What are the symptoms of a severe cervix
Uterine descent (Descensus uteri)
A uterine subsidence is not an independent disease. Rather, it is a symptom of the pelvic floor being too weak or gradually weakening. Therefore, only the symptoms of uterine subsidence can be treated. However, women can use pelvic floor exercises to prevent further lowering.
Doctors initially use conservative therapy (without surgery) to lower the uterus. If the reduction is more pronounced, surgery can also help women. Which treatment is the right one depends on your symptoms, accompanying symptoms (e.g. incontinence), your age, general state of health or whether you want to have children.
Conservative therapy: treat uterine subsidence without surgery
Doctors treat the lowering of the uterus without surgery. Conservative methods often achieve good results with a slight lowering of the uterus and minor incontinence. These measures include, for example:
- Reduce or switch off risk factors such as heavy smoking, chronic constipation or being very overweight
- Learn techniques for correct lifting and carrying
- Exercise the pelvic floor regularly during and after the lowering of the uterus and strengthen the supporting structures
- Use a pessary, a small ring, dice or a bowl made of rubber. The doctor or you put it into the vagina where the device is supposed to stabilize the uterus. Estrogen therapy usually supplements the treatment so that the pessary does not damage the vaginal mucosa.
Tip! Exercises, for example in the form of pregnancy or postnatal gymnastics, can also prevent uterine sagging in (early) pregnancy.
Even if a lowering of the uterus cannot be completely reversed with conservative therapies - the measures help prevent the uterus from lowering further.
Surgery to lower the uterus
Sometimes the conservative treatments are not successful enough. Then the uterine subsidence can be treated with an operation. It is also a possibility if the subsidence is more pronounced or if the uterus is partially prolapsed. There are several surgical procedures to choose from:
- Vaginal fixation on the lateral pelvic wall (sacrospinal colpopexy)
- Procedures that use the nearby ligaments to hold the uterus and vagina in place
- Vaginal compression / vaginal plasty (colporrhaphy)
- Methods in which tissue networks hold the organs and the pelvic floor (mesh insert)
In the case of simultaneous incontinence, there are also surgical procedures that are intended to improve the angle between the urethra and the bladder. A combined procedure can help women who are no longer of childbearing age. The surgeon removes the uterus through the vagina, gathers the vagina and sutures the vaginal tissue.
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