Causes of uterine prolapse and methods of diagnosis and treatment of the disorder

Uterine prolapse is a pathology in which a woman’s internal genital organs are displaced below their normal position. Significant prolapse turns into prolapse - a pathological condition in which the uterus extends beyond the genital slit.

The pathology occurs in approximately 20% of women, and after the age of 50 – in 70%.

Negative consequences of omission:

• decreased quality of life;
• dysfunction of the bladder and rectum.

At CELT you can get advice from a gynecologist.

• Cost of initial consultation - 2,700
• Cost of consultation with ultrasound - 4,200

Make an appointment The following factors can lead to downward displacement of the internal genital organs:

• a large number of births: 3 or more;
• rapid labor;
• large fruit;
• perineal injuries during childbirth;
• age-related weakening of the pelvic and abdominal muscles, sprains;
• hard physical labor;
• connective tissue dysplasia.

There are three degrees of downward displacement of the uterus:

• I degree . Omission. The uterus is located below its normal location, but does not extend beyond the genital slit.
• II degree . Incomplete loss. The organ moves even lower. The cervix protrudes from the genital slit, but it itself is located higher.
• III degree . Complete loss. The entire uterus extends beyond the genital slit. This is the most severe degree of the disease.

• Frequent urination.
• During times of intense physical stress, there may be involuntary urination.
• With complete prolapse, acute urinary retention may occur due to compression of the urethra. This condition requires emergency medical attention.
• Nagging pain in the lower abdomen, sacrum, lower back.
• Sensation of a foreign body in the genital fissure.
• Difficulty emptying the rectum.
• With complete prolapse, the diagnosis is beyond doubt: the prolapsed uterus is visible, it is swollen and has a bluish coloration due to circulatory problems.

If uterine prolapse is detected during a gynecological examination, specialists may prescribe plastic surgery. This expands the range of diagnostic procedures, so you additionally need to undergo:

• Excretory urography.
• Ultrasound or CT scan of the genital organs.
• Culture and general urine analysis.
• Curettage of the uterus.

Additionally, smears are taken to check microflora and look for infections in the vagina. To exclude rectocele, an examination by a proctologist and urologist is prescribed. Differential diagnosis is required to exclude neoplasms and uterine inversion.

Treatment of uterine prolapse

The choice of treatment strategy is made by the doctor based on the information obtained during the diagnosis. The following must be taken into account:

• Age.
• Chronic gynecological diseases.
• Stage of pathology.
• The presence of pathologies in the functioning of the sphincters of the bladder and rectum.
• Possibility of preserving reproductive function.
• The likelihood of complications during surgery.

Conservative treatment

It is prescribed only if the healthy functioning of the genitourinary system organs is maintained. If the uterus has dropped to the genital slit, then surgery is recommended. For minor violations, the gynecologist prescribes the following treatment procedures:

• Gynecological massage.
• Hormone replacement therapy.
• Therapeutic exercises to strengthen the muscles of the genital organs.
• Local application of pastes and gels with female hormones and metabolites.

If surgery is unacceptable due to age, then dense tampons and pessaries (rubber rings with different diameters and thicknesses) are prescribed. Fixing the pessary in the vagina allows you to keep the cervix in the optimal position. The duration of treatment is prescribed by the attending physician.

Wearing rubber rings for a long time is prohibited due to possible complications. Additionally, medicinal drugs and herbal mixtures for douching are prescribed. You can wear pessaries for a month, after which you rest for two weeks.

At least once a month you need to visit a specialist for a gynecological examination.

Surgery

Prescribed in severe cases or after unsuccessful conservative therapy. The main treatment method is vaginoplasty, during which the plastic surgeon strengthens the fascia and muscle tissue of the vagina. This operation is performed in 100% of cases during surgical treatment, since weakening of the muscles leads to prolapse of the uterus.

Strengthening and changing the length and shape of the fascia often leads to positive results, but this is an outdated method. Due to the correction of large fascia, tissue stretching is possible, which leads to relapse. Therefore, these days this method has been abandoned.

In addition, methods in which the main function is performed by alloplastic materials are not used. Rejection of the material used and the appearance of suppuration makes this method ineffective, since the likelihood of complications is too high.

If the patient does not plan to have children, and conservative treatment has not led to results, then complete removal of the uterus is possible. This operation is used in the most severe cases, when other methods do not lead to a positive result.

Prevention of uterine prolapse and prolapse

The most important thing is to avoid enormous physical activity from an early age. It is advisable to exclude physical activity and completely eliminate lifting objects weighing more than 8 kg.

Often the pathology develops during pregnancy and childbirth. In many ways, the presence of complications depends on the professionalism of the attending physician and obstetricians.

It is imperative to see a gynecologist and undergo diagnostics to exclude complications. After childbirth, therapeutic exercises are prescribed to strengthen the vagina.

If it does not lead to results, then plastic surgery is prescribed to strengthen the fascia and muscles.

It is important to exclude gastrointestinal pathologies and constipation. With diseases of the gastrointestinal tract and irregular bowel movements, the load on the pelvic organs increases, which provokes uterine prolapse. If you have these pathologies, you should definitely visit a gastroenterologist.

The multidisciplinary CELT clinic uses modern methods of treating uterine position disorders. Our experienced specialists choose the most effective treatment tactics for each patient, focusing on the degree of uterine displacement and other aspects.

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Our services

The administration of CELT JSC regularly updates the price list posted on the clinic’s website. However, in order to avoid possible misunderstandings, we ask you to clarify the cost of services by phone: +7 (495) 788 33 88

Name of service Price in rubles

Installation of the Optryx system for stress urinary incontinence (excluding the cost of consumables)	63 000 — 95 000
Ventrosuspension with a synthetic implant	120 000 — 155 000
Isolated plastic surgery of the anterior or posterior vaginal wall	63 000

Source: https://www.celt.ru/napravlenija/gynec/zabolevanija/opushhenie-matki/

What are the dangers of uterine prolapse for women and how dangerous is it to neglect the pathology + what treatment methods exist

• This pathology is one of the most common variants of incorrect location of the internal genital organs of a woman.
• In women, cervical prolapse can occur at any age, but people aged 40 to 55 years are at risk.
• In this article we will look at why uterine prolapse is dangerous and how it can be cured.

The essence of pathology and its causes

Uterine prolapse or prolapse is a pathological condition characterized by a downward displacement of the organ relative to the normal location of the uterus. In a neglected state, the uterus may prolapse outward, while the cervix remains in its place.

Negative factors may include heavy lifting or frequent constipation.

There are a number of reasons that can provoke the occurrence of such a pathology as cervical prolapse:

• birth injuries resulting from abnormal positioning of the fetus. In addition, perineal ruptures can provoke prolapse of the uterus if the fetus is too large;
• congenital and acquired pathologies of the pelvic organs;
• injury to the pelvic muscles, ruptures of the genital organs, which can be not only external, but also internal;
• age category of women over 45 years old - often excessive physical activity does not affect health in any way at a young age, but over time, when the woman is already elderly or near-elderly, all these stresses make themselves felt;
• excess body weight.

Associated symptoms

Prolapse of the cervix has characteristic symptoms , due to which the disease in most cases can be identified at the initial stage:

• constipation, diarrhea, urinary incontinence, increased gas formation. Even with frequent urination, a woman may experience a feeling that her bladder is not completely emptied. Urinary incontinence is characteristic of a disease occurring at a later stage;
• pain in the lower abdomen during and after sexual intercourse;
• vaginal discharge, which can be either pure white or mixed with blood. Discharge that is too abundant and does not go away for a long time is a direct sign of the presence of pathology in the body, and a signal that it is necessary to immediately consult a doctor;
• menstrual irregularities;
• The perineal tissues are almost always in a swollen state, and bedsores begin to form on the walls of the vagina. The tissues of the perineum swell precisely because of the prolapse of the uterus, which makes it difficult for a woman to take a sitting position. Bedsores occur as a result of impaired blood circulation, which develops against the background of necrosis of compressed tissues;
• in women suffering from varicose veins, the disease is greatly aggravated;
• Often, when the uterus prolapses, colitis, as well as strangulation of intestinal loops, can be observed.

Pain in the lower abdomen is the most characteristic and first sign of uterine prolapse. Often such pain can radiate to the perineum and lower back. Pain at an early stage is usually dull and aching in nature. At a later stage of the disease, the pain intensifies and becomes more severe.

Menstrual irregularities can be of two types - hyperpolymenorrhea and algomenorrhea.

With hyperpolymenorrhea, the number of periods is very abundant, which can lead to a consequence such as anemia, and, as a result, signs characteristic of this condition:

• constant weakness;
• dizziness;
• frequent headaches;
• fast fatiguability.

With algodismenorrhea during menstruation, a woman experiences severe pain, similar to cramping, sensations. Sometimes the pain can be aching and localized in most cases in the lower abdomen.

How dangerous is the disease?

One of the most serious complications of uterine prolapse is organ strangulation, which, if not promptly consulted by a doctor or with improper treatment, can lead to tissue necrosis, which can only be eliminated through surgery; often, during such an operation, the uterus is completely removed.

So, to summarize, we can say with confidence what the dangers of uterine prolapse in an advanced state are:

• impossibility of conception;
• difficulties associated with pain during sexual intercourse;;
• miscarriages and premature births;
• problems with childbirth;
• inflammation and infection of the internal genital organs, rectum, bladder;
• injury and bedsores of the uterus and vaginal walls;
• strangulation of the uterus or rectum.

Degrees of descent

There are several degrees of development of such pathology as cervical prolapse:

At the initial stage of the disease, uterine prolapse is slight. With this pathology, a woman begins to experience menstrual irregularities and may experience pain and slight discomfort during sexual intercourse.

In the second degree of the disease, the uterus descends almost to the genital slit. In this case, the woman experiences severe pain, a foreign body in the vagina, and sexual contact becomes almost impossible.

Most women in the second stage of uterine prolapse experience a frequent urge to urinate.

In the third stage, the vaginal walls descend beyond the entrance to the vaginal canal, and the uterus is completely located in the vagina. Discharge appears, often mixed with blood.

The woman experiences severe excruciating pain while walking and sitting. Urinary incontinence begins. Sometimes at the third stage of uterine prolapse, in addition to other signs, infectious inflammatory processes of the genital organs can be observed.

At the fourth stage of the disease, the uterus, along with the walls of the vagina, completely falls out. The woman experiences excruciating pain while walking and cannot sit. Inflammatory processes at this stage of the disease almost always lead to the formation of bedsores and abscesses.

Effect on pregnancy

A pathology such as uterine prolapse is very dangerous during pregnancy. This is due to the fact that during pregnancy, when the uterus prolapses, all the negative conditions experienced by a woman (pain in the lower abdomen, heaviness) intensify several times.

The danger of uterine prolapse during pregnancy also lies in the fact that the pathology can provoke premature birth or miscarriage.

Possible consequences

Often, when the uterus prolapses, a woman begins to experience hormonal imbalances, resulting in a malfunction of the adrenal glands. This failure leads to menstrual irregularities and infertility. Even if there is a chance of conceiving a child, it is very small.

To recover from infertility, a woman who wants to become a mother in the next few years must take all necessary measures to get rid of uterine prolapse as quickly as possible and restore the menstrual cycle.

General treatment regimen

At an early stage, uterine prolapse can be treated conservatively at home. Therapy consists of performing a set of exercises aimed at strengthening the ligaments and muscles of the pelvic floor.

Such exercises help to completely restore the previous position of the genital organs and prevent their further displacement. Kegel exercises are especially effective in this case.

Women after childbirth are recommended to perform the “bicycle” exercise, raising their legs while lying on their side, squeezing and unclenching the muscles of the genital organs.

Often, at the initial stage of the disease, the doctor recommends that women wear a bandage. This is especially true for women who have recently become a mother - the bandage, in addition to holding the stomach, supports the internal organs and does not allow them to move.

There are several types of surgery used for uterine prolapse:

• perineoplasty . The purpose of this procedure is to carry out aesthetic and functional correction of the perineum. During the operation, a special mesothread is used, which disintegrates over time and is replaced by collagen fibers, thereby forming an organic frame inside the tissue and supporting the perineum;
• Colpoperineolevatoroplasty . During the procedure, the vaginal walls are sutured and a synthetic mesh frame is used to support the pelvic tissue;
• colporrhaphy . This procedure involves suturing the anterior or posterior walls of the vagina, thereby correcting its size and eliminating prolapse;
• uterus removal . This method is the most radical and is used in extremely severe cases, when it becomes clear that no other methods can help eliminate the problem.

Source: https://zhenskoe-zdorovye.com/ginekologija/bolezni-matki/opushchenie-m/chem-opasno.html

Uterine prolapse

Uterine prolapse is an incorrect position of the uterus, displacement of the fundus and cervix below the anatomical and physiological border due to weakening of the pelvic floor muscles and uterine ligaments.

In most patients, uterine prolapse is usually accompanied by downward displacement of the vagina. Prolapse of the uterus is manifested by a feeling of pressure, discomfort, nagging pain in the lower abdomen and vagina, urination disorder (difficulty, increased frequency of urination, urinary incontinence), pathological discharge from the vagina. May be complicated by partial or complete prolapse of the uterus. Uterine prolapse is diagnosed during a gynecological examination. Depending on the degree of uterine prolapse, treatment tactics can be conservative or surgical.

Uterine prolapse is an incorrect position of the uterus, displacement of the fundus and cervix below the anatomical and physiological border due to weakening of the pelvic floor muscles and uterine ligaments.

It manifests itself as a feeling of pressure, discomfort, nagging pain in the lower abdomen and vagina, urination disorder (difficulty, increased frequency of urination, urinary incontinence), pathological discharge from the vagina.

May be complicated by partial or complete prolapse of the uterus.

The most common variants of incorrect location of the internal genital organs of a woman are prolapse of the uterus and its prolapse (uterocele).

When the uterus prolapses, its cervix and fundus shift below the anatomical border, but the cervix does not appear from the genital slit even with straining. Extension of the uterus beyond the genital slit is regarded as prolapse.

Downward displacement of the uterus precedes its partial or complete prolapse. In most patients, uterine prolapse is usually accompanied by downward displacement of the vagina.

Uterine prolapse is a fairly common pathology that occurs in women of all ages: it is diagnosed in 10% of women under 30, at the age of 30-40 it is detected in 40% of women, and after the age of 50 it occurs in half. 15% of all genital surgeries are performed for prolapse or prolapse of the uterus.

Uterine prolapse is most often associated with weakening of the ligamentous apparatus of the uterus, as well as the muscles and fascia of the pelvic floor and often lead to displacement of the rectum (rectocele) and bladder (cystocele), accompanied by dysfunction of these organs.

Often, uterine prolapse begins to develop during childbearing age and always has a progressive course.

As the uterus prolapses, the accompanying functional disorders become more pronounced, which brings physical and mental suffering to the woman and often leads to partial or complete loss of ability to work.

The cervix is ​​deviated posteriorly, forms an angle of 70-100° relative to the vagina, its external os is adjacent to the posterior wall of the vagina.

The uterus has sufficient physiological mobility and can change its position depending on the filling of the rectum and bladder.

The typical, normal location of the uterus in the pelvic cavity is facilitated by its own tone, relationship with adjacent organs, and the ligamentous and muscular apparatus of the uterus and pelvic floor. Any violation of the architectonics of the uterine apparatus contributes to prolapse of the uterus or its prolapse.

Uterine prolapse

There are the following stages of uterine prolapse and prolapse:

• prolapse of the body and cervix - the cervix is ​​determined above the level of the entrance to the vagina, but does not protrude beyond the genital slit;
• partial uterine prolapse - the cervix appears from the genital slit during straining, physical exertion, sneezing, coughing, lifting heavy objects;
• incomplete prolapse of the body and fundus of the uterus - the cervix and part of the body of the uterus protrude from the genital slit;
• complete prolapse of the body and fundus of the uterus - exit of the uterus beyond the genital slit.

Anatomical defects of the pelvic floor that develop as a result of:

• damage to the pelvic floor muscles;
• birth injuries - when applying obstetric forceps, vacuum extraction of the fetus or removing the fetus by the buttocks;
• previous surgical operations on the genital organs (radical vulvectomy);
• deep perineal lacerations;
• disturbances of the innervation of the genitourinary diaphragm;
• congenital malformations of the pelvic area;
• estrogen deficiency developing during menopause;
• connective tissue dysplasia, etc.

Risk factors for the development of uterine prolapse and its subsequent prolapse include multiple births in history, heavy physical labor and heavy lifting, advanced and senile age, heredity, increased intra-abdominal pressure caused by obesity, abdominal tumors, chronic constipation, and cough.

Often, the interaction of a number of factors plays a role in the development of uterine prolapse, under the influence of which the ligamentous-muscular apparatus of the internal organs and the pelvic floor weakens. With an increase in intra-abdominal pressure, the uterus is forced out of the pelvic floor.

Prolapse of the uterus entails displacement of anatomically closely related organs - the vagina, rectum (rectocele) and bladder (cystocele).

Rectocele and cystocele enlarge due to internal pressure in the rectum and bladder, which causes further prolapse of the uterus.

If left untreated, uterine prolapse is characterized by gradual progression of displacement of the pelvic organs.

In the initial stages, uterine prolapse is manifested by nagging pain and pressure in the lower abdomen, sacrum, lower back, sensation of a foreign body in the vagina, dyspareunia (painful sexual intercourse), and the appearance of leucorrhoea or bloody discharge from the vagina.

A characteristic manifestation of uterine prolapse is changes in menstrual function such as hyperpolymenorrhea and algomenorrhea. Often, when the uterus prolapses, infertility is noted, although pregnancy cannot be ruled out.

Subsequently, the symptoms of uterine prolapse are joined by urological disorders, which are observed in 50% of patients: difficulty or frequent urination, the development of the symptom of residual urine, congestion in the urinary organs and subsequently infection of the lower and then upper parts of the urinary tract - cystitis, pyelonephritis develop , urolithiasis disease. Long-term progression of uterine prolapse leads to overstretching of the ureters and kidneys (hydronephrosis). Often, downward displacement of the uterus is accompanied by urinary incontinence.

Proctological complications with prolapse and uterine prolapse occur in every third case. These include constipation, colitis, fecal and gas incontinence.

Often it is the painful urological and proctological manifestations of uterine prolapse that force patients to turn to related specialists - a urologist and proctologist.

The protruding part of the uterus has the appearance of a shiny, matte, cracked, raw surface.

Subsequently, as a result of constant trauma when walking, the protruding surface often ulcerates with the formation of deep bedsores, which can bleed and become infected.

When the uterus prolapses, circulatory disturbances in the pelvis develop, the occurrence of congestion, cyanosis of the uterine mucosa and swelling of adjacent tissues.

Often, when the uterus is displaced below physiological boundaries, sexual activity becomes impossible. Patients with uterine prolapse often develop varicose veins, mainly of the lower extremities, due to impaired venous outflow. Complications of uterine prolapse and prolapse can also include strangulation of the prolapsed uterus, bedsores of the vaginal walls, and strangulation of intestinal loops.

Uterine prolapse and prolapse can be diagnosed by consulting a gynecologist during a gynecological examination.

To determine the degree of uterine prolapse, the doctor asks the patient to push, after which, during vaginal and rectal examination, he determines the displacement of the walls of the vagina, bladder and rectum.

In cases of prolapse and prolapse of the uterus, requiring organ-preserving plastic surgery, and in case of concomitant diseases of the uterus, additional examination methods are included in the diagnostic complex:

• hysterosalpingoscopy and diagnostic curettage of the uterine cavity;
• ultrasound diagnostics of the pelvic organs;
• taking smears for flora, degree of vaginal cleanliness, bacterial culture, and also to determine atypical cells;
• urine culture to exclude urinary tract infections;
• excretory urography to exclude urinary tract obstruction;
• computed tomography to clarify the condition of the pelvic organs.

Patients with uterine prolapse are examined by a proctologist and urologist to determine the presence of rectocele and cystocele. They assess the condition of the sphincters of the rectum and bladder to identify gas and urinary incontinence under stress. Prolapse and prolapse of the uterus should be distinguished from uterine inversion, vaginal cyst, newborn myomatous node and differential diagnosis should be carried out.

When choosing treatment tactics, the following factors are taken into account:

1. The degree of prolapse or prolapse of the uterus.
2. The presence and nature of gynecological diseases accompanying uterine prolapse.
3. The need and possibility of restoring or maintaining menstrual and reproductive functions.
4. Patient's age.
5. The nature of dysfunction of the sphincters of the bladder, rectum, and colon.
6. The degree of anesthetic and surgical risk in the presence of concomitant diseases.

Taking into account the combination of these factors, treatment tactics are determined, which can be either conservative or surgical.

When the uterus prolapses, when it does not reach the genital slit and the functions of adjacent organs are not impaired, conservative treatment is used, which may include:

• physical therapy aimed at strengthening the muscles of the pelvic floor and abdominal muscles (Kegel exercises, according to Yunusov);
• gynecological massage;
• estrogen replacement therapy, which strengthens the ligamentous apparatus;
• local introduction into the vagina of ointments containing metabolites and estrogens;
• transferring a woman to lighter physical work.

If it is impossible to carry out surgical treatment for prolapse or prolapse of the uterus in elderly patients, the use of vaginal tampons and pessaries, which are thick rubber rings of various diameters, is indicated.

The pessary contains air inside, which gives it elasticity and firmness. Once inserted into the vagina, the ring creates support for the displaced uterus. When inserted into the vagina, the ring rests against the vaginal vault and fixes the cervix in a special hole.

The pessary should not be left in the vagina for a long time due to the risk of developing bedsores.

When using pessaries to treat uterine prolapse, it is necessary to perform daily vaginal douching with chamomile decoction, solutions of furatsilin or potassium permanganate, and see a gynecologist twice a month. Pessaries can be left in the vagina for 3-4 weeks, followed by a break for 2 weeks.

A more effective radical method of treating uterine prolapse or prolapse is surgery, the indications for which are the ineffectiveness of conservative therapy and a significant degree of organ displacement.

Modern surgical gynecology for uterine prolapse offers many types of surgical operations that can be structured according to the leading feature - anatomical formation, which is used to correct and strengthen the position of organs.

The first group of surgical interventions includes vaginoplasty - plastic surgery aimed at strengthening the muscles and fascia of the vagina, bladder and pelvic floor (for example, colpoperineolevatoplasty, anterior colporrhaphy). Since the muscles and fascia of the pelvic floor are always involved in the prolapse of the uterus, colpoperineolevatoroplasty is performed in all types of operations as a main or additional stage.

The third group of operations for uterine prolapse is used to strengthen the fixation of the uterus by suturing the ligaments together.

Some operations in this group deprive patients of their ability to bear children in the future.

The fourth group of surgical interventions consists of operations with fixation of displaced organs to the walls of the pelvic floor (sacral, pubic bone, pelvic ligaments, etc.).

The fifth group of operations includes interventions using alloplastic materials used to strengthen ligaments and fix the uterus. The disadvantages of this type of operation include a significant number of relapses of uterine prolapse, alloplast rejection, and the development of fistulas.

The sixth group of operations for this pathology includes surgical interventions leading to partial narrowing of the vaginal lumen.

The last group of operations includes radical removal of the uterus - hysterectomy, in cases where there is no need to preserve reproductive function.

Preference at the present stage is given to combined surgical treatment, which simultaneously includes fixation of the uterus, vaginal plastic surgery, and strengthening of the ligamentous-muscular apparatus of the pelvic floor using one of the methods.

After the operation, a course of conservative measures is required: physical therapy, diet therapy to eliminate constipation, and avoidance of physical activity.

The most important preventive measures for uterine prolapse and uterine prolapse is adherence to a rational regimen, starting from the girl’s childhood. In the future, it is necessary to strictly adhere to legislation in the field of women's labor protection, to prevent heavy physical work, lifting and carrying weights over 10 kg.

During pregnancy and childbirth, the risk of genital displacement increases.

In the development of uterine prolapse, an important role is played not only by the number of births, but also by the correct management of pregnancy, childbirth and the postpartum period.

Properly provided obstetric care, protection of the perineum, avoidance of protracted labor, and selection of the correct delivery method will help to avoid future troubles associated with uterine prolapse.

Important preventive measures in the postpartum period are careful comparison and restoration of perineal tissue, prevention of septic complications.

After childbirth, in order to prevent uterine prolapse, it is necessary to perform gymnastics that strengthens the muscles of the pelvic floor, abdominal muscles, and ligaments; in cases of traumatic labor, prescribe laser therapy and electrical stimulation of the pelvic floor muscles.

In the early postpartum period, heavy physical activity is contraindicated. If women are prone to constipation, a diet aimed at preventing constipation is recommended, as well as special therapeutic exercises.

Source: https://www.KrasotaiMedicina.ru/diseases/zabolevanija_gynaecology/opuschenie_matki

Uterine prolapse

Uterine prolapse is an unnatural position of the uterus, a downward displacement of its fundus or cervix, which is caused by sagging muscles in the pelvis or uterine ligaments.

The content of the article:

The main symptoms of uterine prolapse and their manifestations:

1. Discomfort;
2. Presence of dull pain in the lower abdomen or vagina;
3. Problems with urination;
4. Presence of abnormal vaginal discharge.

These symptoms may indicate the development of a pathology that can lead to uterine prolapse.

Practice shows that doctors encounter this problem quite often. When the uterus is prolapsed, its cervix and fundus are lowered below the normal limit of location, although this is not visible from the outside. If the uterus has come out of the woman’s genital circumference, then this is already called prolapse, which, in turn, can be complete or partial. In most patients, the uterus moves down the vagina.

As practice has shown, uterine prolapse is quite common these days. We usually see this in patients after childbirth, but a tendency to spread among young girls has already been noticed.

Prolapse or prolapse of the uterus is closely associated with disorders of the functioning of the pelvic muscles, in which pathologies of the rectum and bladder are possible. All this together leads to improper functioning of these organs.

Very often, prolapse and prolapse of the uterus occurs at an age when a woman is ready for childbearing and is developing rapidly. Complications of the disease can be so great that they can lead to a woman's inability to perform any type of work.

The anatomically correct location of the uterus is in the pelvis, symmetrically from the walls, as well as within the distance between the bladder and the rectum. The uterus, as a rule, can change its anatomical shape depending on the location of nearby organs, of course, within normal limits. The angle formed by the uterus should not exceed 100 degrees.

The correct position of the uterus is facilitated by its tone. Any anomaly associated with its incorrect location can lead to prolapse.

Proper blood flow also plays a role. As we know, blood is the source of life in our body. Every second the heart pumps it throughout the body, maintaining the functioning of internal organs.

It should also be noted that some injuries can also provoke prolapse and prolapse of the uterus. As a rule, here this disease will serve as a background disease when the deformation is applied. In case of injury, the pelvic organs temporarily or completely lose their ability to work and therefore the risk of prolapse and prolapse of the uterus becomes very high.

When considering a specific case of uterine prolapse, the doctor evaluates the presence of a trauma factor first.

Classification of uterine prolapse and prolapse

Speaking about the classification of uterine release and prolapse, the following stages should be noted:

1. Primary displacement of the body and cervix: the uterus is still above the level of the external entrance;
2. Secondary displacement: during physical activity, part of the cervix can be seen externally;
3. Partial uterine prolapse: the uterus and part of the cervix are visible from the woman’s genitals;
4. Uterine prolapse: The uterus falls out of a woman's reproductive organ.

Causes of uterine prolapse and prolapse

The main causes of prolapse and prolapse of the uterus can be:

1. Deformation or laxity in the pelvic muscles;
2. Injuries during childbirth - surgical and natural;
3. Vaginal lacerations;
4. Disorders of the genitourinary system;
5. Pelvic pathologies from an early age, as well as congenital ones;
6. Menopause;
7. Tissue deformation.

The main factors that can affect the risk of prolapse or uterine prolapse:

• a large number of births;
• great physical activity;
• lifting weights (more than 10 kg);
• age;
• hereditary predisposition;
• overweight;
• cancer;
• constipation or loose stools.

All of the above affects the occurrence of sagging muscles of the pelvic organs. As a result, the pressure increases, and the uterus may descend or fall out, and displacement of other nearby organs may occur.

Symptoms of prolapse and uterine prolapse

Any disease has its own symptoms, which distinguishes it from other ailments. It is this that makes it possible to correctly and timely make a correct diagnosis.

As with any disease, the lack of treatment leads to progress in the course of the disease. Let's consider the main stages and symptoms of uterine prolapse and prolapse.

Initially, prolapse is characterized by nagging pain and pressure in the lower abdomen. Very often, patients complain of lower back pain and a feeling of “something” in the vagina. Sexual intercourse becomes painful, leucorrhoea and spotting appear. The menstrual cycle is disrupted.

As the disease progresses, the general condition of the pelvic organs worsens. This primarily concerns the bladder. First, a disorder begins in his work, for example, incontinence, painful urination or the inability to go to the toilet. Soon the infection spreads upward and affects other organs, such as the kidneys. In advanced cases, incontinence and polyneuritis are observed.

Complications in the functioning of the rectum, such as colitis and constipation, are very often observed. As a result, the woman has to resort to the help of other specialists.

At the next stage, a woman may discover a tumor that is visible from the genitals. This neoplasm is quite easily injured and it is very easy to get infected. As a rule, prolapse leads to poor circulation and swelling of the tissue.

The patient's sex life becomes impossible. Varicose veins may develop against the background.

Diagnosis of uterine prolapse and prolapse

The gynecologist can be the first to detect this pathology during a routine examination. Through simple manipulations and actions, the doctor determines the degree of displacement of the uterus. If the suspicions are justified, the woman is registered and must undergo mandatory routine checks and colcoscopy.

In some cases, plastic manipulation is required.

In some cases, the following procedures are prescribed:

1. Curettage of the uterus for diagnostic purposes;
2. Ultrasound of the pelvic organs;
3. Smear examination;
4. Urine and stool tests;
5. Urography;
6. CT.

A consultation with a proctologist and urologist is required. This consultation is prescribed to find a rectocele or cystocele, and also to assess whether there are any deformities in the rectum.

Prolapse and prolapse of the uterus is an independent disease; it in no way relates to inversion, cyst formation or other complications of the uterine tract.

Treatment of uterine prolapse and prolapse

The doctor assesses the stage of the disease and the possibility of the most effective treatment. The treatment regimen is influenced by:

1. How many centimeters has the uterus prolapsed or prolapsed;
2. What other gynecological diseases are present besides this;
3. Does the woman plan to have children in the future, what is the likelihood of maintaining this opportunity;
4. Are there any irregularities in the menstrual cycle or its absence;
5. Woman's age;
6. Presence of urological diseases;
7. Determining other diseases and the patient’s health level;

Based on the above and diagnostic practice, the doctor develops a treatment regimen, which can be conservative or operative (surgical).

In some cases, both methods are used.

Conservative treatment of uterine prolapse and prolapse

special physical activity that eliminates sagging pelvic muscles, exercises to strengthen the abs;

massage performed by a specialist;

estrogen manipulation;

insertion of medications into the vagina;

a job change that does not involve heavy lifting.

The conservative method is the technique of using tampons and pessaries. As a rule, these are rings that have different diameters and contain air inside them. The rings have a resilient and elastic structure. They are usually inserted into the vagina and act as a threshold to support the uterus, preventing it from moving downwards.

This method is dangerous only if the rules of use are neglected. Rings should not be worn for more than 4 weeks and a break should be taken every 2 weeks. When wearing pessaries, the vagina should be treated daily with special solutions or medications, and douching should be done.

This method is suitable for older women and when surgery is not possible.

Surgical treatment of uterine prolapse and prolapse

Nowadays, there are many operations and surgical manipulations. As practice shows, gynecological operations are the most popular in our time.

Modern diseases have a strict tendency to become “younger”. Every year, an increasing number of young girls under the age of 30 suffer from prolapse or prolapse of the uterus.

• Surgical treatment of uterine prolapse and prolapse is used at a late stage in the detection of this disease, as well as when conservative techniques are unable to cope with their task.
• Surgical treatment is considered more effective and radical.
• Ultimately, most cases of uterine prolapse use surgery to treat the condition.

For prolapse and prolapse of the uterus, there is a full range of special surgical interventions. In turn, they can be distinguished by their distinctive features and the nature of their implementation. The main factor of division is anatomical, as well as the degree of strengthening or correction of organ tissue.

Taking into account the above, surgical manipulations for prolapse and prolapse of the uterus are divided into:

1. Plastic;
2. Deforming;
3. Fixing;
4. Stitching;
5. Alloplastic;
6. Narrowing;
7. Deleting.

Plastic manipulation strengthens the muscles and tissues of the pelvis, for example, the walls of the vagina or the facia of the bladder. In all cases, colpoperineolevatoroplasty is provided.

The reason is that when the uterus prolapses or prolapses, the muscles of the entire pelvis become sagging and unable to support the organs.

This manipulation acts as both a main and an additional method, depending on the specific case.

The third type of operation is ligament suturing. This is done to achieve fixation of the uterus. But these operations can destroy a woman's ability to give birth to children. Therefore, these methods are used mainly when a woman already has a child and does not plan to become pregnant again. When performing surgical interventions of this kind, the doctor is obliged to warn about the consequences.

In the fourth type of surgical interventions to eliminate uterine prolapse and prolapse, ligaments of adjacent organs are involved. They are used to stabilize the uterus and prevent it from descending.

The fifth type of operation uses additional materials, so-called alloplastic. These materials are additionally used to strengthen ligaments. Being a foreign body, they may not take root in a woman’s body and may lead to the development of various types of complications, for example, fistulas.

The sixth type of manipulation for vaginal prolapse and prolapse are operations that are aimed at narrowing the lumen in the vagina. As a rule, this narrowing is partial.

And finally, the seventh type of operations that are aimed at removing the uterus. This manipulation is carried out when a woman does not want to have more children or other treatment methods have not helped. After extirpation, the woman will never be able to give birth again.

It should be noted that this manipulation can lead to negative consequences. The female body may not tolerate hysterectomy well. All this can affect the patient’s hormonal levels and aggravate existing chronic diseases.

I would like to emphasize the presence of a psychological factor. Some women, after undergoing this procedure, do not feel like women at all. All this causes depression and can often lead to the development of severe mental illness. Cases of suicide on this basis have been recorded in medical practice.

Often, in parallel with observation by a gynecologist, a woman is offered a consultation with a psychologist and psychotherapist.

This is done in order to find out the emotional state of the patient and prevent the development of any kind of psychological and mental abnormalities.

Nowadays, combined treatment is carried out and several types of operations are used to treat prolapse and prolapse of the uterus.

All types of operations are performed through the vaginal opening or externally, through the peritoneum.

As a rule, after the operation, a rehabilitation period begins, during which the woman must adhere to special rules. A woman should not work, lift weights and must watch her diet.

At the same time, the doctor prescribes a set of conservative methods and monitors the speed and quality of recovery after surgery. During rehabilitation, any physical activity of the patient is excluded.

A big plus in rehabilitation is also adherence to a diet and a healthy lifestyle.

Prevention of uterine prolapse and prolapse

Prevention of uterine prolapse and prolapse begins from birth. You should monitor the health of a growing girl.

As stated above, the most basic factor that influences uterine prolapse is a large number of pregnancies and births. Based on this, you should follow a correct lifestyle and monitor your health from the moment you conceive a child and throughout your pregnancy.

During childbirth, the doctor takes on the primary role; the health of the child and the expectant mother depends only on his competent work.

The doctor prescribes a set of exercises and other methods based on the specific case. This gymnastics is aimed at strengthening the pelvic muscles and keeping them in good shape. Any physical activity is prohibited.

If childbirth resulted in injuries, then in this case a different prophylaxis is prescribed, after assessing the injuries and the patient’s recovery.

Preventative methods also include diet and healthy eating to prevent digestive disorders. As you know, frequent chronic constipation can also lead to prolapse and prolapse of the uterus. This should also include special gymnastics.

In any case, women should not do heavy physical work. This point should be mentioned in the modern legislative framework. Women are strictly prohibited from lifting weights over 10 kilograms.

Special methods of prevention are also present during menopause. This period leads to hormonal disruption of the entire body, so you should take it seriously. Here you should reduce or remove physical activity, introduce special gymnastics, sports, more rest and walks.

One type of prevention is the prescription of medications that are aimed at changing a woman’s hormonal levels. The mechanism is quite simple; during it, blood circulation improves. As a result, blood flow into the pelvis and blood supply to all organs of the pelvic area improves.

Nowadays, medicine has moved forward quite progressively; it is able to cure almost any disease, but despite this, people still resort to traditional medicine.

Undoubtedly, some diseases can be cured using traditional medicine. As a rule, such a disease does not require surgical intervention, and the authorship of these very folk remedies is quite doubtful.

Traditional methods and herbs are suitable for preventive purposes. Some herbs have excellent anti-inflammatory properties and serve as good antiseptics, but nothing more.

In such a serious illness as prolapse and prolapse of the uterus, you need the help of a specialist, but not self-medication.

Source: https://www.mosmedportal.ru/illness/opushchenie-matki/