Causes
Basically, the cause of a uterine prolapse is a weakening of the pelvic floor. This is made up of ligaments and muscles and can lose function and stability through overloading. A connection with vaginal births is particularly common.
The birth process as well as the pressing (abdominal press means an increase in pressure within the abdominal cavity) leads to a pronounced strain on the pelvic floor, which rarely regenerates completely afterwards. The constant protrusion of the vagina can also lead to a change in the vaginal environment. The otherwise very moist mucous membrane can dry out, which can often lead to inflammation.
Some women also notice an increased, sometimes even bloody vaginal discharge. Depending on whether the uterine prolapse also affects the bladder, problems with urination may also occur. In this case a weakened urine stream is often noticed.
In some women, however, urination is also made considerably more difficult by so-called pollakiuria. Pollakiuria means frequent urination, but only very small amounts of urine can be passed. One gets the unpleasant feeling that there is always a residual urine left in the bladder.
In case the lowered uterus presses backwards on the rectum and the rectum, problems with bowel movement (constipation, pain) can also occur. A high birth weight of the child can also be a risk factor for a prolapsed uterus after birth. It has also been observed that multi-partum mothers are more likely to experience uterine prolapse than women who have never given birth or who have only given birth vaginally.
However, there are also other reasons for a weakening of the pelvic floor. For example, even years of heavy physical exertion can lead to overloading of the ligaments and muscles. Similarly, obesity (adiposity) or chronic coughing means an increase in pressure in the abdomen and thus also on the pelvic floor.
Diagnosis
In most cases, a uterine prolapse can be quickly diagnosed through a consultation with a doctor and a gynecological examination. Affected women often notice after going to the toilet that something is protruding from their vagina, which can be pushed back quite easily with a finger. However, if the pressure in the abdomen increases (e.g. by pressing, sneezing, coughing), a new incident occurs.
This description usually gives the doctor enough information for the suspected diagnosis of uterine prolapse. The next step is the specula examination (speculum means vaginal mirror) on the gynecological stool. Here, an existing uterine prolapse can be clearly identified.
In any case, a short rectal palpation examination is also performed, during which the doctor can feel possible protrusions of the rectum into the vagina. Finally, an ultrasound examination is performed to assess the bladder. In extreme cases, even the bladder may be affected by the uterus prolapse.