Terry Huff, MD is chairman of department Obstetrics and Gynecology at Banner Baywood Medical Center. His office can be reached at (480) 897-8000.
Question: I have heard women say that their uterus started “falling out” after having children. Is that possible?
Answer: The condition you are referring to is called uterine prolapse, which occurs when the uterus prolapses or drops through the birth canal. In most cases, it results from irreparable damage to the tissues that support the uterus. Pregnancy and delivery can be very traumatic and may cause such damage. Normal aging and the cessation of estrogen production can also contribute to prolapse.
Uterine prolapse is graded on how far the uterus drops. Stage I prolapse is when it drops half way down the vagina; Stage II is when it drops to the opening of the vagina; Stage III is when it protrudes through the vagina; and Stage IV is when the uterus is all the way out of the vagina.
Since pregnancy and childbirth can also cause damage to the anterior and posterior walls of the birth canal, women may also experience prolapse of the bladder known as a cystocele. This condition may be accompanied by urine leakage when coughing, sneezing, laughing or running. Damage to the posterior wall of the vagina that results in bowel issues and discomfort is known as a rectocele.
Prolapse, which progresses over time, affects an estimated 30 to 40 percent of women, most of whom first notice it in their 40s. While it is not life threatening, prolapse can be life altering and inhibitive of normal sexual function. Despite being a relatively common condition, many women fail to seek medical treatment due to embarrassment.
Treatment options vary based on the type of prolapse and overall health status. There are many surgical treatment options, including the use of mesh to provide vaginal support. Though surgery is generally most effective, nonsurgical options such as Kegel exercises to help strengthen the pelvic floor muscles and pessaries (rubber devices that are inserted into the vagina to provide mechanical support) may provide relief.
Women are encouraged to delay surgical intervention to treat prolapse until child bearing is done due to the risk of recurrent damage to the birth canal and tissues that could make a second repair more difficult and less effective. Find a physician who is well trained in prolapse treatment techniques to ensure the best results.