A prolapsed uterus occurs when weakened pelvic floor muscles and ligaments cause the uterus to descend from its normal position into or through the vaginal canal. This condition is a form of pelvic organ prolapse, classified using a grading system from Grade I (mild descent) to Grade IV (complete protrusion outside the body). While mild cases may not require immediate intervention, delaying treatment for a progressing prolapse leads to worsening physical discomfort and serious functional complications. Untreated uterine prolapse impacts the function of nearby organs and overall health.
Worsening Physical Symptoms
The physical manifestation of an untreated prolapse is a progressive increase in localized pressure and discomfort within the pelvis. As the uterus descends further, the feeling of “heaviness” or “pulling” becomes more intense and noticeable. This sensation is often described as feeling like sitting on a small ball or bulge. Symptoms typically worsen significantly after prolonged periods of standing, walking, or physical exertion, due to gravity contributing to the downward pressure.
This pressure can also lead to chronic low back pain that is not relieved by rest. As the prolapse advances to Grade III or Grade IV, the protrusion of the uterus or cervix outside the vaginal opening, known as procidentia, can occur. This visible tissue bulge interferes with daily activities like walking and sitting, causing friction, irritation, and discomfort when wearing clothing. The increasing descent and associated pain progressively degrade quality of life, limiting exercise and the ability to perform routine tasks.
Impact on Bladder and Bowel Function
The anatomical shift caused by an untreated uterine prolapse severely compromises the function of adjacent organs, particularly the bladder and the rectum. The uterus sits between the bladder and the rectum, and its descent distorts the shape and function of both organs, leading to complex urinary and bowel issues.
Urinary dysfunction manifests in two seemingly contradictory ways: stress urinary incontinence (SUI) and urinary retention. In earlier stages, the prolapse may pull on the bladder’s neck, causing SUI, which is the involuntary leakage of urine during activities like coughing, sneezing, or lifting. As the prolapse progresses, it can obstruct the urethra, making it difficult to empty the bladder completely. This urinary retention leaves residual urine that becomes a breeding ground for bacteria, significantly increasing the risk of recurrent urinary tract infections (UTIs).
Bowel function is similarly affected, especially if the prolapse involves the rectum bulging into the back wall of the vagina (a rectocele). The structural distortion prevents the rectum from straightening properly, leading to chronic constipation and the sensation of incomplete evacuation. In advanced cases, some individuals must manually press on the vaginal or perineal area, a procedure known as manual splinting, to assist in passing stool. This chronic straining and incomplete evacuation contribute to a cycle of pelvic floor pressure that further worsens the prolapse over time.
Serious Health Complications
Beyond functional issues, advanced, untreated uterine prolapse presents a risk of severe pathological and systemic health complications. When the prolapsed tissue protrudes completely outside the vaginal opening, it is susceptible to external friction from clothing and movement. This constant irritation causes the exposed vaginal mucosa to become dry, inflamed, and eventually form decubitus ulcers.
These ulcers are open sores that can bleed and become infected, posing a risk of tissue necrosis. Infections from these exposed tissues can potentially spread, creating a systemic health threat. A severe risk associated with extreme prolapse (Grade III or IV) is obstructive uropathy.
The extreme descent of the uterus can compress the ureters—the tubes that carry urine from the kidneys to the bladder. This ureteral compression obstructs urine flow, causing urine to back up and swell the kidneys, a condition called hydronephrosis. If this obstruction is prolonged, the increased pressure can damage kidney tissue, potentially leading to renal dysfunction or chronic renal failure. The physical and medical complications negatively impact psychosocial well-being, often leading to anxiety, depression, and pain during sexual intercourse.