bubble_chart Concept

Prolapse of uterus, also known as prolapse of uterus, refers to the condition where the uterus is positioned lower than normal, prolapsed, or protruding outside the vaginal opening.

This condition, Zhubing Yuanhou Lun refers to as "prolapse of uterus descending and prolapsing," Qianjin Fang refers to as "prolapse of uterus," "yin tui," "prolapse of uterus," "yin zhi," Sanyin Jiyi Bingzheng Fanglun refers to as "yin descending and prolapsing," and Ye Tian-shi's Gynaecology refers to as "prolapse of uterus." Since it often occurs postpartum, it is also referred to as "postpartum intestinal non-retraction."

bubble_chart Pattern Analysis

1. Qi Deficiency︰There is a protrusion from the vagina, which may retract when lying down but worsens with fatigue, accompanied by a heavy sensation in the lower abdomen, soreness and distension in the lower back, and mental fatigue with lack of strength. There may also be frequent urination and increased leucorrhea. The tongue texture is pale with a thin coating, and the pulse is weak and thin. This condition is often caused by constitutional weakness, deficiency of middle qi, excessive exertion during childbirth, or premature exertion due to consumptive disease from blood coagulation, leading to qi deficiency and sinking. This results in the relaxation of the uterine ligaments that support the uterus, making it unable to retain the uterine body, causing the uterus to descend. It is often accompanied by symptoms such as a sagging sensation in the lower abdomen, mental fatigue with lack of strength, and frequent urination. The treatment aims to tonify qi and lift the sinking, using the prescription Middle-Tonifying Qi-Replenishing Decoction, with the addition of Submature Bitter Orange and Motherwort.
2. Kidney Deficiency︰There is a prolapse in the vagina, a sagging sensation in the lower abdomen, and frequent urination. The lower back is sore and the legs feel weak, accompanied by dizziness and tinnitus. The tongue appears pale red, and the pulse is deep and thin. This condition is often caused by early marriage and multiple childbirths, leading to kidney qi deficiency, failure of the belt vessel to regulate the meridians, and the uterus losing its support. Alternatively, it may result from improper postpartum care, injuring the uterine collaterals and weakening their ability to hold the uterus. The key diagnostic features of this condition are persistent lower back soreness, weak legs, abdominal sagging, and frequent urination. Treatment should focus on nourishing the kidneys and yin, warming yang, and replenishing qi. The recommended prescription is Major Original-Qi Tonifying Decoction supplemented with powdered Pilose Antler and motherwort herb.
3. Deficiency of Both Qi and Blood︰Prolapse of uterus, complexion shallow yellow, dry skin, dizziness and ringing in the head, tinnitus, blurred vision, soreness in the waist and aching bones, dry stool, tongue texture slightly pale, pulse weak, thin, and rapid. It is caused by excessive postpartum metrorrhagia, qi collapse following blood loss, and the uterus failing to retain. The key points of differentiation: accompanied by complexion shallow yellow, dry skin, dry stool accumulation, tongue texture slightly pale, etc. It is advisable to tonify qi and blood, and the prescription used is Ten Major Tonics Decoction minus Cassia Bark, such as degelatinized deer-horn.
4. Dampness-heat︰The uterus protrudes outside the vaginal orifice, with burning pain and swelling, or ulceration and discharge of yellow fluid. There is dragging pain in the lower abdomen and excessive yellow vaginal discharge. Restlessness and thirst, or hot and dark urine with frequent and painful urination, or severe constipation. The tongue coating is yellow and greasy, and the pulse is mostly slippery and rapid. This is a pattern of root deficiency and excess manifestation. It is mostly caused by qi deficiency and sinking or kidney deficiency failing to secure, leading to prolonged protrusion of the uterus outside the vaginal orifice, which is then rubbed by clothing and infected, resulting in surface ulceration and profuse yellow discharge. Treatment should focus on clearing and draining damp-heat, assisted by lifting. The recommended formula is Gentian Liver-Draining Decoction minus Akebia Stem, plus raw Astragalus Root.

This condition can also be treated with external methods: (1) Submature Bitter Orange 60 grams, decoct and use the hot liquid to first fumigate and then wash the external genital area, 1-2 times daily. (2) Smoked Plum 15 grams, Chinese Gall 9 grams, Pomegranate Rind 9 grams, use the same method as above. (3) Sophora 12 grams, Cnidium Fruit 15 grams, raw Phellodendron Bark 9 grams, Dahurian Angelica 9 grams, dried alum 6 grams, use the same method as above.

bubble_chart Documentation

1. Yizong Jinjian Gynecology Essentials-External Genitalia Disorders: "Women with prolapse of uterus, either due to injury of the uterine collaterals, excessive exertion during childbirth, qi deficiency causing sinking, or dampness-heat pouring down, may have a protrusion from the vagina resembling a snake, mushroom, or cockscomb, which is akin to the ancient condition of hernia. For cases with heat, there will be swelling, pain, and scanty dark urine, and Gentian Liver-Draining Decoction is recommended; for cases with deficiency, there will be a heavy, sagging sensation and clear, copious urine, and Middle-Tonifying Qi-Replenishing Decoction with green tangerine peel and gardenia is recommended, along with external use of Cnidium Fruit and Smoked Plum boiled in water for fumigation and washing. Additionally, applying a paste of lard mixed with false hellebore powder will cure the condition without fail."
2. Gu Yingtuo's Gynecology Collection．Volume Nine．Vaginal Orifice Disorders: "For prolapse of uterus, ... the treatment method is as follows: for cases with liver-spleen stagnation and qi deficiency causing sinking, Middle-Tonifying Qi-Replenishing Decoction should be used. For cases with liver fire and dampness-heat causing difficult urination, Gentian Liver-Draining Decoction should be used."