- Cystocele: bulging of vaginal wall(upper) where a part of bladder bulges into vagina which may leads to retention, regency, urinary frequency and incontinence (urine loss).
- Retrocele: the herniation of lower rear vaginal wall where a part of rectum bulges into vagina leads to difficult bowel movements.
- Enterocele: the herniation/bulging of vaginal wall (upper rear) where a small portion of bowel bulges into vagina, standing leads to pulling sensation and backache which is relieved by lying down.
Causes of uterine prolapse:
- Conditions that lead to increased pressure in abdomen such as in bronchitis and asthma, straining (in constipation), accumulation of fluid in abdomen (edema), pelvic tumors.
- Being overweight and obese
- Major surgery in pelvic area
- After menopause (weakening and loss of tissue tone)
- Pregnancy, childbirth or difficult delivery through vagina
Risk factors:
- Being Caucasian
- Lifting excess weight
- Advancing age
- Increased BMI
- Chronic coughing
- Chronic constipation
Uterine prolapse symptoms:
- Recurrent bladder infections
- Increased bleeding (vaginal)
- Increased vaginal discharge
- Pulling or heavy feeling in the pelvis
- Constipation
- Problems with sexual intercourse
- Feeling that something is coming out of vagina
- Discomfort walking
- Low back pain
- Difficulty in urination
How is uterine prolapse diagnosed?
Uterine prolapse can be diagnosed by evaluating symptoms and performing pelvic exam.
· During this exam, device called speculum is inserted to see inside vagina and examine vaginal canal and uterus.
· To rule out other pelvic problems ultrasound is performed. As a wand is passed and inserted into abdomen and vagina to create sound wave images.
· Due to complete prolapse such as in ureteral obstruction, renal sonography or IVP (intravenous pyelogram) is performed. In this procedure, dye is injected into vein and then X-ray series is performed to view progress through bladder.
· To increase the pressure inn abdomen, patient is asked to cough or strain while lying down.
· Examination in standing position is performed.