(Pelvic Floor Hernia; Pudendal Hernia; Pelvic Relaxation)
by Michelle Badash, MS
Uterine prolapse occurs when the uterus slips out of place and into the vaginal canal. The severity of uterine prolapse is defined as:
The uterus is normally supported by pelvic connective tissue. It is held in position by special ligaments. Weakening of the tissue causes the uterus to descend into the vaginal canal.
Risk Factors TOP
Increasing age and white race increase your chances of having uterine prolapse. Other factors include:
Symptoms may include:
Your doctor will ask about your symptoms and medical history. A physical exam will also be done. Uterine prolapse that has no symptoms may be diagnosed during routine examinations. Your doctor may refer you to a gynecologist, who will do a pelvic exam.
Talk with your doctor about the best treatment plan for you. First or second degree prolapse without symptoms may not require treatment. Treatment options include:
Kegel exercises involve tensing the muscles around the vagina and anus, holding for several seconds, then releasing. The repetition of this exercise will help to tone pelvic muscles.
Your doctor may recommend estrogen therapy. This may help prevent further weakness of the pelvic floor.
Pessary Insertion TOP
Your doctor may insert a pessary into the upper portion of the vagina. A pessary is a rubbery, doughnut-shaped device. It helps to prop up the uterus and bladder. Pessary placement is more often used in older women.
Surgery may be needed for severe uterine prolapse. These procedures are usually not done until you have finished having children. Options include:
If you are diagnosed with uterine prolapse, follow your doctor's instructions.
To help prevent uterine prolapse:
American Congress of Obstetricians and Gynecologists
US Department of Health and Human Services Women's Health
Canadian Women's Health Network
Society of Obstetricians and Gynaecologists of Canada
Colpocleisis (LeFort procedure). International Center for Laparoscopic Urogynecology website. Available at: http://www.miklosandmoore.com/lap_proc11.php . Accessed April 22, 2013.
Pelvic organ prolapse. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what . Updated January 22, 2013. Accessed April 22, 2013.
Pelvic organ prolapse. International Urogynecological Association website. Available at: http://www.iuga.org/resource/resmgr/Brochures/eng_pop.pdf . Published 2011. Accessed April 22, 2013.
Pelvic relaxation syndromes. Merck Manual for Health Care Professionals. Available at: http://www.merckma... . Updated February 2012. Accessed April 22, 2013.
Vaginal pessary. American Academy of Family Physicians Family Doctor website. Available at: http://familydocto... . Updated August 2010. Accessed April 22, 2013.
10/21/2008 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Shariati A, Maceda JS, Hale DS. High-fiber diet for treatment of constipation in women with pelvic floor disorders. Obstet Gynecol . 2008;111:908-913.
Last reviewed June 2013 by Andrea Chisholm
Last Updated: 6/24/2013