Descensus uteri - Symptoms and treatment

The uterus is held in position in the pelvis by ligaments, connective tissue and by the pelvic floor muscles. A uterine prolapse occurs if the connective tissue, the muscles or the ligaments are weakened. Pregnancy, major physical exertion or excessive weight facilitate the development a discensus uteri. However, increased pressure in the abdomen with chronic constipation or constant coughing (chronic bronchitis) can also cause a uterine prolapse.

The symptoms differ, depending on the severity of the prolapse. Mild descensus uteri often does not cause any symptoms. If there is a more severe descensus uteri or a prolapse, the patient typically has bladder issues, digestive difficulties, a feeling of pressure and vaginal pain. Descensus uteri puts pressure on the bladder and the rectum, which results in an increased need to urinate, uncontrollable loss of urine (urinary incontinence), a stronger urge to defecate, but also constipation can be a result. Uterine prolapse can cause infection and ulcers. Sometimes there can also be a prolapse of the bladder (cystocele) or the rectum (rectocele) through the vagina without the uterus being affected.

Descensus uteri is diagnosed with a gynaecological examination. The severity is assessed while the patient is at rest and while they strain. An ultrasound examination of the uterus and the bladder is often carried out as well.

The treatment depends on the severity of the descensus uteri. Mild cases can be treated with pelvic floor training or a pessary. If the patient is suffering from severe descensus uteri or prolapse, surgical treatment is usually unavoidable. You can find out more about the surgical treatment options in the pelvic floor weakness surgery section.

Pelvic floor training and postnatal exercises are important preventative measures.