Brief overview of the various diagnostic options
Anamnese: Many questions about the state of health and quality of life can be asked in the anamnesis, which allow direct conclusions to be drawn about a possible illness.Clinical examination: A physical examination will be performed to determine the degree of prolapse.Imaging procedures: In an ultrasound examination, the woman’s pelvic organs can be visualized and the degree and causes of prolapse can be further clarified. In rare cases, magnetic resonance imaging can provide further information. Defecography examines whether defecation disorders occur. Special investigations: If there are unclear changes in the bladder and/or uterus together with vaginal prolapse, a mirror in this area can provide clarity.
anamnese
The anamnesis is a fundamental step in diagnosing a vaginal prolapse and includes a detailed questioning of the patient by the doctor. This conversation will record previous medical events, symptoms, family history, and lifestyle factors to identify possible causes of the prolapse. For example, the patient may be asked whether there have been vaginal births in the past that could increase the risk of vaginal prolapse, or whether certain physical activities have been performed that have placed increased stress on the pelvic floor.
The doctor will also collect information about current symptoms such as pressure in the abdomen, sensation of a foreign body in the vagina, pain or problems with urination or bowel movements. This data helps the doctor get a comprehensive picture of the disease and plan appropriate further diagnostic steps. The anamnesis also discusses the extent to which the vaginal prolapse affects the patient’s daily activities and quality of life.
The anamnesis thus forms the basis for a targeted clinical examination and the selection of further diagnostic procedures. It is also crucial for assessing whether conservative therapy is sufficient or whether surgical measures should be considered.
Clinical examination
The clinical examination is an essential part of the diagnosis of vaginal prolapse. The physical examination includes viewing and palpating the female genital organs, often in conjunction with a cough test, to check for the effects of pressure on the affected areas.
The examination of the pelvis is often particularly informative. The patient is asked to strain as if she were having a bowel movement and to tense the pelvic floor muscles as if she were trying to stop the flow of urine. This can provide information about the degree of prolapse and the strength of the pelvic floor muscles. In the case of posterior vaginal prolapse, which is often detected during a pelvic examination of the vagina and rectum, a bulge may become visible, which provides information about the size and location of the vaginal prolapse.
Imaging procedures
The palpation examination is usually followed by an ultrasound examination of the pelvic organs. This image of the uterus, ovaries, bladder and urethra looks for changes that promote prolapse, such as: B. a uterus enlarged by fibroids. In addition, the extent and type of prolapse as well as the functionality of the pelvic floor during pressing and tensing can be assessed.
Further imaging procedures such as magnetic resonance imaging (MRI) of the pelvis can be helpful in some cases if the ultrasound shows unclear changes.
Since vaginal prolapse is often accompanied by further dysfunction of the pelvic organs such as the bladder or intestines, advanced diagnostics may be necessary.
A specific test that is sometimes used in diagnosing vaginal prolapse is defecography. This examination can be used to assess the ability of the intestine to empty. Defecography combines a contrast agent with an imaging test such as an X-ray or MRI to examine the function of the rectum.
If there is evidence of a simultaneous bladder dysfunction or emptying disorder, imaging the urinary tract with contrast medium on an X-ray or MRI can provide further information.
Specialized examinations
If there are unclear changes in the bladder and/or uterus that occur at the same time as vaginal prolapse, a bladder or hysteroscopy can be carried out. During this examination, a small camera is inserted into the interior of the organ to make changes directly visible, take tissue samples and, if necessary, remove smaller changes directly.
Since vaginal prolapse is often accompanied by bladder prolapse and/or bladder incontinence, a urodynamic examination can provide further information about bladder dysfunction.