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A B C D E F G H I J K LM N O P Q R S T U V W X Y Z 0-9
(A-Z listing includes diseases, conditions, tests and procedures)

Uterine Prolapse

Uterine Prolapse: What You Need to Know

  • When pelvic muscle, tissue and ligaments weaken, the uterus can drop down into the vaginal canal, causing uterine prolapse.

  • Nearly one-half of all women between ages 50 and 79 have some degree of uterine or vaginal vault prolapse, or some other form of pelvic organ prolapse.

  • Factors that increase your risk of uterine prolapse include childbirth, age, obesity, chronic constipation and having a hysterectomy.

  • Many women with uterine prolapse have no symptoms. If symptoms are present, they may include bulging in the vagina, feeling pressure in the pelvis or vagina, and lower back pain accompanied by bulging in the vagina.

  • There is no definitive way to prevent uterine prolapse. Losing weight, eating a fiber-rich diet, quitting smoking and performing pelvic floor exercises can help to reduce the risk of this condition.

Uterine prolapse is a condition that occurs when the muscles, tissue, ligaments and nerves in your pelvis weaken. When this weakening happens, your uterus drops down into your vaginal canal. Sometimes, it comes out through your vaginal opening. This can also happen if you have undergone a hysterectomy. In that case, the top of the vagina (or the vagina vault) can drop down into the vaginal canal. In severe cases, your entire vagina may turn inside out and protrude out of the vaginal opening.

Nearly half of all women between 50 and 79 have some degree of uterine or vaginal vault prolapse, or some other form of pelvic organ prolapse.

What are the causes of uterine prolapse?

If you have given birth, you have the highest risk for uterine prolapse. If you have had a vaginal delivery, you are more likely to develop uterine prolapse than if you have had a cesarean section. If you are menopausal, Caucasian, overweight or obese, you are also more likely to experience uterine prolapse. Smoking is another factor that may increase your risk.

#TomorrowsDiscoveries: Pelvic Floor and Women’s Health

Dr. Victoria Handa and her team at the Johns Hopkins Women's Center for Pelvic Health and Reconstructive Surgery study how childbirth leads to long-term physical and functional changes in a woman’s body. Watch to learn more.

What are the symptoms of uterine prolapse?

Many women with uterine prolapse have no symptoms. However, if symptoms start, they may include:

  • Bulging in your vagina

  • Feeling of heaviness, fullness or pressure in your pelvis or vagina

  • Lower back pain, especially if this is accompanied by bulging in the vagina

Women with prolapse may also have urinary/bladder symptoms including but not limited to leakage of urine, overactive bladder and difficulty emptying the bladder.

How is uterine prolapse diagnosed?

If your doctor suspects that you have a prolapsed uterus, he or she will probably perform a physical examination to check for irregularities in your pelvis. If you’re also having problems like urinary incontinence or a feeling of incomplete emptying of your bladder, your doctor may perform other office procedures.

Your physician might also order other radiologic imaging procedures, such as a vaginal ultrasound or an MRI scan, to better see the organs within the pelvis, such as the uterus, ovaries, kidneys and ureters.

What treatments are available for uterine prolapse?

If your uterine prolapse symptoms bother you or keep you from feeling comfortable during everyday activities, talk with your doctor about treatment options.

  • Lifestyle changes, like losing weight, may help. So can a regular routine of Kegel exercises. These strengthen your pelvic floor muscles. To perform a Kegel exercise, squeeze the muscles you use to control the flow of urine for up to 10 seconds before releasing. Although the most optimal number of times these exercises should be performed is not clear, it is reasonable to aim for 10 to 20 repetitions two to three times per day.

  • A pessary can provide relief from the symptoms of uterine prolapse. This is a silicon device that is placed inside your vagina to support your pelvic organs. The doctor fits you with this device in the clinic. Once properly fitted, you may be taught how to remove and replace this device yourself. You should not feel any discomfort from this device once it is properly fitted.

  • Surgical treatments may include a hysterectomy (removal of uterus) or hysteropexy, which keeps the uterus inside the body but attaches it to your ligaments. Surgical options may also include uterosacral suspension, sacrospinous fixation and sacrocolpopexy, which are different procedures to attach the vagina or the uterus to your ligaments. These procedures can be performed through the vagina or through the abdomen. Procedures performed through the abdomen can be done with a larger incision (10 to 15 centimeters) or through small incisions (1 centimeter or less) using laparoscopy or robotic surgery. Many of these procedures involve using your own ligaments, or they may involve placing a piece of mesh (synthetic material) through the abdomen to support the vagina/uterus. Your doctor will discuss surgical options with you at length depending on your anatomy and your priorities to come up with the best surgical option for you.

How can you prevent uterine prolapse?

There is no surefire way to prevent uterine prolapse. However, the following interventions may help to lower your risk:

  • Lose weight if you’re overweight.

  • Follow a diet rich in fiber and fluids to prevent constipation and straining.

  • Avoid heavy lifting.

  • Quit smoking.

  • Seek prompt treatment for a chronic cough, which can place extra pressure on your pelvic organs.

  • Regularly perform Kegel exercises to strengthen your pelvic floor muscles.

These strategies may also help if you have already developed uterine prolapse. Consult your doctor when uterine prolapse symptoms first start to bother you. Don’t wait until your discomfort becomes severe.

How to manage or live with the condition

Surgery is an option but not always necessary. Medical devices, exercises and lifestyle changes can sometimes provide relief from bothersome symptoms. It is important to seek care from a doctor to better understand your options.

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