What are the symptoms of postpartum uterine prolapse and vaginal wall prolapse?

Apr 10, 2023 Source: Cainiu Health

Dr. Zhao Xiaodong

Introduction

Postpartum uterine prolapse and vaginal wall bulging are generally caused by reproductive tract injuries resulting from pregnancy and childbirth. Common symptoms include lower back pain, a sensation of heaviness in the lower back, protrusion of tissue from the vagina, abnormal vaginal bleeding, and decreased libido. It is recommended to seek timely medical care at a hospital and receive standardized treatment under a doctor's guidance. Additionally, proper postpartum care should be taken, with attention to hygiene to prevent infection.

Postpartum uterine prolapse and vaginal wall bulging are generally caused by damage to the female reproductive system during pregnancy and childbirth. Common symptoms include lower back pain, a sensation of heaviness in the lower back, protrusion of tissue from the vagina, abnormal vaginal bleeding, and decreased libido.

1. Lower back pain

Postpartum uterine prolapse and vaginal wall bulging can gradually weaken the pelvic floor muscles and tissues, reducing pelvic stability and leading to lower back pain.

2. Sensation of lower back heaviness or dragging

As the condition progresses, the downward displacement of pelvic organs such as the uterus and bladder due to uterine prolapse and vaginal wall bulging may cause a feeling of weight, pressure, or fullness in the lower back and pelvic area.

3. Vaginal tissue protrusion

Postpartum uterine prolapse and vaginal wall bulging may also cause genital tissues to protrude into the vaginal canal, forming a mass that is visible or palpable.

4. Abnormal vaginal bleeding

When the above conditions occur, the gradual descent of organs such as the uterus and bladder may lead to friction against the vaginal walls, potentially causing inflammation or bleeding, resulting in vaginal bleeding unrelated to the menstrual cycle.

5. Decreased libido

If these symptoms are severe, physical changes or persistent lower back pain may affect normal sexual function, leading to reduced sexual desire.

If the above symptoms interfere with daily life, it is recommended to seek timely medical evaluation and follow standardized treatment under a doctor's guidance. Additionally, proper postpartum care should be maintained, including good hygiene practices to prevent infection.

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Vaginal wall prolapse in late pregnancy is generally caused by factors such as fetal descent into the pelvis, vulvar varicose veins, and excessive pressure on the lower body. Additionally, pelvic floor muscle relaxation can also lead to symptoms of vaginal wall prolapse. Pregnant women should pay close attention to their physical condition to ensure the health of both themselves and the fetus. If any discomfort occurs, immediate medical attention is recommended.

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Does vaginal wall prolapse always accompany uterine prolapse?

Vaginal wall prolapse does not necessarily accompany uterine prolapse, although most patients with uterine prolapse may also have vaginal wall prolapse. It is mainly associated with engaging in heavy physical labor too early after childbirth, or may result from repeated deliveries causing ligament laxity. Therefore, patients are advised to promptly seek outpatient treatment at a hospital. Vaginal wall prolapse can be classified into anterior vaginal wall prolapse and posterior vaginal wall prolapse.

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What Should Be Done for Uterine Prolapse After Childbirth?

Postpartum women with uterine prolapse may undergo pessary treatment. The patient should lie supine with knees flexed and feet apart. The posterior rim of the pessary is then tilted downward. In severe cases, the posterior vaginal wall is gently and gradually pushed upward into the upper vagina until the patient reaches her tolerance limit; subsequently, the anterior portion of the pessary is carefully inserted toward the pubic bone. This maneuver can effectively alleviate symptoms. The pessary must be removed before sleeping at night.

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What causes vaginal wall prolapse in the late stages of pregnancy?

In late pregnancy, after the fetal head descends into the pelvis, the pelvic muscles and ligaments stretch fully to facilitate childbirth. This descent leads to pressure on the sacrum and perineum, which is caused by the fetus. As the fetus gradually increases in size, it impedes blood flow in the external genital veins, resulting in sustained elevation of venous pressure and consequently vulvar varicosities, leading to vaginal wall bulging. A history of multiple deliveries reduces vaginal elasticity and causes pelvic floor muscle relaxation. In late pregnancy, uterine enlargement further contributes to these conditions.

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Can vaginal wall prolapse after a normal delivery recover?

Vaginal wall prolapse after vaginal delivery is a normal physiological phenomenon. With active pelvic floor exercises such as Kegel exercises, or following medical advice including acupuncture to promote pelvic floor muscle contraction, recovery is usually possible. However, if the vaginal prolapse is severe—for example, when vaginal wall tissue is exposed externally—and the condition is ignored without proactive intervention and treatment, it generally will not resolve on its own and may lead to urinary incontinence or even organ prolapse.

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What are the symptoms of anterior vaginal wall prolapse?

The perineal mass decreases in size when lying supine or at rest. However, it enlarges with excessive fatigue, increased physical activity, or prolonged standing. In women, this may cause urinary difficulty. Due to residual urine in the bladder, recurrent urinary tract infections (UTIs) commonly occur, leading to symptoms such as urinary frequency, urgency, and dysuria. Some women exhibit prominent stress urinary incontinence and may also have uterine prolapse.

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What are the diagnostic methods for anterior vaginal wall prolapse?

Symptoms of vaginal anterior wall prolapse primarily manifest in two aspects: First, enlargement of the anterior vaginal wall, which may cause urethral displacement and result in urinary dysfunction. Some patients experience difficulty urinating, while many suffer from urinary incontinence—particularly stress incontinence, such as urine leakage during coughing or sneezing. Second, increased vaginal discharge and secretions. Because the prolapsed vaginal wall protrudes externally, it rubs against undergarments.

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Does vaginal wall prolapse affect sexual intercourse?

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