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Jane Advice Uterine Prolapse & Tilted Uterus!!!!
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Aleigh1978 posted:
Hi Jane I was wondering if you had any advice on a Uterine Prolapse & Tilted Uterus!I have both and was wondering how common it is in women and if it was a serious condition ?what kind of symptons do they both cause?Thank you in advance for your time!take care :)
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Jane Harrison Hohner, RN, RNP responded:
Dear Aleigh: Let's take "tilted uterus"first. There are three basic positions of the uterus: anteverted (tipped forward), middle, and retroverted (tipped back). Unless a woman has a a tipped uterus from scar tissue (eg endometriosis) a tipped uterus is considered normal. A tipped uterus does not commonly cause major symptoms---and we do not "fix it" so everybody is a midline/middle.

There are several types of prolapses. When the upper part of the vaginal canal loses its muscle tone or attachments holding the vagina up (especially common among women with hysterectomies) that is called vaginal prolapse. If muscle support is poor, or interrupted, the bladder can prolapse down through the "roof" of the vagina causing a cystocele. The urethra may drop down as well (urethrocele). If the weakness is in the "floor" of the vagina the rectum can bulge upward. As was mentioned above, the uterus and cervix can slump down through the vaginal canal.

The most consistently cited risk factors are: increasing age, being overweight, and increased number of vaginal deliveries. Number of deliveries by C-section does not increase prolapse risk (Luckacz, 2006). Other associated factors can include irritable bowel syndrome, constipation, and overall poor health (Rortveit, 2007).

Kegel exercises have been recommended for POP but, unlike urinary stress incontinence, there are few large studies demonstrating the effectiveness of Kegels. According to one recent study of 48 women, pelvic floor exercise/Kegels significantly improved symptoms of prolapse (Hagen, 2009) Some women will also try a pessary.

If one has a prolapse of the uterus, hysterectomy may be suggested. Care is taken to refasten the top of the vaginal canal to other structures so it does not droop down after the hysterectomy.

If the prolapse is coming from the top or "roof "of the vagina, pelvic fascia tissue can be used to bridge the weak area. If the prolpase is coming from the lower or "floor" of the vagina (causing a bulging of the rectum into the vaginal canal), the rectal muscles can be used

We cannot change our genetics, age, or number of vaginal births! Sadly there are not many scientific studies testing different forms of POP prevention. The strategies for prevention that are most often suggested include:
"022 Kegel exercises up to four times daily. The hope is that by strengthening muscles in the pelvic floor that those muscles can help delay, or reduce, the onset of prolapse. For information about how to do Kegel's correctly check out this link: http://women.webmd.com/tc/kegel-exercises-topic-overview
"022 Physical exercise. Regular exercise can help keep one's body weight down, and being overweight is linked to prolapse. Exercise is also reputed to keep muscles and ligaments more flexible.
"022 Decrease straining to have a bowel movement. Constipation, or having to bear down, increases pressure in the abdomen which "pushes down" on pelvic organs. Eating a healthy diet with whole grains, fruits, and vegetable not only helps constipation, but can improve body weight.
"022 Treat chronic coughs. If one is a smoker—quit. If there is another reason for a chronic cough—have it treated. A cough increases the pressure inside the abdomen which can "push down" on pelvic organs. There are studies linking smoking with poorer tissue integrity after POP repair (Araco, 2009).
"022 Use a correct technique for heavy lifting. Straining to lift increases pressure within the abdomen.
"022 Hysterectomy surgery considerations. If one is having a hysterectomy there are studies which suggest that attaching the uterine ligaments to the top of the vagina may help to keep the vagina from dropping down (Yazdany, 2008).

If you would like more information about pelvic prolapse, consider checking this site:

http://women.webmd.com/repair-of-the-vaginal-wall-vaginal-vault-prolapse

Yours,
Jane
 
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An_194060 replied to Jane Harrison Hohner, RN, RNP's response:
Hi, I'm new here and have some questions reguarding prolapse. I noticed 3 days ago that I have the beginning of a prolapse. I caught it right away because only about an inch or 3/4 inch is protruding from the opening of my vagina. I started to experience pain in my abdomen and can't get in to see and OBGYN for another 2 days. I also have 4 inner hemmorhids and 1 tag left from thrombosing of the vein because of constipation that I've been dealing with since I was a pre-teen. I started my menstrual cycle when I was 11&1/2 put on the pill @ 12yrs old and my sick in the head Munchausen by proxy mother allowed me to experience endometrosis surgery at 15 years. I also had a double hernia when I was 3-4 (I do not know or remember any of this). My problem - I'm against hystorectamey and have been doing Kegel excercises when I was around 7-8 years old. I'm active, at my weight goal per my doctors (I'm not supposed to exceed 165lbs and I'm 5'8". I never wear jeans, I am allowed to wear what I want when I'm at the studio I belong to so I've been comfortable without tight clothing for ten years now. I'm only 42, went through perimenapause already, my prolactin is so high I don't have periods which is caused by an in-operable 7mm Adenoma on my Pitutuary gland, I take Vytorin 10/40's, 1 81mg asprin daily, and I take Haliperidol for PS, diazepam, for PS, Benzetropine, Trazadone and Potassium because my electrolytites are depleated easily and don't know why.

Question - How serious should I take this prolapse and if I caught it this early will they suggest a hysteroctmy?

Thank you for your time,

M-


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