Definition
Uterus prolapse is the lowering of the uterus down into the pelvis.
Introduction
Normally, the uterus is fixed in position by many structures. This is ensured by ligaments, connective tissue and the pelvic floor muscles. If these structures are weakened and can no longer withstand the strain, the uterus is lowered.
In extreme cases, this can go so far that the uterus partially or completely protrudes through the vagina. This is called a uterine prolapse. Often other organs are also lowered in the course of uterus prolapse, which also affects the bladder and rectum.
Frequency
Approximately 30 to 50 percent of all women suffer a general pelvic floor prolapse during their lifetime, which includes uterus prolapse. Older women are mainly affected, but in younger women, too, uterus prolapse can occur during childbirth, for example.
Duration
A uterine prolapse, which occurs after the natural delivery of a child, usually disappears of its own accord within a week. If this is not the case or if severe symptoms occur, only a therapy is necessary.
Causes
When a child is born naturally, the uterus is put under a lot of strain. The supporting structures of the uterus are stretched so much that they cannot return to their original state immediately after delivery. This results in the uterus sinking after birth.
The risk of the uterus sinking after birth is reduced by an episiotomy, as this keeps the pressure on the uterus low. Uterus prolapse can also have other causes. After the menopause this is the case in almost all women, but younger women can also be affected. Very weak connective tissue is the most common cause in younger women. In addition, very hard physical work and overweight can lead to a prolapsed uterus.
Symptoms/pain
A uterine prolapse after birth does not necessarily lead to symptoms or pain in the uterus. Often it is completely asymptomatic. Depending on the extent of the prolapse, however, it can also lead to different and differently pronounced symptoms.
Various other organs of the lower abdomen can also be affected, as they are located in the immediate vicinity of the uterus and are connected to it by ligamentous structures. The affected woman can feel a feeling of pressure in the lower abdomen, which can also be perceived as pain, depending on the severity of the problem. Depending on how far down the uterus has sunk, a foreign body sensation can occur in the vagina.
This goes so far that the affected women often have the feeling that something could fall out of the vagina. For fear of this, they often cross their legs. If the uterus enters the vagina, this can upset the vaginal flora and lead to bleeding and inflammation there.
Typical symptoms of uterine prolapse are abdominal pain and lower back pain. Pain also occurs during sexual intercourse. The fact that the uterus presses down on other organs, such as the bladder and rectum, also causes pain there.
The constant pressure tends to cause an urge to urinate, but also problems urinating or bladder weakness. So-called stress incontinence often occurs. If the woman concerned coughs, sneezes or does heavy physical work, urine is involuntarily released.
If the uterus tends to press on the rectum, this leads to constipation and discomfort during bowel movements. If the uterus has sunk so far that the bladder sinks, urine can back up into the kidney and lead to complications. However, this happens rather rarely.
