Causes and symptoms of uterine prolapse. Treatment
Prolapse of the uterus is considered to be its incorrect location in the pelvic space - below certain limits, compared to the anatomical norm. The severity of the pathology is different: some patients are helped by gymnastics when the uterus descends, and in some, the development of the descent requires radical measures.
Meaning of the problem
The normal location of the uterus is between the bladder and the rectum in the space of the small pelvis, while the distance from the pelvic walls is the same. Insignificant deviations in the location of the uterus are allowed - they depend on how full the adjacent bladder and rectum are.
This location is supported by the tone of the uterus itself, and its topographic relationship with neighboring organs and tissues, as well as the elasticity of the pelvic floor.
Different variations of the lowering of this organ are observed. If his body and neck have fallen below the natural level, but the neck does not show in the genital opening when straining, then this is, in fact, descent. If the displacement has developed to such a degree that a part of the uterus protrudes beyond the genital slit, this is already prolapse. The pathology is also unpleasant for the reason that it develops a displacement of the vagina, as well as the rectum and bladder. Their displacement is important for how to treat uterine prolapse of various degrees.
If earlier prolapse of the uterus was expected in a woman at an older age (namely after 50 years), today it is detected in every tenth woman in the age category up to 30 years. This creates problems not only gynecological, but also psychological. About 15% of all plastic surgeries in gynecology are performed precisely for this nosology.
Reasons of uterine prolapse
There are many factors that contribute to uterine prolapse. First of all, these are anatomical shifts from the side of the pelvic floor. They are caused by:
- surgery on the organs of the small pelvis (depending on its volume, isolated prolapse of the front or back wall of the uterus may develop);
- damage of muscle arrays;
- traumatization in childbirth;
- perineal tears;
- pathology of the nervous structures of the genitourinary diaphragm;
- defects formed during intrauterine development of the fetus;
- connective tissue diseases.
Factors against the background of which the process of descent of the uterus accelerates:
- a large number of births;
- regular lifting of heavy objects in everyday life or due to professional specifics;
- increased pressure inside the abdominal cavity - with pertussis cough, large neoplasms, persistent constipation.
If the causes are not eliminated, the treatment of prolapse of the cervix and its body will be ineffective.
Symptoms of uterine prolapse
Clinical symptoms of uterine prolapse:
- pulling pains and a feeling of heaviness in the lower abdomen, as well as in the lumbar, sacral region;
- false feeling of a foreign body in the vagina;
- discomfort and pain during intercourse;
- bloody vaginal discharge;
- menstrual disturbances - they are painful, more blood is released than usual.
In addition to the described symptoms of uterine prolapse, the inability to conceive is often noted, in the best case, pregnancy occurs after numerous attempts.
It is characteristic that the descent of the uterus "triggers" a number of disorders on the part of the urinary system. Half of such patients experience difficulty and/or frequent urination, urinary incontinence. Stagnation of urine provokes the attachment of an infectious agent, and this already threatens the impression of the urinary system. On our site https://dobrobut.com/ you can learn more about the causes and consequences of uterine prolapse.
Proctological shifts develop in a third of patients. These are constipation, incontinence of feces and biological gas, as the pathology progresses, infection also joins, inflammatory changes develop in the rectum.
With further progression, intercourse becomes impossible due to pain and a purely mechanical factor. Pregnancy can also be complicated. Therefore, the question of what to do when the uterus descends during pregnancy and after childbirth is relevant.
Diagnosis of the disease
Uterine prolapse is easy to diagnose during a gynecological examination of the patient using mirrors. During it, the woman who is being examined strains and strains the abdominal perineum, while the displacement of the vaginal walls and neighboring organs (bladder, rectum) is noted.
Instrumental and laboratory diagnostics are carried out in order to find out the causes of the disease and to choose a method of treatment - conservative or surgery for uterine prolapse in women. The pathology itself depresses women, and they may not pay attention to concomitant pathologies - they are also detected during an additional examination. The following methods are important:
- colposcopy;
- hysterosalpingoscopy;
- separate diagnostic scraping of the uterus and cervical canal;
- Ultrasound of pelvic organs;
- taking smears for the analysis of the microflora of the vagina, the degree of its cleanliness and cytological examination;
- various types of urography (to detect complications in the form of pathology of the urinary system).
Gymnastics for uterine prolapse and other methods of treatment
Treatment of uterine prolapse depends on the following factors:
- launch of the process;
- age of the patient;
- presence of complications;
- combined pathologies.
If the prolapse of the uterus occurred recently, it is insignificant and appears only when the patient exerts herself, then you can try to stop it with the following methods:
- avoidance of work related to straining;
- remedial physical education (Kegel exercises when lowering the uterus and vagina, gymnastics according to Yusupov);
- estrogen therapy;
- course of gynecological massage with repetition;
- physiotherapeutic treatment;
- sanatorium-resort treatment.
If the result of such treatment is not satisfactory, the pathology progresses further and complications develop, surgical intervention is suggested. It consists in performing plastic operations, during which the uterus is shifted to its physiological position and fixed in it, as well as the fascia of the vagina, bladder, and pelvic floor are strengthened. When performing plastic surgery, both own and artificial hypoallergenic tissues are used.
In some cases, surgical narrowing of the vagina is performed.
If the operation is contraindicated (for example, in elderly patients or in the presence of severe somatic pathologies), it is recommended to use vaginal tampons, as well as pessaries - devices that, when inserted into the vagina, prevent the descent of the uterus. Pessary for signs of uterine prolapse is an effective, but symptomatic method of treatment.
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Colposcopy
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