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Genital prolaps

Senast uppdaterad: Senast reviderad:
Sakkunnig:

Defintion:
Sänkning av ett eller flera bäckenorgan ner mot vaginalöppningen, såsom urinblåsan, tarmen, livmodern eller vaginaltoppen om livmodern är bortopererad.
Förekomst:
Prevalens av kliniskt signifikant prolaps uppges vara runt 3–6 %
Symtom:
Måttlig prolaps ger få eller inga symtom. Vid mer uttalade förändringar märks tryck- och tyngdkänsla i underlivet, och det kan komma ut en bula ur slidan. Tilläggssymtom som kan förekomma är blåstömningsproblem, trängningar, urininkontinens, svårigheter att tömma tarmen, inkontinens för gas och avföring och samlagssvårigheter.
Kliniska fynd:
Prolaps kan provoceras fram i gynekologiskt läge.
Diagnostik:
Tilläggsundersökningar behövs vanligen inte, eventuellt kan urodynamisk undersökning vara av värde vid samtidig inkontinens eller för att avslöja dold ansträngningsinkontinens.
Behandling:
Bäckenbottenträning, viktminskning, eventuellt pessar, lokalt östrogen eller kirurgi.
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  • Barbro Larson, docent och specialist i gynekologi och obstetrik, Stockholm
  • Anna Nager, med dr och specialist i allmänmedicin, Karolinska institutet