New Delhi: Uterine prolapse, where the uterus descends into the vaginal canal, is a relatively common condition in India, especially among women who have experienced childbirth and menopause. It occurs due to the weakening of pelvic floor muscles and ligaments, which can no longer support the uterus in its normal position. Though often underreported, this condition can significantly affect a woman’s quality of life, but it is both manageable and treatable with timely intervention.
In an interaction with News9Live, Dr.Yashica Gudesar, Director and Unit Head, Ob-Gyn at Max Hospital, Dwarka, answered all FAQs about the condition.
What Is a Uterine Prolapse?
Uterine prolapse happens when the uterus slips down into or protrudes out of the vaginal canal. This descent may cause symptoms such as pelvic heaviness, discomfort, urinary leakage, or difficulty emptying the bladder. The severity can vary, from mild cases with no visible signs to more advanced prolapse where the uterus protrudes outside the vagina. Understanding the signs early is crucial for effective treatment and prevention of further complications.
When Does It Happen and Who Is at Risk?
The condition most commonly affects women after childbirth, particularly those who’ve had multiple vaginal deliveries. Difficult labor, large babies, or a lack of postnatal pelvic care can increase the risk. As women age, especially after menopause, the body produces less estrogen, a hormone that helps maintain the strength of pelvic tissues. This hormonal decline makes older women more prone to prolapse.
Other factors such as chronic constipation, obesity, and persistent coughing put additional pressure on the pelvic floor, contributing to tissue weakening. While childbirth is a major risk factor, some women who have never given birth (nulliparous) or who’ve had only one or two children may also experience prolapse, particularly in certain regions of India. Studies suggest higher incidence rates in Northern and Eastern India, possibly due to disparities in healthcare access and awareness.
Uterine Prolapse Management and Treatment
Treatment depends on the severity of the prolapse and the individual’s age, health, and reproductive plans. Mild to moderate prolapse is often managed conservatively. Physiotherapy, especially pelvic floor exercises like Kegels, can strengthen the supporting muscles and alleviate symptoms. Vaginal pessaries—devices inserted into the vagina to support the uterus—are a safe, non-surgical option for many women.
Surgical intervention becomes necessary when symptoms are severe or conservative treatments fail. Depending on the case, doctors may recommend procedures to repair or suspend the uterus or perform a hysterectomy. Notably, some surgical options are uterus-sparing and allow for future pregnancies, making them suitable for younger women.
Is Uterus Removal Surgery the Only Cure?
A hysterectomy is not the only solution for uterine prolapse. While it may be necessary in some cases, especially where the uterus is severely displaced or when other uterine conditions are present, many women can avoid it. Uterine-sparing procedures and conservative treatments offer effective alternatives. The choice of treatment should be based on a thorough medical evaluation and discussion with a healthcare provider.
Importance of Early Intervention
Early diagnosis can prevent the prolapse from progressing and improve long-term outcomes. Women often dismiss symptoms such as a heavy feeling in the pelvis, urine leakage, or urinary retention, assuming these are normal with age. However, these signs should not be ignored. Prompt medical advice ensures timely care and opens up more options for non-invasive treatments.
Seeking Medical Advice
If you’re experiencing any sensation of heaviness in your pelvic region, urinary incontinence, or difficulty with bowel movements, it’s important to consult a doctor. An early conversation with a healthcare provider can lead to a personalized treatment plan and prevent the condition from worsening. With the right care, women can manage uterine prolapse effectively and maintain a good quality of life.