Uterine prolapse is the protrusion of the uterus (womb) into the vagina, and at times outside the
vagina, due to loss of support from the muscles and ligaments surrounding
the uterus. Uterine prolapse is one form of pelvic organ prolapse. The bladder,
rectum, or small bowel can also protrude into the vagina in related disorders.
Uterine prolapse has been reported to occur in approximately 14% of women.
Several factors may increase a woman's risk of uterine prolapse, including
her number of vaginal deliveries, delivery of a large infant, increasing age,
and frequent heavy lifting. A number of conditions, including chronic obstructive
lung disease, chronic constipation, and obesity, may also contribute to the
development of uterine prolapse.
The April 27, 2005, issue of JAMA includes
an article that reviews the causes, diagnosis, and available treatments for
The symptoms associated with uterine prolapse vary depending on the
degree of prolapse. In severe cases, the uterus may be easily felt or be visible
to the woman, while in other cases there may be no symptoms.
Sensation of vaginal or pelvic fullness
Urinary complaints including urinary incontinence (involuntary urination), frequency, or urgency (the
sensation of the immediate need to urinate)
Bowel symptoms, including pain with defecation, constipation,
Sexual complaints, including pain with intercourse
In addition to a complete medical history and physical examination,
your doctor will perform a complete pelvic examination to look for signs of
prolapse. He or she may also order an imaging study (ultrasound or MRI) of
your pelvis to better delineate the prolapse. Your doctor may refer you to
a gynecologist (a doctor with specialized training
in diseases of the female reproductive tract) for more specialized testing
and evaluation for treatment.
In cases where the prolapse is minor or not bothersome to the
patient, no treatment may be necessary.
Pelvic floor muscle exercises (Kegel
exercises) strengthen the pelvic floor muscles that support the uterus and
may be helpful for some patients.
Pessaries (devices that can be inserted
into the vagina to support the uterus) may be effective for some patients.
A variety of these devices are available and your doctor can help you determine
which one would be most appropriate.
A number of surgical treatment options are available.
American College of Obstetricians and Gynecologists202/638-5577 http://www.acog.org
National Women's Health Information Center800/994-9662 http://www.4woman.gov
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com. A Patient Page on hysterectomy was published in the March 24/31, 2004,
Source: American College of Obstetricians and Gynecologists
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TOPIC: WOMEN'S HEALTH
Ringold S, Lynm C, Glass RM. Uterine Prolapse. JAMA. 2005;293(16):2054. doi:10.1001/jama.293.16.2054