Descending or uterine prolapse is a condition when the uterus descends and protrudes from the vagina. This condition occurs due to weakening of the muscles and tissues around the pelvisso unable to support womb.
Normally, the uterus is located in the pelvis and is supported by the muscles and surrounding tissue. The muscles and tissues that support the uterus can weaken as a result of pregnancy, childbirth, or aging. When the muscles and tissues that support the uterus are weak, the uterus can move out of position and descend into the vagina.
Descendants or uterine prolapse can be experienced by women of all ages. However, this condition is more common in women who have entered menopause and in women who gave birth vaginally.
Descending or descending the uterus can be divided into four stages, namely:
- The first stage: the cervix descends into the vaginal canal
- The second stage: the cervix descends to the vaginal opening
- The third stage: the cervix is outside the vagina
- Fourth stage: the entire uterus is outside the vagina (procidentia)
Causes and Risk Factors for Descendants
Descendants are caused by weakening of the muscles and tissues that support the uterus in the pelvis. This condition can occur due to the following factors:
- Having a vaginal delivery (normal delivery), especially when giving birth to a baby weighing more than 4 kg or giving birth to twins
- Experience a decrease in estrogen levels after entering menopause
- Experiencing complications due to pelvic surgery
- Have chronic (chronic) bronchitis or asthma
- Being overweight or obese
- Experiencing chronic constipation
- Having a pelvic tumor
- Often lift heavy weights
- aging
- Smoke
Symptoms of Descendants
Descending the breed does not cause symptoms if it is still in a mild stage. Symptoms usually only appear when descent increases to a moderate or severe stage. These symptoms include:
- Constipation or constipation
- Discomfort when walking
- Pain during sexual intercourse
- Feeling of fullness and pulling in the pelvis
- Pain in the pelvis, abdomen, and lower back
- Blood or fluid or uterine tissue coming out of the vagina
- Urinary disturbances, such as urinary incontinence (difficulty controlling urination) or urinary retention (difficulty passing urine)
- Recurrent or recurring bladder infections
The above symptoms are often not bothersome in the morning, but can get worse during the day or at night and when the sufferer stands or walks for long periods of time.
When to go to the doctor
Immediately consult a doctor if you experience the above symptoms. If left unchecked, this condition will interfere with daily activities and risk causing complications.
Take medication if you have a condition that can increase your risk of getting offspring, such as chronic cough or constipation. By treating these conditions, you can avoid procreation.
Inherited Diagnosis
The doctor will first ask the patient's symptoms and medical history. After that, the doctor will perform a physical examination of the pelvis. In a pelvic exam, the doctor will use a speculum (cocor duck) to see the inside of the patient's vagina and uterus.
To find out how far the uterus is out of its normal position, the doctor will ask the patient to push. The doctor will also measure the strength of the patient's pelvic muscles by asking the patient to perform movements such as holding back urine.
If necessary, the doctor will perform several supporting examinations, such as:
- Intravenous pyelography (IVP) or X-rays with the help of contrast fluid, to detect urinary tract obstruction
- Ultrasound of the pelvis and urinary tract, to rule out symptoms caused by problems other than descent
- Urodynamic tests, to check the function of the muscles and nerves in the bladder, the pressure around the bladder, and the rate of urine
Hereditary Medicine
Treatment for offspring will be adjusted according to the severity. In mild cases of descent that are asymptomatic or cause only a few symptoms, the doctor will recommend self-therapy that can be done at home.
The goal of self-therapy is to relieve symptoms and prevent the condition from getting worse. Self therapy can be done by:
- Lose weight
- Overcoming constipation or constipation
- Doing Kegel exercises to strengthen the pelvic muscles
If needed, the doctor will also suggest placing a vaginal support ring (pessary) to support the protruding tissue. Placing a pessary is also recommended for patients who cannot undergo surgery. During use, this support ring should be cleaned regularly.
Meanwhile, for heavy descent, the doctor will recommend surgery, such as:
- Surgery to correct the position of the uterus, to replace the supporting tissue of the uterus with tissue from the patient's body, donor tissue, or synthetic materials
- Hysterectomy or surgical removal of the uterus
Although effective in treating offspring, this operation is not recommended for women who are still planning to have children in the future. The reason is, pregnancy and childbirth will put heavy pressure on the pelvic muscles so that it can damage the position of the uterus that has been repaired through surgery.
Complications of Descendants
Descending breeds can cause disturbances in other pelvic organs. This can cause the patient to experience complications such as:
- Cystocele, which is a condition where the bladder protrudes into the vaginabladder prolapse)
- Rectocele, which is a condition where the rectum protrudes into the vaginaposterior vaginal prolapse)
- Vaginal walls protrude on descent of heavy breeds which can lead to infection
Prevention of Descendants
There are several ways that can be done to reduce the risk of descent, including:
- Exercising regularly, such as doing Kegel exercises, especially after giving birth
- Avoid over-exercising or lifting heavy weights on the waist or back
- Overcome constipation by eating high-fiber foods and drinking lots of water
- Overcome cough and quit smoking
- Maintain ideal body weight