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Uterus prolapse: causes, symptoms, and treatments

The prolapse of the uterus (genital prolapse) is a pathology caused by a combination of the instability of the muscles, ligaments and fasciae of the lower pelvis of the woman and the muscle weakness around the reproductive organ.

The disease is caused by the displacement of the uterus from the anatomical bed and its advancement down to the vaginal fissure, entraining the organs directly connected with it.

The normal state of the internal organs of the female reproductive system is maintained through three levels of protection (fixation).

Uterus prolapse

Uterus prolapse - phases of the disease

Первый уровень обеспечивает фиксацию верхней части влагалища и широкой верхней части матки к поверхности тазовых костей, а узкая часть органа фиксируется к верхней части ее нижнего сегмента (шейке). 1) The first level fixes the upper part of the vagina and the wide upper part of the uterus to the surface of the pelvic bones, and the narrow part of the organ is fixed to the upper part of its lower segment (neck).

Второй уровень предусматривает крепление влагалищных стенок, уретры, мочевого пузыря и прямой кишки. 2) The second level involves securing the vaginal walls, urethra, bladder and rectum. This provides the pelvic ligament and its fiber.

Третий уровень фиксирует внутренние органы таза, благодаря мышцам и фасциям промежности, в массиве которых, имеются естественные проходы для мочеиспускательного канала, прямой кишки и влагалища. 3) The third level fixes the internal organs of the pelvis, thanks to the muscles and fascia of the perineum, in the array of which there are natural passages for the urethra, rectum and vagina. Normal muscle tone prevents displacement of the vagina, prevents the unauthorized exit of feces and urine.

The prolapse of the uterus and the displacement of any organs of this zone can cause violations of any level of this protection.

Fascial defects may be accompanied by the development of hernial buckling of the inner shells of the vaginal walls, leading to their prolapse, leading to the prolapse of the anterior wall of the uterus. This is accompanied by the formation of cystocele - prolapse of the excretory system into the cavity of the vagina, disrupting its function.

Content

Causes of pathology

The main causative factors are classified in three ways.

  1. The presence of chronic diseases that trigger metabolic disorders, which increases the likelihood of developing muscular atrophy.
  2. Injuries of the musculo-fascial pelvis, causing uterine prolapse after childbirth (mechanical birth trauma).
  3. Disturbance of secretion and synthesis of sex hormones (steroid).

This is facilitated by:

  • age-related changes in the female body (menopause period);
  • overstrain and hard work;
  • abdominal surgery;
  • increased abdominal pressure;
  • chronic obesity and constipation.

Classification: degrees of manifestation

The severity of uterine prolapse is classified according to three degrees (phases) of the flow.

Degree 1 - Slightly uterine displacement and descent of the cervix, not beyond the vagina.

2 Degree - Offset due to the proximity of the lower segment of the uterus at the exit of the vagina or its partial loss, while the genital organ itself does not come out of the vaginal cavity.

Degree 3 - The vaginal walls are inverted and are located together with the body of the uterus beyond the internal framework of the vagina, manifesting itself as a prolapse of the organ.

At the third degree of manifestation, there is a lowering in the outwardly inverted vaginal walls of the intestinal loops, organs of the urogenital system, the bladder and the walls of the direct intestine.

Pathology does not belong to the category of hereditary diseases. The probability of manifestation is due to a number of provocative factors.

Symptoms and signs of uterine prolapse

Each phase of the disease has its clinical signs of uterine prolapse.

Symptoms and signs of uterine prolapse , первой фазы заболевания проявляются: Symptoms of the initial , first phase of the disease appear:

  • pulling painful syndrome in the lower abdomen and lumbar area, reminiscent of the state before the beginning of the monthly discharge or perceived as a consequence of a cold;
  • soreness with intimacy;
  • increased pain during menstruation;
  • profusion and duration of discharge;
  • problems with conception.

, клиническая картина патологии добавляется: In the second phase , the clinical picture of the pathology is added:

  • symptoms of a disorder in the urogenital system - involuntary discharge of urine (enuresis), purulent-inflammatory process in the tissues of the bladder and kidneys, urolithiasis (stones in the urine);
  • an unpleasant feeling of incomplete release of the bladder;
  • tenesmus;
  • painful muscular tension (spasm) of the anal sphincter (squeezing of the anus);
  • sense of presence in the vagina of foreign bodies.

обусловлена запущенностью болезни предыдущих этапов развития. The third phase of prolapse is due to neglect of the disease of the previous stages of development.

There is uterine prolapse in the cavity of the vagina. Part of the reproductive organ is visible through the genital slit. It may cause injury. Intimate relationships are impossible.

The eloquent symptoms of uterine prolapse and the consequences of the disease pose a real threat to the health of the woman.

The real threat and consequences

  1. The genital organ that fell from the vaginal walls is subjected to quite serious injuries during movement.
  2. On its shell there is a rapid development of erosive processes and tumor-like foci of abscess.
  3. Severe bleeding is a real threat.
  4. The functions of the reproductive mechanism are impaired.
  5. Malfunction of the sex glands disrupts the cycle of menstrual flow.
  6. Jamming of organs caused by prolapse provokes malfunctioning of the urinary and digestive system.
  7. Stasis of urine during infringement, provokes inflammatory and infectious diseases, tissue necrosis.

If you find characteristic symptoms of uterine prolapse, treatment and elimination of the consequences of the disease should be carried out immediately.

Diagnostic Techniques

Diagnostic Techniques

Diagnostic Techniques

Diagnosis of uterine displacement and prolapse is easily determined by examination by a gynecologist.

For a complete presentation of the clinical picture, a proctologist and a urologist are involved in the diagnosis. The degree of pathology (omission and offset) is determined by vaginal and rectal examination.

The functional state of the valve devices (sphincter) of the excretory system is assessed - the determination of neuromuscular dysfunctions, a gasket test for urinary incontinence (with straining) and gases.

If there are indications for plastic surgery or surgery, the diagnosis is supplemented by the appointment:

  • Ultrasound examination;
  • hormone imbalance tests;
  • smear on the detection of bacterial flora;
  • hysteroscopy and curettage;
  • bacterial-seeding the urethra or vagina.

Modern treatment of prolapse of the uterus

Modern treatment of prolapse of the uterus

Modern treatment methods

For a long time, the treatment of prolapse was carried out by tightening and attaching the organ to the peritoneum, leaving a large postoperative scar, and complications were not excluded. When neglected pathology was appointed hysterectomy (complete removal).

Modern techniques, for the most part - organ-preserving. The use of high-precision modern equipment allows for reconstructive reconstruction with a minimal incision, which provides an easy recovery period.

Ушивание влагалищных стенок проводится методом хирургической пластики – кольпорафии. 1) Sewing of the vaginal walls is carried out by the method of surgical plastics - colporrhaphy. It is the main method of vaginoplasty.

Операция пластики промежности – кольпоперинеопластика. 2) Perineal plastic surgery - colpoperineoplasty. Strengthen the ligament apparatus by shortening them.

Роботизированная установка сетчатого поддерживающего каркаса – коррекция положения органов. 3) Robotic installation of the mesh support frame - correction of the position of organs. The implant contributes to the formation of new fascias, to further strengthen the genitals in the correct position.

При противопоказаниях к хирургическим вмешательствам, альтернативой могут служить специальные приспособления – пессарии. 4) With contraindications to surgical interventions, an alternative may be special devices - pessaries. Installed in the vagina to prevent prolapse, have the form of rings. Gynecological rings in case of uterus prolapse are usually established for elderly patients for whom surgical techniques are unacceptable.

Treatment of uterine prolapse at home is possible only at the stage of early development of the disease.

Home treatment

Reduced elasticity and muscle tone of the musculo-fascial pelvis contributes to the displacement of the genitals. Specially developed programs of therapeutic exercises in case of uterus prolapse are included in the composition of therapeutic techniques of prolapse.

Exercises are aimed at restoring muscle tone, restoring normal blood circulation and preventing the development of inflammation processes.

The most popular method was Kegel exercise, aimed at the muscle training of the vaginal area and urinary system.

The technique includes:

Регуляция расслабления и сокращения мышц – трех секундное максимальное мышечное сокращение с последующей релаксацией (снятие напряжения). 1) Regulation of relaxation and muscle contraction - a three-second maximum muscle contraction with subsequent relaxation (stress relief). It is performed in any position and in any convenient place. The number of repetitions - as far as possible.

Удержание напряжения – пятиминутная пауза в состоянии напряжения. 2) Voltage retention - a five-minute pause in a state of tension. Every week a couple of minutes are added to the pause.

Поочередное напряжение (по типу мигания) – поочередно напрягаются вагинальные и анальные мышцы. 3) Alternate tension (like flashing) —vaginal and anal muscles are alternately strained. Execution time - 10-15 minutes.

Напряжение мышечно-фасциального пласта таза с постепенным нарастанием силы (система лифта). 4) Tension of the musculo-fascial pelvis with a gradual increase in strength (elevator system). Five stages (imaginary floors) of stress. From the first to the fifth "floor" to increase the voltage with a five-second pause on each "floor". The reverse process is similar, but with gradual muscle relaxation. Perform from 5 times, gradually increasing the number of exercises.

Prolapse of the genital organs occurs in almost 20% of women of the reproductive period of life and in every second woman of retirement age. It should be remembered - it is necessary to begin treatment when the first symptoms of pathology are manifested, which guarantees the effectiveness of medical techniques.

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