Uterine prolapse, vaginal reduction: Causes, Symptoms & Therapy

21 October 2017

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Throughout life, the uterus displaced downward, this is quite normal. But if it drops too low, can cause the uncomfortable symptoms such as incontinence. In most cases, a uterine prolapse can be treated well - and those affected can also do something about it.

What is uterine prolapse?
From a uterine prolapse (descent of the uterus) speaking doctors, when the uterus slips out of its normal position in the pelvis toward the vaginal opening. Often it is accompanied by a reduction vaginal (vaginal prolapse) accompanied.

Pelvic muscles and ligaments may be weaker pregnancies and deliveries, as well as heavy physical work - they grind it were made. This uterus and vagina descend from. This is normal and initially caused no problems. But when the cutting progresses, the victim often feels uncomfortable symptoms such as feeling of pressure and pain. Also, problems with urination, and incontinence are possible consequences.

share medical uterus prolapse or vaginal reduction in four degrees on:

Uterine prolapse and vaginal reduction are usually Consequences of pelvic floor weakness. Normally, the pelvic floor holds the organs of the pelvis in its position (brace). The pelvic floor consists of several layers of muscles and connective tissue, which are attached as a kind of hammock to the bone of the pelvis.

Permanent overload can cause the muscles and connective tissue of the pelvic floor wear out. This weakening can have various causes. Other risk factors are about

many patients do not notice at first, when her uterus changes its position. From the second stage about a quarter of women experience discomfort. the symptoms are the further the lowering progresses, all the stronger. Typical are:

If ever residual urine remains in the bladder, increases the Risk of urinary tract infections. Especially women after menopause who suffer frequently among bladder or vaginal thrush should seek to clarify whether a uterine prolapse or vaginal reduction is responsible for the symptoms.

If the posterior vaginal wall lowers, it can also Difficulty in defecation come when feces accumulate in the sac of the intestinal wall towards vagina. Constipation (constipation) or an uncomfortable feeling of fullness of the intestine are the result.

The gynecologist asks the patient first to their complaints (Anamnesis). He may also asks, how much they drink and how often she goes to the toilet. In addition, it provides guidance on whether the patient is at increased risk for uterine prolapse, perhaps because she has experienced complicated births or do hard physical work, is in menopause or has already passed.

Subsequently the doctor scans the vagina of the patient and examines them Using a vaginal mirror (speculum). He can assess the condition of the pelvic floor and determine what position to take the genital organs at rest and during active presses. The vaginal mucosa can examine the doctor. Their nature may indicate, among other estrogen deficiency.

Whether the posterior vaginal wall is lowered, the doctor can determine by scanning the rectum.

additionally the gynecologist examined bladder and kidneys by Ultrasonic (Sonography). He can also determine the residual urine in the bladder. Residual urine in the bladder promotes urinary tract infections. Whether the patient has a urinary tract infection, the doctor can determine using a urinalysis.

Also one X-ray may be useful. So the doctor can check, for example, the mobility of the bladder neck and find out whether the bladder to the anterior vaginal bulge (cystocele).

Sometimes a uterine prolapse itself forms back. Therefore, the doctor may suggest to await. He also advises the patient to get potential risk factors such as obesity under control. If the uterine prolapse or vaginal reduction causes discomfort, the doctor may different ways of treating recommend.

Which makes sense depends on, among other things, how far the womb has already fallen.

Especially in women after menopause estrogen deficiency leads to the urinary and genital organs to the fact that the fabric back there, which favors a uterine prolapse. Therefore, a therapy with estrogen-containing ointments or suppositories (Local Scheidenöstrogenisierung) in these cases often helpful. The intake of estrogen-containing medications, however, does not help.

A slight uterine prolapse can women affected by consistent Pelvic floor exercises counteract and also prevent the uterus falls further. Here, the affected train specifically the pelvic floor muscles (brace) and strengthen them. This an already existing, light urinary incontinence can be reduced.

Also a pessary can improve symptoms. This plastic structure is inserted into the vagina and supports the uterus. The problems with bowel and bladder emptying may improve by pessaries.

What Pessarform is suitable for which type of uterine prolapse is not clear. Some doctors advise to cubic likely to ring or Schalenpessaren and a reduction in the posterior vaginal wall or bracket-shaped pessaries at a reduction of anterior vaginal wall. In any case, however, pessaries can only alleviate the symptoms of uterine prolapse. The reasons they do not eliminate.

at severe forms of uterine prolapse or vaginal reduction may recommend a surgical gynecologist. The aim of the various operational methods is to restore the supporting structures of the female reproductive organs and stabilize.

If possible, the doctor operates Under no abdominal incision from the vagina. The surgical procedure depends on which organ has as greatly reduced:

In both cases, the doctor may also fix the sunken end of the vagina to ligaments of the pelvis. 

For patients without infertility can be a Removal of the uterus be useful. This intervention is usually more reliable than a vaginal repair that needs to be repeated often after a few years.

Patients who are incontinent due to the uterus and vaginal reduction, a TVT procedure help. TVT stands for tension free vaginal tape, so Tension-free vaginal tape. The doctor puts this plastic tape from the vagina with the urethra. There it helps that the urethra remains closed even under load (sneezing, coughing, laughing).

The course of the each cause from. Causes a connective tissue the reduction, the treatment only relieves symptoms, but not the connective tissue. Therefore, after the risk remains that the uterus and vagina to reduce again. Preventive measures, such as pelvic floor exercises, but can mitigate this risk.

As a result of a uterus incident can pressure sores arise at the bulging organs, causing a bloody discharge may.

With increasing symptoms occur in some women during the course of uterine prolapse mental problems on. They suffer, for example, including having to wear an incontinence pad, and fear a possible odor nuisance. This burden can be so strong that affected women no longer dare among people and become isolated. To prevent this, it is important to accept help and to seek treatment. Self-help groups can offer support here.

Women can prevent a uterine prolapse or vaginal reduction, by

In particular, the Pelvic floor exercises can prevent a uterine prolapse. Sufferers can teach it to yourself or learn under physiotherapist guidance. Consistent and regular, daily practice is essential for success.

Pregnant women should attend antenatal exercises and after birth postnatal exercises to prevent uterine prolapse.


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