To prevent genital prolapse, attention must be paid to reducing individual risk factors. Behavioral risk factors Consumption of stimulants Tobacco use with chronic cough Heavy physical labor (especially lifting heavy objects). Overweight (BMI ≥ 25, obesity). Prevention factors (protective factors) Sectio caesarea (cesarean section) → less frequent pelvic floor disorders: in the first 15 years. … Genital Prolapse: Prevention
The following symptoms and complaints may indicate genital prolapse in women: Stress incontinence (formerly stress incontinence) – leakage of urine during physical exertion as a result of a bladder closure problem. Bleeding from vagina / urethra Feeling of pressure “down Dyspareunia – pain during sexual intercourse. Urination disorders Urinary urgency Ischuria (urinary retention) Constipation (constipation) … Genital Prolapse: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Genital descensus and prolapse results from pelvic floor insufficiency (pelvic floor weakness), which is caused by the weakness of the support apparatus of the uterus and the decreasing muscle tone of the pelvic floor muscles. Etiology (Causes) Biographic causes Constitutional connective tissue weakness Behavioral causes Consumption of stimulants Tobacco use with … Genital Prolapse: Causes
General measures Aim for normal weight!Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program. Nicotine restriction (refrain from tobacco use). Medical aids In a later stage of genital prolapse, elevation of the uterus (womb) can be done … Genital Prolapse: Therapy
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes Abdominal wall and inguinal region (groin area). Gynecological examination Inspection Vulva (external, primary female sexual organs). Vagina (vaginal) [presence of cystocele/protrusion of anterior vaginal wall … Genital Prolapse: Examination
2nd order laboratory parameters – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Small blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Urine status (rapid test for: pH, leukocytes, nitrite, protein, blood), sediment, if necessary urine culture (pathogen detection and … Genital Prolapse: Test and Diagnosis
Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification. Abdominal ultrasonography (ultrasound examination of the abdominal organs) – for basic diagnostics; including renal ultrasonography (including the draining urinary tract). Vaginal sonography (ultrasound by means of an ultrasound probe inserted into the … Genital Prolapse: Diagnostic Tests
In cases of pronounced descensus (prolapse) symptoms, vaginal hysterectomy (hysterectomy) with anterior and posterior colporrhaphy (vaginal tightening) and perineoplasty is usually performed. In the case of a pronounced descensus problem that can no longer be managed conservatively, various surgical procedures can be considered. Vaginal hysterectomy (removal of the uterus through the vagina) with anterior and … Genital Prolapse: Surgical Therapy
Medical history (history of the patient) represents an important component in the diagnosis of genital prolapse. Family history Is there a frequent occurrence of connective tissue weakness in your family? Social history What is your profession? Do you have to carry heavy? Current medical history/systemic history (somatic and psychological complaints). Do you have pain or … Genital Prolapse: Medical History
Neoplasms – Tumor Diseases (C00-D48). Tumors of the genital region, unspecified. Genitourinary system (kidneys, urinary tract-genital organs) (N00-N99). Urethrocele – prolapse of the urethra from the urethral orifice. Cystocele – lowering of the bladder floor; lowering of the bladder into the anterior vaginal wall, possibly from the vagina. Partial prolapse of the uterus and vagina … Genital Prolapse: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by genital prolapse: Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Constipation (constipation) Fecal impaction disorder, unspecified Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99) Ischuria (urinary retention). Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99). … Genital Prolapse: Complications
Traditional graduation of a genital descensus’. Grade Description 1 Inside the sheath (= small) 2 Up to the introitus/vaginal entrance (= moderate). 3 Distal of the introitus (= large) Grade classification of a genital descensus by the Baden-Walker halfway system. Grade Description 0 No prolapse 1 Halfway to the hymnal 2 Until hymn 3 Halfway … Genital Prolapse: Classification
