Uterus subsidence after delivery

definition

The lowering of the uterus is the lowering of the uterus into the pelvis.

introduction

Usually the uterus is fixed in position by many structures. This is ensured by ligaments, connective tissue and the pelvic floor muscles. When these structures are weakened and can no longer withstand the load, the uterus subsides. In extreme cases, this can go so far that part or all of the uterus exits through the vagina. Then one speaks of a prolapsed uterus. Often when the uterus is lowered, there is also a lowering of other organs, such as the urinary bladder and the rectum (Rectum) are also affected.

Read more about the topic here: Prolapse of the uterus

frequency

About 30 to 50 percent of all women suffer a general over the course of their lives Pelvic floor depression, which also includes uterine subsidence. Predominantly are older women affected, but also in younger women, a lowering of the uterus can be about under the birth occur.

Duration

A uterine sagging that occurs after a child has natural delivery usually forms within a week back by itself. If this is not the case or if severe symptoms occur, therapy is all that is required.

causes

When a child is born naturally, the uterus is very stressful. The supporting structures of the uterus become strongly stretchedso that they cannot return to their original state immediately after delivery. This results in a sagging uterus after birth. The risk of uterine subsidence after childbirth is increased by a Perineal cut reduced, as this keeps the pressure load on the uterus low.
The uterine sagging can also have other causes. After the Menopause this is the case for almost all women, but younger women can also be affected. A very weak connective tissue is the most common cause in younger women. In addition, it can be very heavy physical labor and Obesity lead to a sagging uterus.

Symptoms / pain

A lowering of the uterus after birth does not necessarily have to lead to symptoms or pain in the uterus. Often this is completely symptom-free. Depending on the extent of the reduction, however, different and differently pronounced complaints can occur. Various other organs of the lower abdomen can also be affected, as these are in close proximity to the uterus and are connected to it by ligamentous structures.
The affected woman can feel a feeling of pressure in the abdomen, which, depending on the severity, can also be perceived as pain. Depending on how far the uterus has sunk down, a foreign body sensation may occur in the vagina. This goes so far that the women affected often have the feeling that something could fall out of the vagina. They often cross their legs for fear of it. If the uterus enters the vagina, this can disrupt the vaginal flora and lead to bleeding and inflammation there.
Typical symptoms of uterine subsidence are abdominal pain and lower back pain. Pain also occurs during sexual intercourse.

Read more on the topic: Painful intercourse

The fact that the uterus presses down on other organs such as the bladder and rectum causes discomfort here too. The constant pressure tends to lead to the urge to urinate, but also to problems urinating or a weak bladder. So-called stress incontinence often occurs. When the affected woman coughs, sneezes, or does heavy physical labor, urine will leak out involuntarily. If the uterus presses on the rectum, this leads to constipation and discomfort during bowel movements. If the uterus has sunk so low that the urinary bladder sinks, urine can back up in the kidneys and lead to complications. However, this rarely happens.
Read more on the subject at: What are the symptoms of uterine subsidence?

therapy

As a rule, a uterine subsidence that occurs after birth resolves on its own within a few days. The holding structures regain their stability and return to their previous state of stretch.
However, if symptoms appear that do not go away after a few days, then treatment is necessary. This also applies if the uterus has shifted too much.
The therapy depends on the age of the woman and on whether or not she wants to have children. Women who are very overweight should reduce this in order to be able to effectively counteract a sagging uterus. If it is only a slight uterine sagging that causes little or no discomfort, then regular pelvic floor exercises should be carried out. These are special exercises that strengthen the muscles of the pelvic floor and that should be done daily. This counteracts any further drop and a slight drop can recede.
If the uterus has already sunk too much, an operation on the uterus should be performed. This should only be done if the lowering of the uterus causes severe discomfort or if the uterus has already bulged into the vagina. There are two different surgical methods available. The doctor can perform the procedure through the vagina or through an incision in the lower abdomen. During the procedure, the pelvic floor muscles are gathered and the organs that have shifted are returned to their original position. Depending on which organs have also subsided as a result of the lowering of the uterus, the skin in front of or behind the vagina is loosened, the excess skin removed and then sewn back together. Depending on the location, one speaks of an anterior or posterior vaginal plastic. If the operated woman no longer wants to have children, the doctor can remove the uterus as part of the operation (hysterectomy).
An alternative is treatment with a pessary. This is particularly useful for older women or women who for whatever reason cannot be expected to have an operation. It is a ring-shaped or bowl-shaped aid made of silicone or plastic, which the gynecologist inserts into the vagina to support the vagina and the uterus. It needs to be changed every 6 to 8 weeks to prevent inflammation.

Read more on the topic: Therapy of uterine subsidence, surgery of uterine subsidence

prophylaxis

As it is well known that a pregnancy puts a heavy load on the uterus and the supporting structures and there is a risk of uterine subsidence, this can be prevented before pregnancy. A well pronounced pelvic floor muscles reduces the risk of uterine subsidence, so everyone supports it Exercises and sportsthat strengthen these muscles, the prevention. swim, to jog, Hiking and almost all sports lead to strengthening of the pelvic floor muscles. But there are also specials Pelvic floor training.
Also and especially during pregnancy it is important to do regular exercises to strengthen the pelvic floor muscles.
One way is to do it regularly Pregnancy gymnastics to visit, where specifically such exercises that strengthen the pelvic floor muscles are shown. These can also be done at home.

Likewise, it's important to attend after giving birth Postnatal exercise take part in order to strengthen the supporting structures of the uterus so that it quickly returns to its correct position.

Obese pregnant women can cause a uterine sagging Weight loss prevent as this is an additional risk factor.
Also if the uterus has already sunken Pelvic floor exercises can be helpful. The lowering cannot be reversed, but further lowering can be prevented. Against Incontinence helps pelvic floor training.

diagnosis

The diagnosis of lowering of the uterus is made by a gynecologist. Due to the typical symptoms, the suspicion of a lowering of the uterus should arise very quickly. This suspicion can then be confirmed during the gynecological examination. With the help of a vaginal mirror (Speculum) the doctor can look into the vagina and detect an existing lowering of the uterus. The gynecologist often asks the woman being examined to cough or strain during the examination in order to be able to assess how far the uterus is moving.
A rectal exam is also usually done. The doctor feels into the rectum to feel any bulging that could be the cause of a blockage.
An ultrasound scan is performed to assess the effects on the urinary bladder.

Read more on the topic: Ultrasound examination of the urinary bladder

Here it can be seen whether the bladder is also displaced due to the lowering of the uterus. If necessary, an ultrasound examination of the kidney is carried out in order to be able to detect any urinary backlog.

For more detailed information on this topic, we recommend our page on: Feel the lowering of the uterus