Uterine prolapse


A uterine prolapse refers to the sinking of the uterus. Cause is a weakening of the pelvic floor, which may be due to birth, among other things. A cervix can be treated with various conservative methods or surgery. Read all important information about uterine cervix here.

ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. N81ArtikelübersichtGebärmuttersenkung

  • description
  • symptoms
  • Causes and risk factors
  • Examinations and diagnosis
  • treatment
  • Disease course and prognosis

Uterine depression: description

Decreasing the uterus (uterine uterus) is a downward movement of the uterus, ie the uterus "hangs" deeper in the pelvis than usual. In extreme cases, the uterus even partially or completely through the vagina to the outside. Physicians then speak of a uterine prolapse (uterine prolapse). In mild cases, lowering the uterus may be asymptomatic. Usually, however, there are various complaints.

Normally, the uterus is held in place by several retaining structures. These include ligaments (ligaments), connective tissue and the pelvic floor muscles. However, these support structures can weaken and the uterus no longer stabilize sufficiently. In the entire pelvic floor there is a general reduction: uterus, urinary bladder or rectum may slip downwards.

Overall, between 30 and 50 percent of all women get a pelvic floor reduction during their lifetime. But symptoms do not necessarily have to happen with every woman. Many women have no symptoms with a slight uterine erosion, so that the uterine reduction is medically often not relevant. Treatment is only necessary if the uterus is more severe with noticeable symptoms or impaired function and, of course, if the uterus proliferates.

Lowering the uterus may also affect younger women. This is especially the case when there is a chronic weakening of the connective tissue.

Divorce and vaginal discharge

In addition to the uterine depression, there is also the vaginal depression (Descensus vaginae). Here, the vagina sags down. If parts are hanging out of the vagina, it is called a vaginal prolapse (prolapse vaginae or vaginal prolapse). Often, a vaginal depression or vaginal discharge occurs along with uterine erosion. Typical of a vaginal depression is a foreign body sensation in the vagina, along with problems with urinary retention.

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Uterine depression: symptoms

Uterine reduction can be felt in several ways. Classic uterine depression symptoms include abdominal or back pain. However, such pains are less specific and are usually attributed to other causes by affected women.

Lowering the uterus in most women causes a chronic sensation of pressure or foreign body in the vagina, as well as a steady downward pull. This creates the fear that something might "fall out" of the vagina. Affected women often cross their legs. In addition, there is increased inflammation and mucosal deposits, as the vaginal flora is changed. Also, pressure ulcers occur. Another symptom is bloody discharge from the vagina.

Because the uterus is in close proximity to the urinary bladder, it can put pressure on it as its position changes. Typical symptoms include pain when urinating, a weakened stream of urine and frequent urination with small amounts of urine (pollakisuria). In some cases, so-called stress incontinence also occurs. For example, if coughing or sneezing, unintentional urine is lost. Also urinary tract infections can accumulate. In extreme cases, there may be a shift or a decrease in the bladder. As a result, the urine backs up in the kidney. This complication is rare.

To the rear, near the uterus, are the rectum and the anal canal. If the uterus slides down and behind, it can also exert pressure on the rectum. Consequences are constipation and / or pain during bowel movements. Fecal incontinence also occurs occasionally.

If a uterine depression goes unnoticed for a long time, it exerts increasing pressure on the pelvic floor. In extreme cases, the uterus can emerge completely or partially from the vagina. Physicians then speak of a uterine prolapse or uterine prolapse. Symptoms are obvious here: The uterus can be seen visually from the outside.

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Uterine ulcer: causes and risk factors

A reduction of the uterus occurs when the ligaments and muscles that normally guarantee the stability of the pelvis are no longer sufficiently strong. The uterus then sinks according to the downward force of gravity. In the course of life, various factors can help to overburden the support structures. This includes:

  • Over- and underload of the pelvic floor due to heavy physical work
  • Pressure increase in the abdominal cavity due to diseases such as chronic bronchitis or chronic constipation
  • obesity
  • general connective tissue weakness

In addition, it may come from birth to a different location of the uterus location. Even with such positional anomalies, the risk of uterine prolapse is increased. Here are often already from the age of 30 first symptoms.

Uterine ulcer after birth

Even after birth, the likelihood of uterine erosion is increased. If the fetuses are heavy, the ligaments in the pelvic area are heavily loaded. Vaginal injuries at birth also pose a potential risk. Women who have had multiple children throughout their lives, therefore, firstly suffer more often and, secondly, sooner from a uterine prolapse.

In addition, a vaginal delivery may result in a transient uterine prolapse. In most cases, this will return by itself within a few days. If this is not the case, a treatment is needed here as well. An episiotomy reduces the risk of uterine erosion, as the targeted incision avoids excessive pressure and tearing of the tissue.

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Uterine ulcer: examinations and diagnosis

In case of a suspected uterine prolapse, the gynecologist is the right person to contact. In a first conversation the medical history (anamnesis) is recorded. You have the opportunity to describe your symptoms. Based on the classic complaints, there is usually a relatively quick suspicion of a uterine depression.

During the gynecological examination, a clear diagnosis can then be made. Using a speculum (vaginal level), the doctor examines the vagina and can detect a uterine depression.

Also, a rectal examination is one of the suspected uterine sinking. The doctor scans directly into the rectum. For example, he can feel an invagination of the wall of the rectum (rectocele) towards the vagina. Such a bulge is a common cause of constipation.

To assess the extent to which the bladder is affected by uterine erosion, an ultrasound scan is performed. Thus, possible consequences of uterine erosion can be better determined. If there is a suspicion of a urethral infection, a urine sample is taken and examined in the laboratory.