UTEROVAGINAL PROLAPSE

What is it?

Uterovaginal prolapse is when the womb (or uterus) drops down towards the entrance of your vagina pulling the walls of the vagina with it. Sometimes the neck of the womb (or cervix) comes right down through the opening of the vagina so you can feel or see it outside.

What causes it?

Your womb is held in place by a whole series of muscles and tissues called the pelvic floor. If your pelvic floor muscles get weak - usually because of having babies - your womb can drop down towards the opening of your vagina. This problem often gets worse as you get older because your muscles tend to become weaker and the lining of your vagina less elastic. Smoking and obesity can make it worse.

Who gets it?

If you have had children and especially if you have had a normal delivery rather than a caesarean section you will be more likely to have a prolapse. You may be more likely to have symptoms once you reach the menopause.

What are the symptoms?

You may notice a dragging sensation or feel a lump coming out 'down below'. Often the first thing you will notice is a slight leaking of your waterworks. You may lose a little urine without meaning to when you laugh, cough, sneeze or exercise. This is called stress incontinence.

When should I see my doctor?

Stress incontinence and uterovaginal prolapse are extremely common and often quite easy to treat. You should not be embarrassed to make an appointment with your GP about them. If you are bothered by feeling uncomfortable down below or by incontinence you should certainly make a routine appointment.

Think about what you are going to say beforehand so you will not get flustered or forget anything.

What tests will my doctor do?

Your doctor will almost certainly want to do an internal examination to see if there is any sign of prolapse. He may send you to a hospital to have special tests on your bladder.

What is the short-term treatment?

One of the most common treatments is physiotherapy to strengthen the muscles of your pelvic floor. Your doctor may give you an advice sheet or refer you to a physiotherapy department which will give you treatment and advice about the exercises you should do.

Will I need long-term treatment?

If exercises do not help it is possible that you will need an operation to pull your womb up into its proper position and fix it there. Or your doctor may arrange for you to have a small rubber ring called a ring pessary fitted into your vagina to keep everything in place.

How can I stop it getting worse?

Because your muscles are always stretched and weakened by having babies you should start doing pelvic floor exercises as soon as possible after you give birth. Try to get into the habit of doing them every day for the rest of your life. If you are overweight try hard to lose weight. Being overweight makes a prolapse much worse as do constipation and smoking. Try to stop smoking and eat lots of high-fibre foods to avoid getting constipated.