What to do if the uterus prolapses and the vaginal wall bulges

What to do if the uterus prolapses and the vaginal wall bulges

Uterine prolapse and vaginal wall prolapse are two diseases, but they are usually mentioned together because the two conditions often coexist and are collectively called pelvic organ prolapse (Pelvic organ prolapse, referred to as POP in English), and they often need to be treated.
This group of conditions and others, such as stress urinary incontinence, vaginal laxity, and anal incontinence, are often grouped together in a relatively new specialty, gynecologic urology.
When uterine prolapse occurs, part of the uterus prolapses from its original position, which may be accompanied by partial bulging of the vaginal wall, mainly the anterior wall. The main manifestation is that sagging tissue can be touched in the vagina, similar to a ping-pong ball, with a sense of falling. In severe cases, it can affect the bladder and rectal function, manifested as difficulty urinating or defecating. Some people need to push the prolapsed uterus or vaginal wall into the vagina to urinate or defecate. Many people have long-term difficulty walking due to loose uterus or vaginal wall, which affects people who engage in outdoor activities and affects their quality of life. Generally, it is mild in the morning and worsens after activities in the afternoon..


Why does uterine prolapse and vaginal wall prolapse occur? Most people have uterine prolapse and vaginal bulging. During vaginal delivery, the fetus squeezes the pelvic wall, causing damage to the pelvic floor muscles and nerves, leading to uterine prolapse and vaginal wall bulging. Many people are concerned about whether a cesarean section should be performed routinely instead of a vaginal delivery. This is only a preventive measure for pelvic floor prolapse. After all, after a cesarean section, endometriosis may also occur through the incision. It is not recommended to have problems such as pregnancy scars, uterine rupture, etc. the next time you get pregnant, therefore.
Another contributing factor to uterine prolapse and vaginal wall bulging is menopause, where the collagen and muscle fibers shrink as estrogen levels drop, worsening prolapse, which is why estrogen therapy is also a reason to help relieve prolapse and urinary incontinence.
How to treat it? For obvious symptoms of prolapse, surgery is not necessary. You can try to exercise the pelvic floor muscles to reduce prolapse by contracting and strengthening the pelvic floor muscles. Postmenopausal patients can also consider local use of estrogen.


For mild to moderate swelling and vaginal wall and uterine prolapse, erbium laser treatment may be tried. The laser irradiates the vaginal mucosal tissue, collagen remodeling occurs, the vaginal mucosa will contract, reducing the degree of vaginal wall prolapse and uterine prolapse, and improving vaginal relaxation and urinary incontinence.
Uterine care is a non-surgical treatment that prevents prolapse of the vaginal wall or uterus by placing a support ring in the vagina. Uterine care is a simple and convenient treatment method. It is also a good treatment method for elderly patients who are at risk of surgery or are not currently suitable for surgery. Uterine care alone cannot fundamentally treat prolapse. In addition, after a long time, there may be ulcers, which need to be removed regularly and followed up with the doctor regularly. The application of uterine support before surgery also helps to understand whether the patient has hidden urinary incontinence (that is, it does not appear during prolapse, but appears after surgery to correct prolapse).
For prolapse of more than 3 degrees or with symptoms, surgical prolapse can be considered, depending on the age, the patient's fertility requirements, whether there are recurrence factors, and considering the surgical method, young patients can consider surgical treatment, truncation of the cervical part, and strengthening of the ligaments. The ligaments can be strengthened through vaginal or laparoscopic surgery. For elderly patients, according to the specific location of the protrusion, the line can be repaired or the uterine vaginal wall reinforced ligaments. Patients or patients with partial resection of recurrence 4 degrees can also be considered to put the steel mesh into operation. A serious patient's uterus or vaginal wall hanging to the sacral periosteum is also a classic procedure. If there is no sexual life requirement for the elderly, vaginal surgery can also be considered to be closed, which can also get good results.

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