Diagnosis | Lowering of the uterus

Diagnosis

First of all, an anamnesis, i.e. a systematic questioning of the patient, is carried out. Here the doctor asks about complaints or symptoms as well as possible risks for weak pelvic floor muscles, such as births and their number. Next, a physical examination of the patient is performed.

During a palpation examination, the doctor can assess the strength of the pelvic floor or get an idea of possible bulges in the vagina. In a speculum examination, the doctor inserts an examination instrument into the vagina. This gives him a better view into the vagina and allows him to assess, among other things, the cervix with cervix.

Normally, the portio, i.e. the transition from the cervix to the vagina, can be seen to protrude slightly into the vagina. If there is a suspicion that the uterus is prolapsing, the patient is allowed to push briefly during this examination. If the uterus is prolapsed, the cervix will visibly continue to descend during the pressing.

Similarly, a speculum examination may also reveal protrusions of the vagina wall, which may indicate a cysto or rectocele. If the bladder is also involved in a uterus prolapse and the resulting incontinence problems occur, further examinations can be carried out. A uterus prolapse can often be palpated by the gynaecologist by means of a routine palpation.

Initially, the palpation does not differ from the annual cancer check-up. If the suspicion of uterus prolapse is confirmed, the gynecologist will perform a more detailed examination, also to determine how far the uterus has already prolapsed. The cervix is used as a reference point.

It represents the lowest part of the uterus. The height of the cervix indicates the severity of the prolapse. The cervix is felt as a ring-shaped, rough structure in the vaginal canal.

Normally, it lies directly above the vagina. High-grade cervical prolapse is usually easier to feel than those that are still in the early stages. Here, an ultrasound examination can provide further information.

However, the cervix already extends far into the vagina with a grade 1 uterus prolapse, so that a palpation is often sufficient to confirm the suspicion. In the course of the palpation, the gynaecologist asks the patient to perform various maneuvers, such as coughing and pressing. This increases the pressure in the abdomen and can affect the extent of the reduction or unmask it first.

In the case of advanced depressions, these can also be palpated by the patient herself. If the uterus is already protruding above the level of the vaginal outlet, parts of the uterus that are further up can be palpated in addition to the cervix. Would you like to learn more about this topic? You will find detailed information on this topic under: How can you palpate a prolapsed uterus?