With inflammation of the ovary, there may be prolapse of the uterus. Symptoms and treatment of prolapse of the uterus and reviews. The reasons for the prolapse of the uterus

Article outline

Prolapse of the uterus is a pathological condition in which the uterus shifts down into the vagina due to weakening of the ligaments and muscles of the pelvic floor. Often, the displacement of the uterus in women occurs up to its prolapse. The condition is accompanied by a feeling of discomfort, pressure, pain in the vagina and lower abdomen, urinary disorders and unusual vaginal discharge.

The disease is diagnosed during a gynecological examination. Pelvic organ prolapse can occur at any age, including older women over 50-65 years of age. Pathology causes not only physical inconvenience, but also psychological. Young girls are slightly less likely to suffer from the disease than older women, but the risks are high. There are many reasons for the development of prolapse, often provoked by complex childbirth and injuries of the pelvic floor muscles.

The condition is dangerous, and also leads to reproductive disorders, sexual dysfunction, infectious complications, etc. A woman who has been diagnosed with a prolapse of the cervix must be treated, as the pathology progresses and leads to disability. There are several ways to cure prolapse, below in the article you will find out what symptoms and treatment of pathology, how to avoid it and quickly suspect it.

Why arises

Before analyzing the reasons for the prolapse of the uterus, you need to understand how it holds. The exit of the pelvis is closed by three powerful muscle layers that form the pelvic floor. Their importance can hardly be overestimated, since any life processes occurring in this area are not complete without the participation of muscles. For example, they keep the internal organs in the correct position and are actively involved in childbirth.

In addition to the muscles, the uterus is held by the ligamentous apparatus, therefore, any violations of the uterine tone and weakening of the ligamentous apparatus lead to changes in the usual position of the uterus. One of the main factors of prolapse is age-related changes. But, according to statistics, pelvic organ prolapse is found in every tenth woman out of a hundred under the age of 30. Therefore, we can say with confidence that old age is not the main cause of the development of pathology.

The uterus can descend due to such negative factors:

Damage to the muscle layers of the pelvis.
Birth trauma, application of obstetric forceps, extraction of the fetus by the buttocks.
Connective tissue dysplasia.
Severe vaginal tears.
Congenital developmental disorders of the pelvic region.
Serious genital surgery.
Deficiency of female sex hormones, or rather estrogen, which leads to menopause.
Increased intra-abdominal pressure.
Too hard physical labor.
Loss of muscle tissue elasticity due to old age.

In the development of the process, not only one provoking factor can participate, but also several. During pregnancy, slight organ prolapse is permissible. The fetus grows, the uterus grows, so it can go down a little. An exception is the case when the pathology was even before pregnancy.

In addition to the above factors, women at risk are women with the following problems:

Operations in the uterus;
Regular overstrain, heavy physical activity;
Numerous generic activities;
Obesity;
Chronic constipation
Diseases accompanied by persistent severe cough;
The presence of benign tumors in the small pelvis;
Old age, etc.

All these factors sooner or later lead to various diseases, including prolapse of the walls of the vagina and uterus.

How does it manifest

A mild form of pathology can be asymptomatic, so many women wonder how to determine the prolapse of the uterus in advance in order to start treatment faster. As the disease progresses, the uterus begins to press on adjacent organs from which such symptoms of prolapse of the uterus may occur:

There is a feeling of pressure or heaviness.
Pain during sex.
Frequent bladder infection.
Constipation.
Difficulty urinating, urgency to go to the toilet, involuntary urination.
Unusual discharge from the genital tract.
Prolapse of the uterus into the vagina.
Pain in the pelvis, lower back and abdomen.

It is impossible not to notice the signs of violation, they are bright and can significantly spoil the life of a woman. Some patients feel as if the vagina is present. foreign body, there is a mucous or bloody secretion. If the disease progresses, the pain of prolapse of the uterus becomes stronger, especially during menstruation. Blood loss can be so severe that anemia and all the accompanying symptoms develop.

With the development of pathology, sexual intercourse becomes impossible, the psychological state of the woman worsens, makes it difficult to urinate, and at stages 2-4, the patient herself can determine the problem, since the organ protrudes from the genital slit.

Degrees

In medicine, several degrees of the disease are distinguished, these are:

First degree - the condition is characterized by a slight displacement. The cervix is \u200b\u200bsometimes located at the level of the vestibule, if you strain, it is not visible. Doctors note the gaping of the vagina, but the walls are slightly lowered;
Uterus prolapse of the 2nd degree - the organ partially falls out, with tension the cervix is \u200b\u200bvisible from the outside;
Third degree - incomplete prolapse occurs, both the cervix and part of the uterus are visible from the vagina;
Fourth degree - this stage is characterized by complete loss of the organ from the genital fissure.

At the beginning of the development of pathology, there are no strong changes, minor dull pain, discharge and menstrual irregularities may disturb. Depending on the degree of prolapse of the uterus, a course of treatment is selected.

Some patients call the pathology the prolapse of the posterior wall of the uterus or the prolapse of the anterior wall of the uterus. These definitions are incorrect, since the entire organ descends, and not only one or both walls. Another thing is when the walls of the vagina descend, it shifts unevenly. On examination, the uterus is outside the entrance, and when the muscles are strained, it does not appear from the vagina.

How to treat prolapse of the uterus

Medical tactics are selected depending on the degree of development of the pathology, the presence of accompanying problems and planning of conception in the future. It is important to understand that at 3-4 stages you cannot do without surgery. Massage for prolapse of the uterus and gymnastic exercises are prescribed if the stage is mild. Conservative therapy is possible only when the cervix or uterus has slightly shifted beyond the anatomical border.

Medication for prolapse of the uterus includes taking special hormonal drugs... For local use, ointments and suppositories containing estrogens, as well as ingredients that improve microcirculation and metabolism, are prescribed. In the early stages, gynecological massage is shown, which is done by a specialist for several months. The massage is performed on a chair or on a special table, each procedure lasts 10-15 minutes.

Conservative therapy includes physical therapy, which is needed to strengthen the muscle layers of the abdominal press and pelvic floor. The ligamentous apparatus is strengthened by drugs that contain estrogens and metabolites. The woman is transferred to easier work. If there is an outward prolapse of the organ, in this case, surgical methods of treating prolapse of the uterus are used. There are many of them, so it is difficult to choose the most effective one.

Often doctors use vaginoplasty - plastic surgery necessary to strengthen the fascia, muscles of the vagina, pelvic floor and bladder. There is another group of surgical interventions - strengthening, shortening of the ligaments that hold the uterus. They are fixed to the wall or sewn together. Sometimes the displaced organ is sutured to the sacral bones, pelvic ligaments, etc. After carrying out such manipulations, there is a high risk of relapse, since the ligaments are greatly stretched.

Today, all over the world, prolapse is treated with the help of surgical intervention using alloplastic material. These are a kind of synthetic mesh that are involved in fixing the organ and strengthening the ligaments. The disadvantages of the method include high risks recurrence, implant rejection and fistula development. Sometimes the doctor prescribes this type of operation as a partial narrowing of the vaginal lumen. If the prolapse is serious enough, there are concomitant problems and diseases, hysterectomy is indicated - removal of an organ.

Other organs often descend after a hysterectomy, so the method is not often used. Mostly specialists are trying to preserve the uterus. It is best to combine several methods in treatment at once, which include simultaneous fixation of the organ, strengthening of muscles and ligaments, and vaginal plastic surgery. All operations are performed through the genital slit or the anterior abdominal cavity. Abdominal or laparoscopic access is used.

After surgery, the patient is shown conservative measures: suppositories with estrogens, physiotherapy exercises, massage, diets for the treatment of constipation, exclusion of strong physical exertion. If the operation cannot be performed, elderly patients who have incomplete prolapse are prescribed special rubber rings. The installation of a pessary during omission requires regular douching with chamomile tincture and a solution of furacilin and potassium.

The rubber rings are filled with air and can be of different diameters. The size is selected individually for each woman. The pessary does not allow the uterus to sink lower, but they put it on for a short time. If the patient has a risk of pressure ulcers and inflammatory processes, change 2 times a month. They can also be installed in young girls who are planning to conceive or have contraindications for surgical intervention.

Sometimes it is used as a therapy, it is used at any age, it is prescribed in the early stages and is not worn for long. The brace lift is mainly used for the treatment of pregnant patients.

To get the maximum effect from the treatment, specialists combine different methods. If you identify the problem in time and contact the clinic, prolapse is favorably cured. After therapy, do not lift heavy objects. It is necessary to strictly follow the recommendations and visit the doctor, only then the disease recedes.

What to do when the uterus prolapses in old age

Over the years, the elasticity and firmness of the ligaments and muscles deteriorates, so prolapse or prolapse of the uterus occurs in old age. The disease develops for a long time, and only at advanced stages manifests itself. In cases where there is a complete or partial prolapse of the organ from the vagina, the woman is shown surgical intervention.

If for some reason this is not possible, the doctor prescribes the use of supporting pessaries and rings. They contain biological material and bioinert synthetics. They come in a variety of sizes and diameters. Elastic and durable products are inserted into the vagina and keep the uterus in a normal position.

This method does not cure the disease, but is used solely for support purposes, since in many elderly patients, the ligaments and muscles are no longer able to hold the pelvic organs. Products can be inserted and removed independently, but it is important to maintain intimate hygiene. Sometimes in old age, the removal of the uterus is prescribed, but because of this, other organs of the small pelvis can go down, because they try to avoid hysterectomy. At the age of 50, a woman should carefully monitor her health and visit a doctor on time, otherwise unnoticed diseases will lead to serious complications.

Consequences and lifestyle

Women suffering from pathology often ask, what is the threat of prolapse? Prolapse is dangerous because it entails prolapse of the vagina, displacement of adjacent organs and impairment of their functionality. With the prolapse of the rectum, a woman has problems with defecation, usually constipation, but there are also cases of fecal incontinence. The urinary system also suffers, there is difficulty with the outflow of urine, stagnation develops, which provokes inflammation and infection. In rare cases, tissue death is observed.

In the cavity, where the uterus used to be located, not only the bladder gets, but also the threads of the small intestine. The condition leads to the failure of the digestive system. The prolapsed vagina and uterus are severely injured, from which unbearable pain occurs with any movement. If left untreated, erosion, abscess, tissue atrophy develops, sometimes the walls of the vagina rupture and mucosal defects appear.

Lack of therapy leads to complications such as menstrual irregularities and ovarian function, reproductive function completely disappears. Permanent injuries provoke severe bleeding, which threatens the patient's life. It is imperative to treat the disease, because it is dangerous not only for the pelvic organs, but also for the body as a whole. After therapy, it is important to change your lifestyle, give up hard work, monitor intimate hygiene and visit a doctor on time.

Due to the fact that pathology causes frequent constipation, it is necessary to eat a balanced diet and monitor your diet. It is advisable to eat light, semi-liquid food, exclude alcohol, fatty and flour dishes. Sports training should be aimed at gradually strengthening the muscle layers of the pelvic floor. Do not overload yourself with intense training. Observe the mode of wakefulness and sleep, rest more often, walk in the fresh air, sit less, rest more.

How to prevent omission

Prevention of prolapse of the uterus consists in regular strengthening of the abdominal and pelvic muscles. Women should avoid hard work and lift weights. It is important to treat angina, bronchitis and other diseases accompanied by cough on time. Pregnancy and childbirth should be accompanied by qualified supervision, and in the postpartum period it is advisable to do gymnastics to tone the muscles and ligaments.

The timing, intensity and should be determined by a competent physician. Sometimes hormone therapy is prescribed to help improve blood supply and tone the uterus. Every woman should do muscle strengthening exercises, here are some of them:

"Bicycle" - you need to lie down, bend your knees and make movements similar to pedaling.
Holding the legs - in the supine position, the legs are raised 45 degrees from the floor, held for a few seconds and lowered. Gradually, the delay time increases to 10-15 seconds.
"Boat" - lying on your stomach, you need to raise your arms and legs (outstretched) at the same time, making a "boat".
Walking stairs - improves muscle tone.

There are a lot of exercises, the above are the easiest ones that you can do at home. Just half an hour a day will help prevent prolapse of all pelvic organs.

Contraindications

First of all, a woman should avoid those factors that can provoke intra-abdominal pressure. You can not lift heavy (more than 5 kg), load intensively, constantly be in motion and overexert yourself. The patient cannot work a lot, sleep and rest a little, worry and regularly experience stress.

Sneezing and coughing provoke a contraction of the diaphragm and increase the internal pressure in the peritoneum. It is important to understand that diseases cannot be triggered respiratory tract and a cold. If the pathology is already present, it is advisable to postpone pregnancy, as it contributes to the progression of prolapse due to fetal growth.

You can not eat fatty, flour food and bring to constipation. It is strictly forbidden to train with dumbbells and barbells, jump rope, engage in intense jogging and do exercises in which you need to spread your legs. As soon as the first signs of prolapse of the uterus appeared, the woman should urgently run to the doctor, early stages respond well to treatment and do not cause complications.

Pregnancy and childbirth

In case of violations of the normal position of the uterus, sooner or later it will sink even more. All doctors recommend that you first undergo treatment, and only then plan conception. Pregnancy with pathology is possible, but you need to understand that a woman can expect such problems:

Miscarriages, fetal freezing, failure - most often this happens in the early stages. Inflammation, deformation of the uterus, constant pressure on neighboring organs - not the conditions under which pregnancy proceeds normally;
A healthy pregnant woman often suffers from heartburn, constipation, and urinary incontinence. With the presence of pathology, these symptoms will be even more pronounced;
Sometimes breakdowns occur, up to the complete loss of the uterus. Inflammation, along with fertilization, provokes an abscess, in which the organ is excised to minimize losses;
The woman will lie on preservation for the entire period, and the lack of normal mobility leads to pressure on the pelvic organs, which aggravates the problem.

Is it possible to give birth with prolapse of the uterus - it is better not to risk it. This leads to an aggravation of the problem and possible complications. If the pregnancy does occur, it is advisable to have a cesarean section.

Conspiracy

Prolapse of the uterus is a very serious disease that requires mandatory treatment. If you refuse therapy or try to fix it yourself, you can seriously harm yourself. Any disease requires adequate treatment, so no conspiracy will help with the prolapse of the uterus.

Appropriate only if the woman is undergoing appropriate treatment at the clinic.

Descent of the cheek of the uterus

A few words about the reasons for the prolapse of the pelvic organs, or why women should not lift weights

Unfortunately, medical statistics extremely disappointing: a prolapse of the cervix is \u200b\u200bdiagnosed by gynecologists in every fourth woman under the age of 40. In older age groups, every third person faces such a problem. The widespread prevalence of this disease and the lack of basic medical knowledge lead to late treatment of this pathology and the occurrence of complications, which will be described in detail below.

What is called prolapse of the uterus? This is a pathology characterized by a displacement of the cervix relative to its normal anatomical position. Over time, a complete loss of this organ may occur, as a result of which it comes out of the genital slit.

A few words about anatomy. The uterus is the organ in which the child develops. Its narrowest part is the neck, the outer part of which is visible during a gynecological examination. Normally, the uterus is strengthened by a powerful ligamentous apparatus and muscles, which prevents its displacement. In pathological conditions, it can go down, which entails a displacement of its neck.

Causes of displacement of the cervix downward

The following factors can lead to an abnormal position of this organ:

Decreased tone of the muscles that form the pelvic floor. With age, the structure of all muscle fibers changes: they become less elastic and strong. In some cases, this situation can also occur in young women who lead a predominantly sedentary lifestyle.
Perineal trauma received during labor. Quite often, the woman in labor is to blame for them, which, contrary to the advice of doctors, does not synchronize attempts with the phases of breathing. Sometimes a large fetus and / or unskilled actions of an obstetrician-gynecologist become the culprits of injuries.
Hard physical work. By the way, improper exercises in the gym can also lead to prolapse of the pelvic organs. Therefore, if you are in doubt about the correct technique for performing an exercise, then be sure to consult a trainer.
Genetic predisposition.
Connective tissue diseases.
Disrupted hormonal background, the most striking manifestation of which is the deficiency of the female hormone estrogen in the blood. In most cases, this situation is typical for women in menopause.
Overweight.
Frequent constipation, especially if a woman strains too much to discharge feces during bowel movements.
High intra-abdominal pressure, which can develop during pregnancy, tumors, or ascites (i.e., fluid accumulation in the abdominal cavity).
Anomalies in the development of the genitourinary system.

Classification of the downward displacement of the pelvic organs

There are such degrees of prolapse of the uterus:

1st degree: the walls of the vagina are somewhat lowered, the genital gap gapes.

2nd degree: pronounced downward displacement of the walls of the vagina, prolapse of the bladder and rectum.

Grade 3: The cervix is \u200b\u200bat the level of the vaginal opening.

4 degree: the cervix is \u200b\u200bbelow the level of the vaginal opening (so-called incomplete prolapse of the uterus).

5 degree: eversion of the walls of the vagina and complete prolapse of the uterus.

Pelvic organ prolapse symptoms

In most cases, a woman is worried about the following symptoms:

feeling of a foreign body in the genital crevice;
discomfort during intercourse or lack of orgasm;
difficulty urinating;
violation of the act of defecation, manifested by the difficulty of passing feces;
menstruation becomes more profuse;
aching pains in the lower abdomen or a feeling of heaviness.

Diagnosis of prolapse of the pelvic organs

Displacement of the uterus or its cervix is \u200b\u200beasily detected during a routine gynecological examination in the mirrors. In exceptional cases, an ultrasound scan with a transabdominal probe may be required.

To diagnose concomitant diseases, general analysis urine, vaginal smear. If an abdominal tumor is suspected, CT or MRI is necessary. To exclude the pathology of the connective tissue, it is recommended to perform rheumatic tests, biochemical blood tests and tests for inflammatory activity.

Treatment of the displacement of the cervix downwards

At the beginning of this section, it is worth making a reservation right away: with pronounced degrees of prolapse of the pelvic organs (above the second), the treatment tactics can only be operational. This is understandable: no conservative (medication or folk) methods will be able to return the organ to its original position.

To date, there are about 2 hundred different surgical interventions that allow fixing the pelvic organs in the correct anatomical position.

In some cases, in older women, complete removal of the uterus through the vagina is used. Sometimes such an operation can also be performed through an incision in the abdomen (especially if the organ is greatly enlarged or there are tumor formations in it).

Modern specialists try, whenever possible, to choose organ-preserving treatment tactics. The following options for surgical interventions are possible, which are especially relevant for women planning to have children in the future:

Implantation of special frames made of biologically inert material with a mesh structure. This design is a kind of "prosthesis" that allows you to maintain the uterus in the correct position and prevent its displacement downward.
Shortening of the overstretched ligamentous apparatus of the genital organs.
Colporrhaphy - fixation and strengthening of the vaginal walls, which prevents the prolapse of the cervix.
Surgical correction of the anatomical position of the uterus using special devices.
Colpoperineoplasty - the imposition of surgical sutures on the vagina, as well as back wall uterus. Due to this, the pelvic organs become practically immobile, retain their original position and can perform a reproductive function.

Prevention and physiotherapy exercises

Prevention and treatment of displacement of the pelvic organs in the initial stages

In young women, a special set of therapeutic exercises can be used, which is aimed at strengthening the muscles of the pelvic floor. Performing it regularly, it is possible not only to prevent the described disease, but also to significantly reduce its manifestations (or even completely defeat it) in the early stages.

So, take a few minutes a day to exercise therapy and forget about the prolapse of the cervix.

Lie on your back, lift your legs up (if possible, straighten them completely at the knee joints) and simulate the movements of the scissors for 1 minute.
After that, do the "bike", just do not be lazy: try to bend your knees only in extreme abductions.
Take a knee-elbow position. Next, bend your back down while moving your head up, then slouch smoothly, lowering your head down. Do 7-8 of these repetitions.
Stand in the swallow pose for 30-35 seconds. Make sure the pelvis is level and the spine is in the middle position.
Do some smooth, slow squats. Monitor your breathing carefully so as not to increase intra-abdominal pressure. Remember to exhale while lifting your torso.

It is very important that this set of exercises is performed on an empty stomach and after emptying the pelvic organs.

Yoga classes are quite useful for women suffering from cervical prolapse.

You can also practice the following exercise throughout the day: Tighten well, squeeze and hold your pelvic floor muscles tense for as long as possible. This will not only strengthen the muscles and ligaments, but also narrow the vagina. The latter is important for women giving birth.

Uterine prolapse is a diagnosis that will not leave indifferent any woman. A very common disease among women in the age group from 35 to 60 years old, usually detected in the late stages.

The main reason for organ prolapse is the weakening of the pelvic floor. Usually this phenomenon is typical for women after childbirth, after physical exertion. The uterus, as it were, partially hangs down, and often, together with the vagina, falls out of the abdominal cavity, accompanied by minor discomfort.

Prolapse of the uterus can also occur in young nulliparous women who, while actively playing sports, abruptly stop exercising. There is a chronic weakening of connective tissue, ligaments, muscles, which leads to organ prolapse.

What it is?

The prolapse of the uterus is an incorrect position of the uterus, a displacement of its bottom, as well as a displacement of the cervix below the normal level due to the weakness of the muscle fibers of the pelvic floor and ligaments.

The pathology is accompanied by a number of characteristic symptoms: a feeling of pressure, a feeling of discomfort, the patients are worried about pulling pains in the abdomen and vagina. Patients may experience difficulty urinating, vaginal discharge. The disease is complicated in some cases by partial or complete organ prolapse.

Development reasons

Weakness of the musculo-ligamentous apparatus of the uterus can be caused by a number of factors.

Some of the reasons leading to prolapse of the uterus include:

surgical interventions on the organs of the reproductive system;
age-related muscle weakening;
disorders of the innervation of the pelvic floor muscles;
substantial and regular physical activity (lifting weights);
pathology of the connective tissue of the ligaments;
congenital malformations in the pelvic area;
family (genetically determined) predisposition;
birth trauma;
hormonal imbalance during menopause;
neoplasms (cysts, fibroids, fibroids).

During childbirth, significant perineal tears (in particular, with breech presentation of the fetus) in some cases lead to serious muscle damage. Injuries can also be sustained by a woman in labor when obstetricians use a vacuum extractor and forceps. Benign neoplasms increase the load on the ligaments of the pelvic region, which may well provoke prolapse of the uterus. One of the predisposing factors may be a severe chronic cough, in which the muscles of the diaphragm are constantly tense.

Usually a combination of two or more factors takes place in the development of the disease.

Symptoms

In women of different ages, uterine prolapse has quite noticeable symptoms:

pulling pains, which often radiate to the lower back;
squeezing in the pelvic area;
constipation;
frequent urge to urinate;
a feeling of a foreign object in the vagina;
having a lot of mucus or blood. With large blood loss, anemia may develop;
pathology of the menstrual cycle (soreness, violation of the frequency);
the inability to live a sexual life due to pain during intercourse or the impossibility of committing them (in the later stages).

If the prolapse of the uterus is not diagnosed in time and is not started to be treated, then the woman will experience an increase in dysuric pathologies, which will manifest as urinary incontinence or, conversely, difficulty in urinating. In turn, this will contribute to the risk of developing infectious diseases of the urinary system, which include pyelonephritis, urethritis.

Stages

Depending on the degree of loss, 4 degrees of the disease are distinguished:

Grade 1 is characterized by slight drooping of the organ in the vagina;
2 degree - displacement of the organ to the entrance to the vagina;
Grade 3 is diagnosed after the protrusion of the uterine body outside the vagina;
Grade 4 - when the uterus completely falls out of the peritoneum.

The girl is able to determine the symptoms of prolapse of the uterus at stages 2, 3 and 4 herself - it is enough to touch the tissues of the organ protruding from the vagina. Signs of prolapse of the uterus are often characterized by a change in the position of the bladder or even the rectum. A prolapse of the uterus is diagnosed by a gynecologist after childbirth, who, according to the stage of pathology, can prescribe either conservative therapy (bandage for prolapse of the uterus) or surgery.

Diagnostics

To establish a diagnosis, they collect complaints, study the history and conduct a gynecological examination. A rectovaginal examination is mandatory. During the examination, the degree of prolapse, the presence or absence of rectocele and cystocele is established.

Each patient undergoes colposcopy. In addition, the following tests are prescribed:

smear on the microflora of the vagina;
smear for cytology;
determination of hormonal status;
general and bacteriological urine tests.

It is also mandatory to carry out a gynecological ultrasound scan with a vaginal sensor (in the presence of pathological changes in the pelvic organs, the issue of their removal is decided). Excretory urography is prescribed in the presence of cystocele, kidney ultrasound if indicated. If a pathology is detected on a gynecological ultrasound, hysteroscopy with diagnostic curettage of the uterus is prescribed.

How is uterine prolapse treated?

The specialist prescribes treatment, having determined the degree of prolapse of the uterus. It depends on the extent to which the uterus has descended, on how much other organs have suffered, whether the woman is going to give birth in the future. The method of treatment recognized by the doctor can be conservative and surgical.

Conservative treatment

This method is used in the initial stages of the disease. The doctor prescribes drug treatment at home, namely drugs with estrogen. Additionally, ointments with metabolites are prescribed.

When the uterus descends, a special set of exercises is performed, as well as massage. If the operation cannot be performed (there are contraindications), the doctor prescribes pessaries for the woman. These are rings of different sizes, made of high quality rubber. When they are introduced into the vagina, the uterus has a kind of support that prevents its further displacement. To normalize bowel function, experts recommend a special diet.

Nowadays it is also very common to wear a bandage to keep the genitals in the correct position. Wearing a bandage while carrying a baby will prevent the organs from dropping. If the completed course of treatment has not brought any result, they switch to surgical treatment.

Exercises for lowering the uterus

A decrease in the tone and elasticity of the pelvic floor muscles creates conditions for a possible displacement of the genitals. A specially developed gymnastics for this muscle group allows you to prevent unwanted processes of prolapse of the uterus and other genitals, and in patients with prolapse of the uterus, it is included in the composition of therapeutic measures.

Therapeutic gymnastics during prolapse of the uterus is aimed at increasing muscle tone, improving blood circulation and preventing inflammatory processes.

The most popular among doctors and patients is the Kegel technique - a set of exercises for the pelvic muscles named after its developer. The essence of the method is to train the muscles surrounding the vagina, rectum and urethra (urethra) by a maximum contraction of 3 seconds and subsequent relaxation. To perform these therapeutic exercises, you do not need to visit a gym or a physiotherapy room, they are performed in any position, they can be repeated in the shower or in bed before bed.
Another popular Kegel exercise is associated with a woman's ability to self-hypnosis: the patient is asked to imagine the muscular pelvic floor in the form of a kind of "lift" on which she rises to the very top and descends back. The ascent begins from the "basement floor" (complete relaxation), gradually the woman slightly strains the pelvic muscles, rises to the "first floor" and lingers for a couple of seconds in this position (stopping the lift), then continues upward, stopping at each impromptu "floor" ... The higher you go, the stronger the muscle tension. On the fifth "floor" it reaches its maximum. The downward movement is accompanied by gradual muscle relaxation.
Each Kegel exercise is repeated many times during the day, carrying out a total of 50 - 100 contractions per day.

From the entire set of exercises for each specific patient, several of the most suitable are selected, or the complex is recommended to be performed in full. The popularity of the Kegel system is explained by the fact that simple exercises can be performed at any time and in any conditions, for example, while sitting at work or on public transport.

The complex of remedial gymnastics for the prolapse of the uterus includes strengthening the muscles of the abdominal press (anterior abdominal wall). The good condition of the abdominal muscles helps to maintain normal intra-abdominal pressure, which prevents the displacement of organs.

Another popular method is exercise therapy according to the Yunusov method. It includes voluntary contractions of the pelvic muscles during the act of urination until the cessation of urine flow. In women with a predisposition to prolapse of the uterus, remedial gymnastics acts as an effective prevention, and in the presence of an initial stage of the process, it can become the only therapeutic measure.

Regular swimming, cycling, and measured physical activity can replace much of the exercise.

Operation

This problem is often solved with surgery. This method has been used for a long time. But before, doctors performed abdominal operations. Surgical intervention was performed if a woman wanted to maintain fertility. Today, the operation is performed laparoscopically. Already on the third day after the intervention, the woman is discharged. The recovery period lasts about a month.

No scars remain after laparoscopy. This negates the likelihood of adhesions. The operation has no effect on the condition of the vagina. Therefore, a woman can have a normal sex life after recovery. The essence of the operation is that the uterus is supported in the form of a mesh. The latest technologies and materials make it possible to leave a mesh inside the body.

At the same time, nothing threatens the woman's health. The material is elastic. During pregnancy, the mesh is simply stretched. The operation allows you to achieve good results in the shortest possible time. The woman does not need to train muscles or use other methods of conservative therapy.

Relapses are excluded here. During the operation, the surgeon, if necessary, corrects the position of the intestines, bladder and vagina.

The prolapse of the uterus is its unnatural position when the organ is below its anatomical and physiological boundaries. This is due to the weakness of the pelvic muscles after pregnancy, as well as the uterine ligaments. Most clinical cases are accompanied by a displacement or very low location of the organ, when it is as close as possible to the bottom of the vagina. Among the complications, the main one is the risk of prolapse of the uterus from the vaginal opening.

Pathology is characterized by the preservation of the cervix in its place. Another name for pathology is known - pelvic organ prolapse. As a rule, women of pre-retirement age, as well as girls who have undergone pregnancy, are at risk of its occurrence.

Usually, the genital organ is attached to the small pelvis using the ligament apparatus, as well as the muscles and fascia found in the pelvic floor. The reason for lowering it is a situation when the muscles holding the organ lose their tone.

The reasons

The prolapse of the uterus can be caused by one of several reasons:

injuries to the uterus that are caused by pregnancy and childbirth. They can be caused by inaccurate use of forceps by the obstetrician, vacuum extractor, as well as improper fetal retrieval;
previous surgical interventions in the genital area;
large tears of the vagina;
diseases of the nervous system. These include, in particular, a violation of the innervation of the urogenital diaphragm;
hereditary defects of the genital organs.

Among the reasons that increase the risk of pathology, there are:

elderly age;
the presence of great physical exertion;
a large number of pregnancies;
obesity accompanied by high pressure in the pelvic region;
periodic;
ailments accompanied by a cough;
tumors in the abdomen.

Symptoms

In women of different ages, uterine prolapse has quite noticeable symptoms:

pulling pains, which often radiate to the lower back;
squeezing in the pelvic area;
constipation;
frequent urge to urinate;
a feeling of a foreign object in the vagina;
having a lot of mucus or blood. With large blood loss, it can develop;
pathology of the menstrual cycle (soreness, violation of the frequency);
the inability to live a sexual life due to pain during intercourse or the impossibility of committing them (in the later stages).

If the prolapse of the uterus is not diagnosed in time and treated, then the woman will experience an increase in dysuric pathologies, which will manifest or, conversely,. In turn, this will contribute to the risk of the appearance of infectious diseases of the urinary system, which include.

There are several stages of genital prolapse:

Stage 1 - the uterus descends almost to the genital slit, but even with attempts it will not come out of it. The cervix may drop strongly;
Stage 2 - the uterus or its cervix may partially fall out of the genital fissure during attempts;
Stage 3 - part of the organ is visible from the vagina;
Stage 4 - the uterus is completely out of the slit.

Treatment

Many women are worried about how to treat prolapse of the uterus, and whether pathology can be treated at home and without surgery. If the pathology is in the last stages, then one cannot do with the treatment of one gymnastics at home - you will have to do an operation. Today, there are several options for treatment with surgery, and the doctor will recommend them depending on the patient's condition. It is worth noting that any treatment through surgery carries the risk of complications or relapses. The most commonly used techniques are:

shortening and strengthening the ligaments responsible for supporting the organ. Further, the muscles are fixed to the wall of the genital organ or they are fastened together with special materials;
fixing the displaced genital organ to the surface of the pelvic walls. For example, the prolapse of the uterus after childbirth can be corrected by attaching it to the sacrum or pubic bone, as well as to the ligaments of the pelvis. In this case, there is a risk of exacerbation of the pathology, since the ligaments that secure the genital organ stretch over time;
use of synthetic mesh made of alloplastic material. This latest technique, which eliminates prolapse of the uterus after childbirth, has a minimal risk of recurrence.

The operation should be done, as a rule, in conjunction with vaginal plastic. Treatment (surgery) can be performed using an access through the vagina or the abdominal wall from the front.

Treatment is carried out based on factors such as the woman's age, the need to preserve the function of childbearing (or lack of such a need), the severity of disorders in the genitourinary system, as well as the degree of medical risk. In some cases, it is possible to treat by removing the organ (hysterectomy), but the indications for this should be concomitant diseases with an indication for removing the uterus. It should be borne in mind that a hysterectomy can cause prolapse of the remaining organs in the pelvic region, so if possible, the organ should not be removed.

Prevention

The period after surgery for women should not include weight lifting and a variety of physical activities. It is also necessary to do the prevention of constipation.

Gymnastics for prolapse of the uterus is nothing more than a preventive method. These methods also include massage, which helps to strengthen the muscles of the pelvis and abdominal region. These two methods are used when the organ has already shifted relative to its anatomical boundaries. At home, it is allowed to do the following exercises when lowering the uterus:

"elevator". A woman undergoing treatment after pregnancy and childbirth should tighten the muscles a little and leave them there for a few seconds. Further, after every few seconds, the muscles need to be squeezed even more. After that, they should be gradually relaxed;
compression. They need to be done gradually, for 3-5 seconds the perineum is clamped and released.

The prolapse of the uterus after childbirth at the first stage is treated using a special bandage. It is an elastic construction designed to replace the function of previously stretched ligaments. When the uterus descends, the bandage is worn until 12 o'clock, and doctors recommend lying down immediately after removing it, so as not to cause the progression of the organ descending. A prolapse brace is a more versatile treatment than obstetric rings or pessaries worn after pregnancy.

Prevention of pathology unpleasant for girls begins from adolescence by strengthening the abdominal muscles. Also, the work should not involve lifting weights more than 10 kg.

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Only answer if you have proven medical knowledge

Diseases with similar symptoms:

Prolapse of the uterus is a change in the location of the internal organs of a woman's reproductive system with partial or complete exit of the uterus out through the genital slit. During the development of the pathology, the patient feels severe pain and tension in the sacrum region, a feeling of a foreign body in the genital slit, impaired urination and bowel movements, increased pain during sex, as well as discomfort during movement.

Changing the position of the uterus is called prolapse, prolapse. In the initial period, the disease is latent and asymptomatic, but in the future it can cause serious consequences. What are the symptoms and treatment of prolapse of the uterus, how dangerous is this disease.

Reasons for physiological displacement

Normally, in a healthy woman, the uterus is located at an equal distance relative to the walls of the pelvic ring, rectum, and bladder. The hollow muscular organ has a fairly good physiological mobility, the position may change slightly, taking into account the filling of the nearby bladder and rectum. Its own tone also affects the normal location of the organ.

Prolapse is a gynecological pathology in which the organ receives anatomical and physiological displacement from the weakened muscles, fascia and the ligamentous apparatus of the pelvic floor.

The patient with the emerging pathology at the initial stages complains of a feeling of pressure, discomfort, pulling soreness in the lower third of the abdominal cavity. With the development of the disease, problems with urination begin, a woman discovers a large amount of pathological vaginal discharge mixed with blood. A displaced and lowered organ can give a serious complication - partial, complete prolapse.

When the organ continues to lower and the disease progresses, the woman experiences physical and mental suffering. Complete loss of performance is possible.

Displacement degrees

With complete or incomplete omission, the nearby organs of the small pelvis are involved in the pathological process. If, together with the uterus, the anterior wall of the vagina is involved in the process, this is called a cystocele, if the posterior one is a rectocele.

The condition of pelvic organ prolapse is classified into three grades:

At the first stage of pathology (prolapse), the uterus is partially displaced downward, but the cervix is \u200b\u200bstill located in the vaginal cavity. The patient has no complaints, the pathology is discovered by chance, during a gynecological examination.
The second stage is incomplete (partial) prolapse. The organ is lowered into the vaginal cavity, the neck is visible at the entrance to the vagina.
At the third stage, the body and the bottom of the organ partially extend beyond the boundaries of the genital cleft.
At the fourth stage (complete prolapse), the vaginal walls are completely turned outward, the walls of the organ can descend at a level lower than the external reproductive organs. The body with the bottom of the organ completely protrudes beyond the boundaries of the genital slit.

The pathological process can involve intestinal loops, rectum, bladder. Displacement of internal organs is palpated by the doctor through the walls of the vagina.

Reasons for displacement

According to statistics, the disease is more common in mature women from 35 to 55 years old (half of the cases), and at a younger age, every tenth is subject to pathology.

The main prerequisite for changing the position of the organ is the weakness of the muscular, ligamentous apparatus of the pelvic organs. In young women, the disease can provoke disorders anatomical structure pelvic organs (congenital defects), trauma to muscle structures, prolonged depression and stress. Possibly prolapse of the uterus after delivery.

Reasons for omission:

Operational interventions.
Hormonal imbalance in combination with connective tissue dysplasia, excessive physical activity in the climacteric period.
Overweight.
Disturbances of intestinal motility (frequent constipation).
Chronic cough.
Abortion.
Hormonal deficiency.
Multiple and prolonged labor.
Birth trauma
Neoplasms of a malignant and benign nature of the pelvic organs.
Neurological diseases in which the innervation of the urogenital diaphragm is disturbed.

Basically, for the disease to develop, one reason is not enough. Usually, prolapse with organ prolapse is the result of several adverse factors.

Prolapse of the uterus after childbirth as a complication occurs in the same way both after natural delivery and after cesarean section.

Initial stage symptoms

In the initial stages, the pathology is asymptomatic. With the progression of the disease, when mixing increases, the patient develops a pulling pain, a feeling of pressure in the lower third of the abdominal cavity. The pain radiates to the region of the sacrum, lower back, groin. The woman feels that there is a foreign body in the vagina, sexual contacts become uncomfortable and painful.

One of the menstrual irregularities follows:

Hyperpolymenorrhea - profuse menstruation with a constant frequency.
Algodismenorrhea - menstruation with constant pain syndrome and accompanied by disturbances in the work of the intestines and psychoemotional disorders.

Abundant leucorrhoea appears between periods, sometimes there are streaks of blood in them.

In the initial stage, the patient begins to worry about discomfort during movement.

Pregnancy with prolapse of the uterus is usually impossible.

The prolapse of the cervix is \u200b\u200ba serious obstacle to healthy conception and gestation. The probability of freezing, intrauterine fetal death reaches 95%.

Symptoms of the developed disease

By the beginning of the second stage, in half of the cases, disorders in the urological sphere join: difficulty in urinating or frequent urination, stagnation in the organs of the urinary system. From chronic stagnation, ascending infection develops, first in the lower, and then in the upper sections: cystitis, pyelonephritis. The woman is suffering from urinary incontinence.

At the second and third stages of the disease, there are overstretching of the ureters and expansion of the renal pelvic system. The lowered neck is susceptible to injury, and the risk of developing cancer in a woman increases.

Of the proctological complications that occur in 30% of cases of the disease, a woman is worried about constipation, colitis. Incontinence of feces, gases are possible.

What does a prolapsed uterus look like: shiny or dull, with cracks or abrasions. From trauma while walking and sitting on a bulging surface, ulceration and bedsores are formed. The wound surfaces of the mucosa bleed and quickly become infected.

From congestion in the small pelvis, the mucous membrane becomes cyanotic, swelling spreads to nearby tissues.

Sex with prolapse of the uterus, as a rule, is impossible: discomfort, pain, discomfort. During sexual intercourse, eversion of the vagina can occur, which can cause severe psychological trauma in a woman.

Physiological prolapse

By late pregnancy, prolapse of the cervix is \u200b\u200bnormal, which indicates the imminent onset of labor. The pelvic organs are preparing for the birth of the fetus: they move it closer to the exit, providing a physiological position for passing through the birth canal.

Physiological prolapse of the cervix in late pregnancy can be identified by the following symptoms:

The contours of the abdomen change.
Digestive discomfort disappears.
The pressure on the diaphragm is relieved. Shortness of breath goes away, it is easier for a woman to breathe.
Frequent urge to urinate.
Difficulty walking.
Sleep disorders.

Such signs of prolapse of the uterus, if they appear three weeks before the expected birth, are considered normal, do not threaten pregnancy and the normal birth of a child.

If the pathology is detected up to 36 weeks, then to prevent the threat of termination, the pregnant woman is hospitalized for conservation.

Diagnostic measures

Prolapse of the cervix and the degree of prolapse is determined by the gynecologist on examination. Before treating the prolapse of the uterus, the specialist takes into account complaints, anamnestic data (the number of births and abortions, concomitant diseases, employment in heavy physical labor).

After vaginal and rectal examination, the specialist determines the degree of displacement in the small pelvis. At the next stage, endoscopic and transvaginal ultrasound examination is prescribed. With the help of these diagnostic procedures, the doctor determines how impaired blood circulation is and how much the work of adjacent organs is impaired.

To determine the causes of uterine prolapse, the following are additionally prescribed:

Colposcopic examination.
Hysterosalpingoscopic examination.
Ultrasound examination, computed tomography.
Culture of vaginal flora.
Sowing urine for bacterial flora.
Excretory urographic examination.

The gynecologist prescribes consultations of related specialists: proctologist, urologist, endocrinologist.

A woman with a confirmed diagnosis is put on dispensary registration.

Healing activities

The choice of therapeutic tactics takes into account the degree of severity, the presence of concomitant pathologies, age and constitutional data, concomitant sphincter disorders in the bladder and rectum.

If there is complete prolapse of the uterus in older women, the degree of anesthetic and surgical risk is assessed.

Based on the aggregate data, the choice of therapeutic tactics is determined: surgical or conservative.

Conservative therapy

If there are no disturbances in the work of adjacent organs in the pathology, the body of the uterus is located above the genital slit, conservative therapy is indicated. In the treatment without surgery for prolapsed uterus included: gymnastics, massage, use of special tampons, pessaries. In conservative therapy, the doctor may include special substitution therapy, vaginal medicines with metabolites and estrogens.

Physiotherapy

To strengthen the abdominal muscles with the pelvic floor muscles, therapeutic gymnastics is prescribed - a set of Kegel and Yunusov exercises.

Techniques allow you to prevent the causes and consequences of prolapse of the uterus, and they can be used at home. The course of gymnastics prevents urinary and fecal incontinence, sexual dysfunction, and the development of hemorrhoids. Conditions in which gymnastics is indicated:

Difficult childbirth.
Gynecological injuries.
Pregnancy planning, preparation for childbirth.
Prolapse of the uterus after childbirth in the initial stage.

As a preventive measure, a gymnastic course is indicated for women with congenital weak muscular and ligamentous apparatus, with overweight.

Gynecological massage course

The procedure can be effective only if performed by a highly qualified specialist. Tasks of the procedure: strengthening the muscular and ligamentous apparatus of the organ, eliminating minor prolapse, improving blood flow and lymph flow. Gynecological massage gives a chance to restore the normal position of the uterus without surgery. The course of procedures improves the physical and psycho-emotional state, normalizes the menstrual cycle and bowel function.

On average, the procedure lasts 15 minutes. The course of treatment is 15 to 20 procedures.

Gynecological massage should be performed exclusively by a specialist. For self-treatment, the procedure is strictly prohibited!

Obstetric pessaries

What to do in old age with uterine prolapse? Surgery is usually contraindicated in older patients, and therefore vaginal pessaries are used as conservative methods.

A pessary is an obstetric device made in the form of a small plastic or silicone ring. They are installed along the vaginal walls to fix organs in a physiological position.

Pessaries are also used for the treatment and prevention of uterine prolapse during pregnancy, with uterine prolapse after childbirth.

But this treatment has its drawbacks:

It is ineffective if the organ falls out completely.
Pessaries and tampons can cause pressure ulcers.
Requires regular disinfection.
Require regular doctor visits.
Only a doctor should install and remove the pessary.

The use of pessaries requires daily douching from a decoction of chamomile, furacilin, pink manganese solution.

A woman should visit a specialist twice a month.

Home treatment

In the initial stages of the disease, when the uterus is partially lowered, the attending physician may prescribe a course of herbal infusions.

What herbs are used to treat the uterus with folk remedies:

Astragalus root tincture.
Herbal collection of white lamb, linden flowers, alder roots, lemon balm.
Quince infusion.
Herbal collection of St. John's wort, calendula, burnet.

In order for the course of treatment at home to be effective, herbal medicine must be complemented by gymnastics.

Surgery

With the prolapse of the uterus, surgery is inevitable if conservative methods to cure the pathology were ineffective.

Possible surgical methods:

Plastic surgery with strengthening the muscular apparatus. Indications: prolapse of the uterus in women planning to give birth; prolapse of the uterus after childbirth.
An operation to strengthen and shorten the muscular and ligamentous apparatus, followed by fixation to the uterine wall. Indications: incomplete prolapse of the uterus.
An operation to strengthen the musculo-ligamentous apparatus, followed by circular stitching.
Operation to fix the nearby organs (sacrum, pubic bone, pelvic ligamentous apparatus). Indications: complete confluence of the cervix.
Surgery to narrow the lumen of the vaginal wall. Indications: prolapse of the cervix in elderly patients.
Complete surgical removal of the organ.

After surgical treatment of prolapse of the uterus, a recovery period begins, which lasts two months.

To avoid complications and to prevent repeated prolapse of the uterus, the patient during this period is recommended:

Completely exclude sexual intercourse.
Eliminate physical activity, lifting weights.
Exclude baths, use a shower for hygiene procedures.
Do not use tampons.

For patients with a diagnosis of uterine prolapse, surgical treatment is supplemented with a course of conservative therapy: gymnastics, special dietary nutrition, lifestyle adjustments with the exception of physical exertion, adherence to a drinking regimen.

Forecast

The prognosis can be favorable only if a woman consults a doctor on time and has fully completed qualified therapy. If earlier it was believed that prolapse and conception are incompatible concepts, then in modern gynecology it is believed that with this pathology it is possible to become pregnant and bear a fetus. The main thing: the earlier the prolapse of the cervix is \u200b\u200bdiagnosed, the easier the treatment and recovery process is.