Name: Prolapse of the uterus and vagina
Omission or prolapse of the uterus is a pathological process in which the uterus descends down, and in the future – its incomplete or complete prolapse.
Varieties of prolapse of the uterus and vagina
There are the following options for prolapse and prolapse of the genital organs:
- prolapse of the anterior wall of the vagina. Not often, along with the anterior wall of the vagina, a part of the bladder falls out – a cystocele (cystocele);
- prolapse of the posterior wall of the vagina, which is sometimes accompanied by prolapse and prolapse of the anterior wall of the rectum – rectocele (rectocele);
- incomplete prolapse of the uterus: the cervix either reaches the genital slit, or goes beyond it, while the body of the uterus remains within the vagina;
- complete prolapse of the uterus: the entire uterus extends beyond the genital slit.
Causes of prolapse of the uterus and vagina
The omission and prolapse of the genital organs is a polyetiological disease, it is based on the failure of the muscles of the pelvic floor and the ligamentous apparatus of the uterus, increased intra-abdominal pressure.
Insolvency of the pelvic floor muscles contribute to:
- traumatic childbirth;
- insolvency of connective tissue structures in the form of “systemic” insufficiency, manifested by hernias of other localizations;
- violation of the synthesis of steroid hormones (estrogen deficiency);
- chronic diseases with impaired metabolic processes, microcirculation.
Under the influence of one or more of these factors, the functional failure of the ligamentous apparatus of the internal genital organs and the pelvic floor begins. With an increase in intra-abdominal pressure, the organs begin to be squeezed out of the genital slit.
The main symptoms of prolapse of the uterus and vagina
Sensation of a “foreign body” in the vagina. The surface of the prolapsed part of the genital organs, covered with a mucous membrane, undergoes keratinization, becomes dull, looks like dry skin with cracks, abrasions, and then ulcerations. In the future, patients complain of a feeling of heaviness and pain in the lower abdomen, lower back, sacrum, aggravated during and after walking, when lifting weights, coughing, sneezing. Stagnation of blood and lymph in the prolapsed organs leads to cyanosis of the mucous membranes and swelling of the underlying tissues. On the plane of the prolapsed neck of the brand, a decubital ulcer is not often formed.
Uterine prolapse is accompanied by difficulty urinating, the presence of residual urine, stagnation in the urinary tract and then infection, first of the lower, and with the progression of the process, of the upper parts of the urinary system. Long-term complete prolapse of the internal genital organs can be the cause of hydronephrosis, hydroureter, obstruction of the ureters.
Every 3rd patient with genital prolapse develops proctological complications. The most frequent of them are constipation, and in some cases they are the etiological factor of the disease, in others – a consequence and manifestation of the disease.
Treatment of uterine and vaginal prolapse
The most effective and radical method of treatment is surgery. Its character is determined by the degree of prolapse of the internal genital organs; the presence and nature of concomitant gynecological pathology; the probability and need to preserve or restore childbearing, menstrual functions; features of dysfunction of the colon and rectal sphincter, the age of the diseased; concomitant extragenital pathology and the degree of risk of surgical intervention.
With small omissions of the internal genital organs, when they do not reach the vestibule of the vagina, and in the absence of dysfunction of neighboring organs, conservative management of patients with the appointment of a set of physical exercises is likely.
Prevention of uterine and vaginal prolapse
It consists, firstly, in limiting physical activity (especially after 45 years), as well as in hygienic gymnastics and sports. The specialist can prescribe special exercises that help strengthen the abdominal muscles, pelvic floor, ligaments during pregnancy and after childbirth.