Uterine decensus and uterine prolapse

Overview

As we get older, our connective tissue gets weaker. As a result, the womb (uterus) and its support structure can descend towards the pelvis, and in extreme cases even protrude from the vaginal opening (prolapse of the uterus). Typical symptoms include pressure in the lower abdomen and a frequent urge to urinate. Special pelvic floor exercises can help.

Symptoms

Minor prolapses often go unnoticed. The following symptoms are typical if the condition progresses:

Main symptoms

• Pressure in the vagina
• Increased urge to urinate
• Involuntary urinary incontinence, in particular when coughing, sneezing or laughing
• Womb pain or lower back pain

Other symptoms

• Frequent bladder infections
• Digestive problems
• Haemorrhoids
• Slimy or bloody vaginal discharge

Causes and treatment

Causes

The uterus is attached to the pelvic wall by a support structure consisting of connective tissue. Increasing weakness of the connective tissue is a common cause for prolapse. Risk factors include:

• Pregnancies
• Hard physical labour/heavy lifting
• Advancing age (increasing connective tissue weakness)
• Increased pressure in the abdominal cavity (e.g. chronic constipation, obesity)

Further treatment by your doctor / in hospital

Possible tests

• Gynaecological examination
• Pelvic ultrasound (sonography)

Possible therapies

• Oestrogen replacement in the form of creams or plasters (helps for connective tissue weakness in old age) $
• Operation (anchoring of uterus to pelvis)
• Pessary (support disk or ring that is inserted into the vagina)

What can I do myself?

• Pelvic floor exercises
• Reduce overweight
• Use correct technique for lifting loads

When to see a doctor?

• Recurrent bladder infections
• Pressure in the vagina
• Urinary incontinence
• Every incident of uterine prolapse (womb protrudes from the vaginal opening)

Synonyms

haemorrhoids, urinary tract infections