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　　Damage to the cervix, the main cervix ligament, and the uterine sacral ligament during delivery, and the failure of the supporting tissues to return to normal after delivery are the main causes of uterine prolapse. Other conditions can also cause uterine prolapse, mainly the following types:
　　1. Delivery injury is the anatomical basis for uterine prolapse. In addition, postpartum women often prefer to lie on their backs and are prone to chronic urinary retention, which makes the uterus prone to retroversion. The uterine axis is consistent with the vaginal axis. When intra-abdominal pressure increases, the uterus descends along the vaginal direction, causing prolapse. Postpartum habits of squatting labor (such as washing diapers, washing vegetables, etc.) can also increase intra-abdominal pressure, promoting uterine prolapse.
　　2. Uterine prolapse in nulliparous women is due to poor development of the supporting tissues of the reproductive organs.
　　3. Increased intra-abdominal pressure can cause this condition on the basis of the above causes, including long-term chronic cough, constipation, ascites, or giant pelvic and abdominal tumors.
　　

　　Patients with uterine prolapse often have vaginal prolapse, or accompanied by cystocele or rectocele. Cystocele patients often have frequent urination, difficulty in urination, or incontinence. Rectocele patients often have constipation and difficulty in urination. Acute uterine prolapse can cause severe peritoneal irritation symptoms (severe lower abdominal pain, pale complexion, cold sweat, nausea and vomiting, etc.). Uterine prolapse is also prone to infection.

　　Patients with uterine prolapse feel a sinking sensation in the lower abdomen, with lumbago, and it is more pronounced when walking or squatting. In severe cases, the prolapsed mass cannot be retracted, affecting mobility. The specific clinical manifestations are as follows:
　　1. Lumbar sacral pain Especially in the sacral area, it is more obvious after labor, and can be relieved after lying down and resting. In addition, patients feel a sinking sensation in the lower abdomen, vagina, and perineum, which is more severe after labor.
　　2. Prolapse of vaginal mass Patients report a spherical object prolapsing from the vagina, which is more obvious during walking and physical labor, and can be spontaneously retracted after lying down and resting. In severe cases of prolapse, the object may fall outside all day and cannot be spontaneously retracted. Due to walking and activity, friction with clothing and pants causes discomfort, and prolonged friction can lead to ulcers, infections, increased secretion, and even bleeding. Over time, the local tissue thickens and keratinizes.
　　3. Urinary tract symptoms Most patients with uterine prolapse experience sudden increase in abdominal pressure when laughing, coughing violently, or exerting force, leading to urinary incontinence and urine leakage. Uterine prolapse is often accompanied by varying degrees of bladder prolapse, but whether stress urinary incontinence occurs depends on whether the anatomical relationship between the bladder and the urethra changes. A few patients with uterine prolapse have difficulty urinating, leading to urinary retention. They need to push the prolapsed bladder forward with their fingers before they can urinate. The reason is that the bladder prolapse is severe, and the enlarged bladder is located below the urethra.
　　4. Changes in menstruation, increased leukorrhea Due to the prolapse of pelvic organs, blood circulation is obstructed, local congestion occurs, affecting normal menstruation, which can cause menorrhagia. In addition, due to the obstruction of blood circulation, prolapsed organs may develop ulcers and infections, causing an increase in leukorrhea and accompanied by bloody discharge.
　　5. Generally, it does not affect fertility, pregnancy, and childbirth However, if the uterus cannot be retracted, edema of the cervix and difficulty in cervical dilation may occur during labor, leading to dystocia.
　　6. Signs The descent of the uterus from the cervix to the inside of the vagina, less than 14 cm from the hymen, can be as long as 4 to 5 cm. In cases of severe uterine prolapse accompanied by bladder prolapse, the transverse groove crease between the vagina and bladder disappears, and the lower boundary of the bladder can be longer than the external orifice of the cervix. Severe uterine prolapse has downward displacement of the bladder and ureter, forming a normal '△' area with the opening of the urethra.

　　Women go through many special physiological periods in their lives, which are also periods when they are prone to illness. Good health care during these periods can prevent or alleviate the pathophysiological basis for the development of uterine prolapse, which is the key to preventing uterine prolapse in perimenopausal and elderly women.

　　1. Strengthen the labor protection of women:Excessive load and posture-related efforts are one of the important causes of uterine prolapse. Strengthening the labor protection of women is a reliable guarantee for preventing and reducing uterine prolapse.

　　2. Do a good job in adolescent health care:Girls between the ages of 12 to 18 are called adolescents. Due to the incomplete development of the ovaries and female reproductive organs during adolescence, they are prone to various diseases influenced by external and internal environments, which may affect the normal development and reproductive function of girls. Girls with underdeveloped muscles, poor ligament tension, and often accompanied by relaxed and weak abdominal walls are known as asthenic physique. Such individuals usually have prolapse of internal organs (such as kidney prolapse and gastric prolapse). If the intra-abdominal pressure increases due to certain reasons, it is easy to develop uterine prolapse. Therefore, it is of great significance to do a good job in adolescent health care to ensure women's physical health and normal development, and to prevent the occurrence of uterine prolapse.

　　3. Pay attention to menstrual health care:Although menstruation is a physiological phenomenon in women of childbearing age, during menstruation, the excitability of the cerebral cortex decreases, and the pelvic congestion is influenced by endocrine changes, so the resistance of the whole body and the local area decreases. If not paying attention to menstrual health care, it is easy to cause various acute and chronic diseases in women, affecting women's health. Especially when women are stimulated by cold during menstruation (mainly cold water), it is easy to cause functional disorders of the ovaries and lead to menstrual disorders or amenorrhea. It is currently believed that there is a significant relationship between ovarian function and the tension of pelvic supporting tissues. During amenorrhea, due to the decline in ovarian function, the secretion of estrogen is reduced, leading to the decrease in tension of the pelvic supporting tissues, which is easy to cause uterine prolapse. Therefore, strengthening menstrual health care is also of great significance in preventing the occurrence of uterine prolapse.

　　4. Do a good job in prenatal health care:Good prenatal health care for women, timely detection and correction of fetal position abnormalities to prevent difficult labor due to fetal position, is also one of the important measures to prevent uterine prolapse.

　　5. Properly handle the various stages of labor:Birth injury is an important cause of uterine prolapse. The longer the labor, the higher the incidence of uterine prolapse, which is related to the greater chance of injury to the supporting suspensory apparatus and pelvic floor soft tissue. The injury caused during the first delivery is more critical. Among patients with uterine prolapse, about 30% have the disease after the first child. Therefore, properly handling the various stages of labor and preventing birth injuries is the most important link in preventing uterine prolapse.

　　6. Do a good job in puerperal health care:It usually takes 6 to 8 weeks for the mother to recover from the placenta to the non-pregnant state of the reproductive organs. This recovery period is called the puerperium. During the puerperium, there are significant anatomical and physiological changes in women. If not paid attention to, it is the most likely period for uterine prolapse to occur. According to reports, the incidence of uterine prolapse during the puerperium is significantly higher than that in other periods. Most of the cases occur within one month of returning to work, accounting for more than 85% of all cases. This is due to the physiological and pathological changes caused by pregnancy and childbirth in the uterus and its supporting structures, which have not been fully recovered before participating in labor (including heavy household chores) easily lead to uterine prolapse. Therefore, doing a good job in puerperal health care is of great significance in preventing uterine prolapse.

　　7. Do a good job in lactation health care:The ovarian function decreases during lactation. Especially after long-term lactation postpartum, the uterus can atrophy due to the long-term low ovarian function, leading to relaxation and weakness of the supporting structures and suspensory apparatus of the uterus, and the tension and elasticity of the pelvic floor muscles decrease. In this situation, any external factors such as increased abdominal pressure or posture-related force can trigger uterine prolapse. Uterine prolapse in lactation within 1 year accounts for less than 9% of the cases, while those with lactation lasting more than 1 year account for more than 90%. This indicates that the incidence of uterine prolapse significantly increases among those with lactation lasting more than 1 year. Another finding is that the uterus of women in lactation drops more明显 compared to non-lactation periods after bearing abdominal pressure, therefore, doing a good job in women's lactation health care is an important measure to prevent uterine prolapse.

　　Instruct the patient not to urinate and take the lithotomy position. During the examination, first have the patient cough or strain to increase abdominal pressure, observe whether there is urine leakage from the urethral orifice, to determine whether there is stress urinary incontinence, and then empty the bladder for gynecological examination.

　　1. Pay attention to the condition of vaginal wall prolapse and uterine prolapse without exertion. Also, pay attention to the condition of the external genitalia and the degree of perineal rupture.

　　2. Observe the vaginal wall and cervix with a vaginal speculum for signs of erosion, and check for a vesicouterine hernia.

　　3. During vaginal examination, pay attention to the condition of both levator ani muscles, determine the width of the levator ani cleft, the position of the cervix, and then clearly determine the size of the uterus, its position in the pelvis, and whether there is inflammation or tumor in the adnexa.

　　4. Instruct the patient to use abdominal pressure, and take a squatting position if necessary, so that the uterus can prolapse for palpation to determine the degree of uterine prolapse.

　　Patients with uterine prolapse should eat more foods rich in vitamins, inorganic salts, and fibers, such as tomatoes, sprouts, cabbage, rapeseed, tangerines, lychees, longans, jujubes, etc.; and more high-protein foods such as chicken, eggs, lean meat, pork liver, carp, sea cucumber, and soy products, which are best eaten as soups or stews.

　　Patients with uterine prolapse should avoid slippery vegetables. Vegetables such as winter melon, cucumber, luffa, bitter melon, lotus root, eggplant, amaranth, cabbage, and spinach are all cold and slippery in nature, and eating them will cause weakness of the spleen and stomach, causing the uterus to slide down and be difficult to retract.

　　Avoid aquatic products that are cold and prone to cause sinking. Clams, snails, and conches are all cold in nature, and eating them will damage the spleen Qi, further aggravating the condition and making it difficult for the uterus to recover from prolapse. Other aquatic products such as crabs, snakes, and turtles also have the effect of sinking, which is easy to cause uterine coldness and prolapse.

　　Avoid foods that damage the spleen and stomach. Lilies and mung beans are products that dissipate summer heat and cool down the body, but they also have the effect of damaging the spleen and stomach. Especially for people with weak spleen and stomach, eating them will cause weakness and lack of strength, and even cause loose stools, uterine prolapse, and the inability of the uterus to retract.

　　Avoid cold and cool fruits. Pears, watermelons, pomelos, lemons, sweet oranges, persimmons, bananas, apricots, hawthorn fruits, and melons are all cold and cool in nature, and eating them will damage the spleen and stomach Yang, aggravating uterine prolapse.

　　Avoid foods that damage the Qi. The cause of uterine prolapse is due to weakness and fatigue, and lack of nutrition. Foods such as radish, salted vegetables, bamboo shoots, turnips, tea, vinegar, etc., will damage the Qi and consume nutrition, making the weak body even weaker due to insufficient nutrition, leading to the inability of the uterus to retract properly.

　　The treatment of uterine prolapse aims to strengthen or restore the support function of the pelvic floor tissues and uterine ligaments. Depending on the degree of uterine prolapse, the uterine pessary therapy or surgical treatment can be chosen.

　　First, Non-Surgical Treatment
　　1. Uterine Pessary: The method is suitable for different degrees of uterine prolapse. The diameter of the uterine pessary is greater than the transverse diameter of the urogenital cleft, which can support the uterus and vaginal wall and maintain them inside the vagina without prolapse. The materials used for making include silicone rubber, plastic, etc., and there are many shapes, commonly used ones include ring-shaped, trumpet-shaped, or spherical uterine pessaries.
　　Choose a uterine pessary of appropriate size. The first use of the uterine pessary should be under the guidance of a physician. Use it during the day and remove it at night for cleaning and storage. Prolonged non-removal can lead to uterine pessary impaction, even causing vesicovaginal or rectovaginal fistula. It is not suitable for patients with cervicitis and vaginal wall inflammation, genital tract ulcers, and severe prolapse that cannot be retracted. Discontinue use during the menstrual period and pregnancy, and review every 3 months after use.
　　2. Pelvic Floor Muscle (Pubococcygeus Muscle) Exercise: Suitable for patients with mild uterine prolapse. Instruct patients to perform anal contraction exercises, contract and relax the pelvic floor muscles with force for 10-15 minutes, 2-3 times a day. This therapy can be combined with the administration of traditional Chinese medicine, such as the Decoction for Invigorating the Middle and Qi, at the same time.
　　3. Improve Overall Condition: Treat and remove chronic diseases that increase abdominal pressure, such as cough and constipation. Postmenopausal women should supplement estrogen moderately to avoid overfatigue, and rest can improve and alleviate the degree of uterine prolapse.

　　Second, Surgical Treatment
　　For patients with II degree and above prolapse, those with symptoms of rectocele and cystocele and those who have no effect from conservative treatment, the surgical principle is to restore the normal anatomical position of the uterus or to remove the uterus, repair the excess mucosa of the vaginal wall, and suture and repair the pelvic floor muscles according to the patient's age, fertility requirements, and overall health status. The following commonly used surgical methods are selected.
　　1. Strengthening Pelvic Fascia Surgery: Suitable for patients with I degree prolapse or II degree prolapse with vaginal anterior and posterior wall prolapse and cervical elongation. Common surgeries include: ① Vaginal anterior and posterior wall repair surgery; ② Vaginal anterior and posterior wall repair + partial cervical resection and uterosacral ligament shortening surgery; ③ Ligament suspension surgery. Laparoscopic shortening of round ligament and sacral ligament is suitable for patients with congenital simple mild uterine prolapse.
　　2. Total Hysterectomy and Vaginal Anterior and Posterior Wall Repair Surgery: Suitable for patients with II and III degree prolapse without fertility requirements.
　　3. Vaginal Closure Surgery: Also known as Le-Fort surgery. Suitable for elderly patients who cannot tolerate major surgery due to cervical no malignancy and partial vaginal closure after surgery, resulting in loss of sexual function.