapist can further advise other types of exercises and preventive measures. If the underlying cause for uterus prolapse, is related to a disease or swelling, that must first be controlled or eliminate, before the uterus can be returned to it’s original position and secured there. Studies have shown more than half of all women who experience uterus prolapse are smokers.

Surgical procedures are available to treat uterus prolapse. A vaginal surgical procedure during a laparoscopic repair is performed for moderate to severe cases of uterus prolapse. During the surgery, a slender instrument is inserted through the naval or may be performed abdominally in some circumstances. The uterus is pulled back into its proper place and reattached to supporting ligaments using permanent stitches. Eventually, the scar tissue grows over these stitches and further strengthens the repair. This type of corrective surgery has a nine out ten successful case results. A hysterectomy (Surgical procedure when the uterus may be completely or partially removed. The fallopian tubes and ovaries may also be removed. A partial hysterectomy removes just the upper portion of the uterus and leaving the cervix intact.) recommended if symptoms are severe or the uterus has dropped extensively that it goes through the vagina. According to an article in the American Journal of Obstetrical Gynecology 2002 (pages 712 – 716), from 1993 – 1998 the third most common reported cause, undergoing a hysterectomy (548,657) due to uterus prolapse. Less common surgical procedure is a resuspension of the uterus. This involves removal of the cervix. As a result, the uterus is kept, but this operation has a high rate of infertility and premature labor. Some women may require additional surgery in the future, for recurrent prolapse of the vaginal walls.

A related surgical procedure for vaginal vault prolapse (Similar to that of uterine prolapse: a mass protruding from the vagina) called sacral colpopexy is performed. This involves attaching at one end a synthetic mesh to the top of the vagina and the other end to the sacral promontory (Upper part of the tail bone or lower part of the spine). This surgical operation has shown excellent results.