Descent or uterine prolapse is a condition when the uterus drops so that it protrudes outside the vagina. This condition occurs due to weakening of the muscles and tissues around the pelvis so that they are unable to support the uterus .

Normally, the uterus is located in the pelvis and is supported by the muscles and tissues around it. The muscles and tissues that support the uterus can weaken as a result of pregnancy, childbirth or aging. If the muscles and supporting tissues of the uterus are weak, the uterus can move out of position and descend into the vagina.

Descent 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 normally .

Causes and Risk Factors for Crossbreeding

Descent is caused by weakening of the muscles and tissues that support the uterus in the pelvis. This condition can occur due to the following factors:

  • Undergo vaginal delivery, especially when giving birth to babies weighing more than 4 kg or giving birth to twins
  • Getting older (aging)
  • Experiencing decreased levels of the hormone estrogen after entering menopause
  • Experiencing complications from hip surgery
  • Suffering from long-lasting (chronic) bronchitis or asthma
  • Suffering from overweight or obesity
  • Experiencing chronic constipation
  • Suffering from a pelvic tumor
  • Often lift heavy weights
  • Smoking, as it can cause a chronic cough

Symptoms of Decreased Breeding

Descending does not cause symptoms if it is still in a mild stage. Symptoms usually only appear when the descent increases to a moderate or severe stage. Some of the symptoms are:

  • Discomfort when walking
  • Pain during intercourse
  • A feeling of fullness and pressure in the pelvis
  • Constipation (constipation)
  • Pain in the pelvis, abdomen and lower back
  • Blood or discharge from the vagina
  • Uterine tissue protrudes into the vagina
  • Urination problems, such as difficulty controlling urination ( urinary incontinence ) or difficulty passing urine ( urinary retention )
  • Recurring or recurring bladder infections

These symptoms often don't bother you in the morning, but can get worse during the day or at night, and when you stand or walk for a long time.

Based on the position of the uterus, descent or descent of the uterus is divided into four stages, namely:

  • First stage: the cervix descends into the vaginal canal
  • Second stage: the cervix descends to the vaginal opening
  • Stage three: the cervix is ​​outside the vagina
  • Fourth stage: the entire uterus is outside the vagina ( procidentia )

When to see a doctor

Immediately consult a doctor if you experience the symptoms mentioned above. If left unchecked, this condition can interfere with daily activities and risk causing complications.

Seek treatment if you have a condition that can increase your risk of having an inheritance, such as a cough or chronic constipation. By treating these conditions, you can avoid procreation.

Diagnostics of Crossbreeding

The doctor will first ask about the patient's symptoms and medical history. After that, the doctor will perform a physical examination of the patient's pelvis. In a pelvic exam, the doctor will use a speculum or cockerel to see inside 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 make movements such as holding back the flow of urine.

If needed, the doctor will carry out 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, pressure around the bladder, and urine flow

Abortion Treatment

Treatment of vaginal discharge will be adjusted according to the severity. In mild vaginal discharge that is asymptomatic or only has mild symptoms, the doctor will recommend self-care that can be done at home.

Self-care aims to relieve symptoms and prevent the condition from getting worse. Self-care can be done by:

  • Lose weight
  • Overcoming constipation or constipation
  • Do Kegel exercises to strengthen the pelvic muscles

If needed, the doctor will also suggest placing a vaginal support ring (pessary) to support protruding tissue. Pessary placement is also recommended for patients who cannot undergo surgery. During use, this support ring should be cleaned regularly.

Meanwhile, for heavy vaginal discharge, 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

Even though it is effective in dealing with childbirth, the above 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 damages the position of the uterus that has been repaired through surgery.

Complications of Descendants

Descent can cause interference with other pelvic organs. This can cause complications in the form of:

  • Cystocele or descending bladder, namely the condition of the bladder protruding into the vagina
  • Rectocele, namely the condition of the rectum protruding into the vagina ( posterior vaginal prolapse )
  • Recurrent bladder infections

Prevention of Descendants

There are several ways you can do to reduce the risk of having a baby, namely:

  • Exercising regularly, such as doing Kegel exercises , especially after giving birth to strengthen the muscles and tissues that support the uterus
  • Do not exercise excessively or lift heavy weights
  • Overcome constipation by eating high-fiber foods and drinking lots of water
  • Treat coughs by consulting a doctor
  • Not smoking to prevent chronic cough
  • Maintain ideal body weight
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