Uterine Prolapse (Uterus Prolapsus): Causes, Symptoms, and Treatment Methods

Uterine prolapse (uterus prolapsus) is the descent or sliding of the uterus from its normal anatomical position down toward the vagina. It occurs as a result of the weakening of the pelvic floor muscles and ligaments. While mild prolapse may not cause symptoms, advanced-stage prolapse can seriously impact daily quality of life.

Stages (Grades) of Uterine Prolapse

• Grade 1: The uterus descends but does not reach the vaginal opening.

• Grade 2: The uterus descends to the vaginal opening (introitus).

• Grade 3: The uterus protrudes outside the vaginal opening.

• Grade 4 (Total Prolapse / Procidentia): The uterus is completely outside the vagina.

Causes

• Vaginal childbirth (especially difficult or multiple births)

• Estrogen decrease after menopause

• Chronic cough or constipation

• Obesity

• Habitual heavy lifting

• Connective tissue weakness after pelvic surgery

Symptoms

• A feeling of fullness or pressure in the vagina

• Back and pelvic (groin) pain

• Discomfort during sexual intercourse

• Urinary incontinence or difficulty urinating

• Constipation

• Tissue protruding from the vagina (in advanced stages)

Diagnostic Methods

• Detailed gynecological examination

• Pelvic ultrasonography

• MRI (Magnetic Resonance Imaging), if necessary

• Urodynamic tests (to evaluate urinary function)

Treatment Methods

1. Non-Surgical Methods

• Pelvic floor muscle exercises (Kegels)

• Use of a pessary (a support ring placed inside the vagina)

• Lifestyle modifications (weight loss, avoiding heavy lifting)

2. Surgical Methods

• Vaginal hysterectomy – removal of the uterus through the vagina

• Sacrospinous fixation (suspension) – surgical correction of the uterine position (suspending the uterus)

• Pelvic floor repair with mesh (in appropriate patients)

Preventive Methods for Uterine Prolapse

• Performing regular pelvic floor exercises

• Following a postpartum exercise program

• Avoiding heavy lifting

• Treatment of chronic cough and constipation

Uterine Prolapse Treatment in Istanbul

As Assoc. Prof. Dr. Cengiz Andan, I offer comprehensive diagnosis and treatment options for patients experiencing uterine prolapse. I create personalized plans based on the patient’s lifestyle, health status, and degree of prolapse.

Frequently Asked Questions (FAQ)

Does uterine prolapse resolve on its own? No, but in the early stages, its progression can be slowed with exercises and support methods.

Can it recur after surgery? The risk of recurrence is low with the appropriate surgical technique and preventive measures.

Is using a pessary safe? Yes, it can be used safely with regular medical check-ups.