Descensus uteri occurs when the uterus drops down towards the vagina. If the prolapse is so severe that the uterus is visible at the vaginal opening, this is known as a uterine prolapse. Descensus uteri can cause weakness in the bladder and urinary incontinence. Regular training of the pelvic floor muscles has a preventative effect. A uterine prolapse must usually be treated surgically.
The uterus is held in position in the pelvis by ligaments, connective tissue and by the pelvic floor muscles. A uterine prolapse occurs if the connective tissue, the muscles or the ligaments are weakened. Pregnancy, major physical exertion or excessive weight facilitate the development a discensus uteri. However, increased pressure in the abdomen with chronic constipation or constant coughing (chronic bronchitis) can also cause a uterine prolapse.
The symptoms differ, depending on the severity of the prolapse. Mild descensus uteri often does not cause any symptoms. If there is a more severe descensus uteri or a prolapse, the patient typically has bladder issues, digestive difficulties, a feeling of pressure and vaginal pain. Descensus uteri puts pressure on the bladder and the rectum, which results in an increased need to urinate, uncontrollable loss of urine (urinary incontinence) and a stronger urge to defecate. Uterine prolapse can cause infection and ulcers. Sometimes descensus uteri also causes a bladder (cystocele) or rectal (rectocelle) prolapse through the vagina.
Descensus uteri is diagnosed with a gynaecological examination. The severity is assessed while the patient is at rest and while they strain. An ultrasound examination of the uterus and the bladder is often carried out as well.
The treatment depends on the severity of the descensus uteri. Mild cases can be treated with pelvic floor training. If the patient is suffering from severe descensus uteri or prolapse, surgical treatment is usually unavoidable. You can find out more about the surgical treatment options in the pelvic floor weakness surgery section.
Pelvic floor training and postnatal exercises are important preventative measures.
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