How does uterine prolapse occur and how is it treated?

  Treatment is simple, safe and effective: 1. Non-surgical treatment: (1) pelvic floor muscle exercise and physical therapy can increase the tension of the pelvic floor muscle groups. Pelvic floor muscle (anal raphe) exercise is suitable for mild patients. Patients should be instructed to perform anal contraction exercises by forcefully contracting the pelvic floor muscles for more than 3 seconds and then relaxing them for 10-15 minutes each time, 2-3 times a day.  (2) Placement of uterine detachment Uterine detachment is an instrument that supports the uterus and vaginal wall and keeps it in the vagina without prolapsing. It is indicated for patients whose general condition is not suitable for surgery, during pregnancy or after childbirth. If the bulging surface is ulcerated, healing of the ulcerated surface should be promoted before surgery.  Uterine prolapse can also cause vaginal irritation and ulceration. The uterus should be removed, cleaned and repositioned intermittently, otherwise serious consequences including fistula formation, impaction, bleeding and infection can occur.  (3) Chinese herbal medicine and acupuncture Tonic Chinese and Yiqi soup (pill) etc. have the effect of promoting the return of pelvic floor muscle tone and relieving local symptoms.  2.Surgical treatment Indications: Patients with uterine prolapse beyond the hymen and symptoms can be considered for surgery. The treatment should be individualized according to the patient’s different age, fertility requirements and general health condition. The purpose of surgery: to relieve symptoms, restore the normal anatomical position and organ function, have satisfactory sexual function and be able to maintain the effect. The surgical procedures include: (1) Mann’s surgery including anterior and posterior vaginal wall repair, shortening of the main ligament and partial cervical excision. It is suitable for patients with prolapsed uterus who are younger and have a lengthened cervix.  (2) Total hysterectomy and anterior and posterior vaginal wall repair: For older patients who do not need to consider reproductive function, but patients with severe uterine prolapse have a higher chance of postoperative recurrence.  (3) Vaginal closure includes vaginal semi-closure and total vaginal closure. It is only suitable for elderly and frail patients who cannot tolerate larger surgery.  (4) Pelvic floor reconstruction surgery Vaginal vault or uterosacral ligament suspension, fixed to the anterior sacral or sacrospinous ligaments by means of a sling, mesh and sutures, can be done transvaginally or transabdominally or open.