Uterine rings for uterine prolapse are an alternative to organ resection. How to pick up a dropped uterus

The treatment method is chosen by the doctor based on the clinical situation, the patient’s age and other factors. Both conservative and radical effects are practiced.

The initial stage of the disease in question is uterine prolapse - downward prolapse of the organ. If proper therapy is not carried out at this stage, the prolapse turns into prolapse. Another name for the disease is diaphragmatic pelvic hernia.

The disease reduces a woman’s quality of life and can cause serious complications in the genitourinary and digestive systems.

Surgical intervention allows you to solve the problem in a radical way, but your health does not always allow you to perform the operation.

Causes

The main contingent of patients are elderly women who have given birth more than 2 times. Menopause itself is a predisposing factor for the occurrence of prolapse and subsequent dystrophic changes, since the lack of sex hormones negatively affects the physiological and anatomical status of the internal genital organs.

The direct cause of the disease is the progressive weakening of the muscles and ligaments of the perineum, pelvic floor, diaphragm and muscle tissue abdominal wall. With age, the uterus gradually changes its position, which creates the preconditions for the occurrence of hernial orifices. Relaxed muscles can no longer withstand natural pressure internal organs, and gradually the latter shift downwards.

Predisposing factors for such a shift are the following:

• Multiple births, multiple or large pregnancies;
• Difficult childbirth, accompanied by perineal ruptures and other injuries;
• Gynecological surgical operations;
• Decreased estrogen production after menopause;
• Heavy physical work, heavy lifting, especially in the postpartum period;
• Degenerative (involutional) age-related changes in tissues and organs;
• Additional pressure on muscles due to obesity;
• Weakening of muscle tone due to exhaustion;
• History of abortion;
• Constant constipation;
• Chronic bronchitis, asthma and other diseases accompanied by a constant cough and increased intraperitoneal pressure;
• Congenital anomalies of the genital organs that appear with age.

In persons Caucasian this disease occurs more often than in Asian and African American women. The first signs of uterine prolapse may appear at a young or middle age, the last stage - prolapse - may occur a year after the initial symptoms.

Symptoms

Uterine prolapse is accompanied by multiple disorders of the reproductive organs, excretory system and digestive system. The disease is almost always accompanied by prolapse of the bladder (cystocele) or rectum (rectocele). A change in the anatomical position of the uterus creates favorable conditions for infection of the reproductive organs: a gaping genital slit is especially dangerous. Prolapse is often accompanied by infectious and inflammatory processes in the vagina, bladder, and urethra.

Typical manifestations of the anomaly:

• Feeling foreign body in the genital area;
• Pain, discomfort in the lower abdomen, lower back;
• Difficulty walking;
• Dysuric disorders – involuntary urination when laughing, coughing, at night (with significant prolapse of the uterus, urination is difficult and is possible only after repositioning the uterus);
• Constipation, incomplete emptying of the rectum;
• Pain during sexual intercourse or complete inability to perform it.

Constant uterine prolapse contributes to traumatization of this organ, leading to the formation trophic ulcers, bedsores, development of endocervicitis - inflammation of the cervical canal.

The abnormal position of the genitals negatively affects blood circulation, lymph outflow, causes disruption of tissue trophism (nutrition), and the formation of blood clots.

Diagnostics

The anomaly usually does not present any difficulties in diagnosis and is easily detected during a standard gynecological examination. To clarify the diagnosis and detect concomitant disorders, blood and urine tests and ultrasound examinations are prescribed. The initial stages of prolapse and prolapse can be detected by the patient on their own - when washing or douching.

Treatment

If the loss is partial or minor, installing an orthopedic ring - a pessary - will help. Other conservative methods at this stage are useless or produce a temporary therapeutic effect.

Most often they resort to radical treatment – surgical correction. The operations are performed as minimally invasive as possible - through the vagina or through laparoscopic access. There are modern medical technologies that can reduce the risk of relapse to a minimum. One of these procedures is the installation of a special synthetic mesh. Sometimes a hysterectomy is prescribed - removal of the uterus; as a rule, this occurs with complete prolapse, which is characterized by the exit of all parts of the uterus beyond the entrance to the vagina (you can read more about this in this article).

In this fragment of the “Doctors” program, Professor K.V. Puchkov. will tell you about the causes and modern methods Treatment of genital prolapse:

Prognosis and possible complications

With timely and professional surgical treatment, the prognosis is relatively favorable. A positive role is played by following medical recommendations regarding limiting physical activity, correcting diet and lifestyle.

The most dangerous complications are inflammatory and infectious processes, kidney pathologies, chronic cystitis and urethritis, erosion, strangulation, uterine edema. Mechanical damage leads to bleeding and painful ulcers on the organs of the reproductive system.

Prevention

The main method of preventing the disease is to detect uterine prolapse at stage 1 and eliminate muscle defects using conservative therapy - gymnastics, wearing a ring. A positive role is played by limiting stress, stabilizing weight, eliminating constipation, correct delivery, professional and timely treatment of any diseases of the reproductive system.

Uterine prolapse, what to do in old age

Uterine prolapse is also called a diaphragmatic pelvic hernia. This disease most often affects postmenopausal women who have given birth on their own more than 2 times. The likelihood that the problem will affect women who have experienced vaginal birth is very high. Uterine prolapse - enough serious violation in the functioning of the body, so at the first symptoms, seek medical help. personnel. We can advise how to treat the disease at home and folk remedies.

What to do if you have uterine prolapse in old age?

Prolapse entails disruption of the functions of all pelvic organs. Therefore, at the slightest beginning of discomfort in the uterine area, you need to consult a doctor and get a diagnosis.

The gynecologist decides how to treat uterine prolapse. The most effective method of treatment remains surgical intervention. Elderly women are recommended to have the organ removed. But there are other methods of treatment.

Laporascopic treatment of uterine prolapse in elderly women

Treatment using this method can be carried out quite quickly and with almost no scars. During the operation to strengthen the fixing apparatus of the uterus, three punctures are made. A miniature video camera is inserted through one, and surgical instruments are inserted through the other two. This shortens the cardinal and uterosacral ligaments. And the uterus returns to its original place.

Alternative to surgery for uterine prolapse

To combat uterine prolapse and uterine prolapse, a pessary is often used. A pessary is a ring that is inserted into the vagina and actually supports the cervix. A modern pessary is made of soft and elastic material, which allows you to achieve the most positive effect. The use of a uterine ring for uterine prolapse is not prescribed for everyone and not always. It's all about the diversity of the course of the disease, and the features female body. Here are a few options that use a uterine ring for uterine prolapse. Important information about it is attached below.

Indications for the use of a pessary for prolapse and prolapse of the uterus

In case of acute uterine prolapse, the pessary allows the woman to normal life and at the same time conduct rehabilitation therapy. It protects the pelvic floor organs from deformation and excessive pressure, it keeps the uterus from swelling and makes it possible to get the necessary time for surgical treatment. In this case, the pessary for uterine prolapse is used temporarily.

The uterine ring is used for pregnant women in critical cases. It saves a woman’s body from stress, and provides a kind of respite, a respite, until the child is born and a solution to the problem is found.

For middle-aged and elderly women with uterine prolapse, uterine rings are prescribed for long periods. The fact is that in these cases, muscle recovery is not always possible. Therefore, the uterine ring becomes an insurance option and sometimes a daily option.

Important information about treating uterine prolapse with a pessary

What features does a pessary have, and what you need to know about the uterine ring in case of uterine prolapse in old age.

Modern uterine rings do not react with body fluids, which means they are very convenient for daily use.

In case of uterine prolapse, uterine rings should be removed at night. This necessary prevention, normal blood circulation.

The uterine ring requires careful care. Your doctor will advise you on cleaning products and techniques.

Despite the structure and elasticity, not every uterine ring is suitable for uterine prolapse in old age. It is selected by the doctor individually.

The uterine ring during uterine prolapse should not put pressure, cause pain or discomfort. If there are such symptoms, then either it is installed incorrectly or it is not suitable.

The design of this device and the technology of its use go back to ancient history. Therefore, we can consider that a pessary is the most conservative treatment for uterine prolapse in old age.

How to do gymnastics in old age with prolapse and prolapse of the uterus?

Treatment of hair loss with gymnastics has shown positive results, but it requires a lot of patience. The entire course lasts 12 months of constant classes. The most difficult thing in this therapy is consistency. Must endure critical period(about days) and you will feel improvement within 2 months.

List of basic Kegel exercises for uterine prolapse

Training the muscles that hold the uterus is a game of staying ahead of the problem. If you are active, love sports, or are simply determined and persistent, then regular use of Kegel exercises is what you need to treat and prevent uterine prolapse in old age. Moreover, if you don’t like playing sports and self-improvement, even then the method is within your power. The fact is that Kegel gymnastics for uterine prolapse does not require a special place, a special state of mind, or special equipment. All you need to do is take a sitting position.

Kegel exercise to force yourself to stop urinating. Every time you urinate, you need to forcefully stop it and start again. If possible, this should be done as often as possible. In the future, you will begin to feel the necessary effort, and will be able to reproduce it while sitting on a chair or driving.

Kegel exercise to tighten the pelvic muscles. To do this, you need to feel the muscles that hold the uterus - the lower abdomen, and try to pull them up. Ideally, the exercise should be performed rhythmically and quickly.

How to do a Kegel exercise with uterine prolapse for gradual contraction from bottom to top? You need to start contracting the muscles from the entrance to the vagina, and upward. At the same time, the “rise” must be divided into several parts and at each stage delayed for a couple of seconds

Pushing exercise. It is necessary to reproduce the labor force. The exercise has its own rhythm, the exercise must be done with a certain effort, and not at the limit of the possible. The main thing is rhythm and regularity of classes.

Kegel exercises should be done frequently. To do this, you can assign yourself three mandatory times for “approaches”. When you fully master the technique, you can conduct training in any place convenient for this.

Elevate gymnastics to the rank of a habit, and the problem of uterine prolapse will disappear by itself. But remember that using exercises will not save you from an incorrect lifestyle.

Gymnastics for uterine prolapse in older women

Basic exercises of classical gymnastics to maintain the tone of the muscles that support the uterus.

Walking is one of the gymnastics exercises. With this problem, you need to walk a lot, this allows you to gradually pump up the necessary muscle group, and causes little effort in the pelvis, which is very important.

If you have uterine prolapse, try to climb stairs more often or even specifically. You can even build an impromptu step and climb it, then descend it in a certain rhythm.

Doing the bike while lying on your back will also help a lot. If the problem is not in a critical phase, then you can use an ordinary bicycle or an exercise machine of this type.

A set of exercises aimed at developing the buttocks is perfect for these purposes. In particular, raising the pelvis with legs bent at the knees and resting on the floor, raising the pelvis with legs at an angle to the floor.

Swimming works great for uterine prolapse in old age.

It’s not too late for anyone to use Kegel exercises. Even if you have already undergone surgery, this technique will help maintain and strengthen your health.

Types of uterine prolapse and their symptoms

The process of prolapse is the displacement of the uterus down the inguinal canal (prolapse) or the sliding of the uterus into the vagina (in in rare cases). In the mildest cases, the uterus protrudes forward at the bottom of the genital slit. Sometimes it partially falls out into the gap, and in the most severe cases of uterine prolapse, it falls out entirely.

Loss is classified by type of loss:

rectocele – prolapse of the back wall of the vagina, right in front of the intestines;

cystocele – prolapse of the anterior vaginal wall;

prolapse is the prolapse of the uterus into the genital opening.

Symptoms of prolapse and prolapse of the uterus in old age

Symptoms accompanying the disease:

pain in the lumbar region;

feeling of heaviness in the pelvic area;

discomfort and pain during sexual intercourse;

abnormal discharge due to uterine prolapse in old age;

frequent cystitis and others infectious diseases genitourinary system;

discomfort during urination, false urges due to uterine prolapse.

Causes of uterine prolapse in old age

The tissues of the uterus are stretched during labor and are injured. Especially if the child is big. As a result, the uterus may gradually slip into the vagina, and uterine prolapse will have to be treated.

in old age, muscle tone becomes very weak and hormonal background and weakening of the vaginal muscles occurs. It can also lead to uterine prolapse, which will need to be treated.

Tumor of the female genital organs as a cause of uterine prolapse in old age.

Genetics. Women in Africa and Asia are less likely to experience uterine prolapse than women in Europe.

As a result of obesity, pressure on the pelvic muscles increases. This can also cause uterine prolapse in old age.

Chronic cough (bronchial or asthmatic) can cause uterine prolapse.

Women who have a degenerating uterus are at risk.

Excessive muscle tension during bowel movements (during constipation) as a cause of uterine prolapse in old age.

Treatment methods for uterine prolapse in older women

The female body holds the uterus with the help of internal muscles. If they weaken, the organ, losing support, slowly moves down the vagina. Experts identify the following types of disease:

• partial prolapse - the uterus does not extend beyond the vagina;
• prolapse - the organ has completely come out of the vagina;
• rectocele - prolapse of the uterus and bladder;
• cystocele - as the organ descends, it pulls the anterior part of the rectum with it.

Prolapse

This type of uterine pathology is the fifth and most severe stage of the disease. It is not difficult to diagnose this species; it can even be done visually. At this stage, the organ completely falls out of the vagina, this happens instantly and is a consequence of injury, difficult childbirth or excessive stress. IN in this case Only surgical treatment is allowed.

Partial loss

The descent of the organ occurs gradually; it moves through the vaginal canal, but does not go beyond its boundaries. This type has several stages:

• initial - entry of the uterine cervix into the vaginal canal;
• medium - the uterus is visible from the perineum when the muscles are tense;
• Not complete loss- the cervix is ​​visible from the vagina without tension, but the uterus remains in the vaginal duct.

Symptoms

To request timely medical care you need to be able to identify the symptoms of uterine prolapse. The main signs of partial or complete organ prolapse in elderly women include:

• Severe discomfort in the pelvic organs, radiating to the lower back. Accompanied aching pain, which increases with prolonged sitting and decreases slightly when changing posture.
• Sensation of a foreign object inside the vagina.
• Problems with the discharge of natural needs.
• Difficulty walking.
• Inflammation of the genitourinary system.
• Impaired blood flow, which leads to the development of varicose veins.

Often women do not know what to do when experiencing uterine prolapse and simply muffle the symptoms with medication. Long-term use Such measures are fraught with complete prolapse of the uterus, which can only be eliminated through surgery.

Causes

If in at a young age There are few reasons for the appearance of such a pathology, but after 55 years a lot of problems appear, the consequence of which can be prolapse of the uterus. These reasons include:

• Consequences of childbirth, especially if a woman has more than 2 children. Frequent childbirth causes a decrease in the elasticity and tone of the muscles that support the uterus. As a result, the tissues weaken and the uterus shifts.
• Being overweight is often a sign hormonal changes and the onset of menopause. Overweight provide strong pressure on the pelvic organs, which leads to their displacement.
• Constipation is a problem that plagues many older women; it causes uterine pathology due to frequent pushing, which causes strong pressure inside the abdominal cavity.
• Wrong lifestyle. Bad habits, excessive physical activity, poor nutrition affect not only the pelvis, but also the entire body as a whole.
• Injuries of the pelvic organs, which lead to deformation of internal organs.
• Hereditary predisposition to pathology.

Diagnosis of the disease

If uterine prolapse occurs, what should you do first? This question worries patients very often: they begin to look for the cause themselves or use independent treatment methods. But in order to accurately diagnose the pathology, a specialist must carefully study the symptoms of uterine prolapse. Using palpation, the doctor can detect uterine displacement and ask the woman to tense her pelvic muscles in order to determine the degree of displacement of the rectum and urinary tract. For a better diagnosis, the patient is examined not only by a gynecologist, but also by a urologist and proctologist.

Additionally, the following procedures are carried out:

• ultrasound examination;
• hysterosalpingoscopy;
• colposcopy;
• urography;
• CT scan;
• bacterial culture;
• smears on the flora.

Thanks to timely and high-quality diagnosis, the patient will be able to avoid surgical intervention, preserving the uterus.

Therapy

Treatment for uterine prolapse depends on the severity of the disease. It involves both drug and conservative therapy, as well as surgery.

Traditional methods

Conservative treatment of uterine prolapse in elderly women has been proven to be effective when diagnosed at an early stage. Therapy involves the use of medications to eliminate or suppress accompanying symptoms. It also involves the use of measures such as installing a uterine ring (pessary) or a bandage to support the uterus, prescribing special tampons or conducting therapeutic massage sessions.

Treatment with surgery

Surgery is the most effective way to treat uterine prolapse. If the latter stages are present, a decision is made to completely remove the organ. If the pathology is at an initial or middle stage, then the tissue and ligaments of the uterus are restored through surgery. Often, surgical intervention is performed when conservative therapy is ineffective or when a woman seeks help late.

• complete removal of the uterus;
• strengthening the vaginal walls using colpography;
• shortening of the vaginal and perineal muscles;
• correction of the position of the uterus;
• installation of supporting implants.

Exercises for a prolapsed uterus

A popular method of treating uterine prolapse in older women has become physical exercise. The most famous is the Kegel complex. These exercises are aimed at improving elasticity and strengthening the vaginal muscles. Preventive and therapeutic include:

• Exercise to stop urinating. Each time you urinate, try to forcefully hold and release the stream. Thus, by contracting and relaxing the vagina, a woman strengthens its muscles.
• Exercise for the pelvic muscles. It consists of pulling up and lowering the lower abdominal muscles at a clear and fast pace.
• Exercise "lifting". It consists of smoothly tightening and relaxing the vaginal muscles.
• "Pushing out." It involves simulating labor pains, but with less effort.

For a good and lasting effect, the complex must be performed regularly, for a long time. In addition to this physical complex, older women are recommended to exercise gymnastic exercises, For example:

• Race walking. Strengthens the pelvic organs and pumps muscle groups, but requires a little effort.
• Steps are the best exercise machine. Climbing stairs, or even one at a time, promotes good blood circulation in the pelvic organs.
• "Bike". The exercise is done while lying on your back with your legs bent at the knees. The legs repeat the movements of riding a bicycle.
• Lifting the buttocks. The exercise is performed in a lying position with legs bent and emphasis on the floor. It consists of lifting the pelvis up and returning to the starting position. It also helps strengthen the gluteal muscles.
• Swimming. It has a beneficial effect on the female body, as it strengthens all muscle groups.

Moderate physical activity, of course, cannot cure uterine prolapse, but it will prevent its development.

ethnoscience

Many women worry about what to do if they experience uterine prolapse in old age. Often folk remedies come to the rescue, but before treating pathology with their help, you should definitely consult with a specialist so as not to harm yourself. Folk recipes are quite varied and involve not only decoctions and infusions, but also douching, herbal baths and special tampons. Basically, traditional therapy is aimed at strengthening the vaginal muscles. There are several most effective methods and means to treat uterine pathologies:

1. Gentian. To prepare the infusion, 1 tablespoon of the plant’s rhizome is steamed in 280-300 ml of boiling water. After cooling, strain. Take 200 ml of infusion daily, 2 times a day, half an hour before meals.
2. Dandelion herbal bath. You will need to pour 20 g of crushed leaves with 5-6 liters of boiling water. The product is infused for 10-15 minutes and added to the bath; the time for taking such herbal baths is from 15 to 20 minutes.
3. Herbal collection from linden inflorescences (50 grams), alder root (10 grams), jasmine (70 grams) and lemon balm (50 grams). Two tablespoons of the mixture are poured into 200 ml of boiling water. After an hour, the product can be filtered. The infusion should be consumed for 21 days, 3 times a day, 100-120 ml. Then you need a break for two weeks, after which the course can be repeated.
4. Eggshells and lemon. You will need the shells of 5-6 eggs and 10 lemons. Citrus fruits are finely chopped and mixed with shells, ground into powder. The mixture is infused for 4 days, stirring occasionally. Then add 0.5 liters of vodka and leave for another 5 days. The tincture is filtered and taken 50 g 2 times a day.
5. Douching with oak bark infusion. You will need 4 tablespoons of crushed bark per 2 liters cold water. The mixture is placed on medium heat and boiled for 2 hours. After cooling, you can strain the broth. Divide the resulting portion into three procedures. Use every day for a month.

It should be remembered that you should not abuse folk remedies, because they are not able to completely cure the disease. If any abnormalities occur or the condition worsens, you should seek medical help.

Prevention

Throughout her life, a woman’s body is exposed to negative factors environment. To prevent the occurrence dangerous pathology, preventive measures should be followed. These include:

• examination by a gynecologist at least once every six months;
• avoiding excessive physical activity and lifting heavy things;
• healthy eating to prevent constipation;
• exercises that improve the condition of the vaginal muscles.

It is necessary to monitor changes in injuries received earlier in the process labor activity. Simple preventive measures will help you avoid problems with women's health and will help strengthen the overall immunity of the body.

Uterine prolapse and prolapse: symptoms, treatment

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

Causes of 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. Hollow muscular organ has fairly good physiological mobility, the position may change slightly taking into account the fullness of the nearby bladder and rectum. The normal position of the organ is also influenced by its own tone.

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

When the pathology occurs in the initial stages, the patient complains of a feeling of pressure, discomfort, and nagging pain in the lower third of the abdominal cavity. As the disease progresses, problems with urination begin, and the woman discovers a large number of pathological vaginal discharge mixed with blood. A displaced and prolapsed organ can cause a serious complication - partial or complete prolapse.

When the organ continues to descend and the disease progresses, the woman experiences physical and mental suffering. Possible total loss performance.

Degrees of displacement

With complete or incomplete prolapse, nearby pelvic organs are involved in the pathological process. If the anterior wall of the vagina is involved in the process along with the uterus, it is called a cystocele, if the posterior wall is called a rectocele.

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

• At the first stage of the pathology (prolapse), the uterus is partially displaced downward, but the cervix is ​​still located in the vaginal cavity. The patient has no complaints; the pathology is discovered accidentally during a gynecological examination.
• The second stage is incomplete (partial) prolapse. The organ is lowered into the vaginal cavity; a cervix is ​​visible at the entrance to the vagina.
• At the third stage, the body and bottom of the organ partially extend beyond the boundaries of the genital opening.
• At the fourth stage (complete prolapse), the vaginal walls are completely turned outward, the walls of the organ may drop to 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 may involve intestinal loops, rectum, and bladder. The displacement of the 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 person is affected by the pathology.

The main prerequisite for changes in the position of the organ is weakness of the muscular and ligamentous apparatus pelvic organs. In young women, the disease can provoke disturbances in the anatomical structure of the pelvic organs ( birth defects), traumatization muscle structures, prolonged depression and stress. Possible prolapse of the uterus after childbirth.

• Surgical interventions.
• Hormonal imbalance combined with dysplasia connective tissue, excessive physical activity during menopause.
• Excess body weight.
• Intestinal motility disorders (frequent constipation).
• Chronic cough.
• Abortion.
• Hormonal deficiency.
• Numerous and long labors.
• Birth injuries
• Neoplasms of malignant and benign nature of the pelvic organs.
• Neurological diseases in which the innervation of the genitourinary diaphragm is impaired.

Basically, a single cause is not enough for a disease to develop. Typically, prolapse with organ prolapse is the result of several unfavorable factors.

Uterine prolapse after childbirth as a complication is equally common both after natural delivery and after cesarean section.

Symptoms of the initial stage

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

The following are one of the menstrual disorders:

1. Hyperpolymenorrhea - heavy menstruation with preserved frequency.
2. Algodismenorrhea - menstruation with constant pain syndrome and accompanied by disturbances in bowel function and psycho-emotional disorders.

Appear between periods profuse leucorrhoea, sometimes they have streaks of blood.

In the initial stage, the patient begins to experience discomfort during movements.

Pregnancy with uterine prolapse is usually impossible.

Cervical prolapse is a serious obstacle to healthy conception and pregnancy. The probability of fading and intrauterine fetal death reaches 95%.

Symptoms of a developed disease

The beginning of the second stage in half of the cases is accompanied by disorders in the urological sphere: difficulty urinating or frequent urination, congestion 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. A woman suffers from urinary incontinence.

At the second and third stages of the disease, overstretching of the ureters and expansion of the renal-pelvic system are observed. A lowered cervix 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, women are concerned about constipation and colitis. Possible incontinence of feces and gases.

What does a prolapsed uterus look like: shiny or matte, with cracks or abrasions. From trauma while walking and sitting, ulcerations and bedsores form on the bulging surface. Wound mucosal surfaces bleed and quickly become infected.

Due to congestion in the pelvis, the mucous membrane becomes cyanotic, and swelling spreads to nearby tissues.

Sex during uterine prolapse is usually impossible: discomfort, pain, unpleasant sensations. During sexual intercourse, vaginal inversion may occur, which can cause severe psychological trauma in a woman.

Physiological prolapse

By late pregnancy, cervical prolapse - normal phenomenon, which indicates the imminent onset of labor. The pelvic organs prepare for the birth of the fetus: they move it closer to the exit, providing a physiological position for passage through the birth canal.

Physiological prolapse of the cervix later Pregnancy can be determined by the following symptoms:

• The contours of the abdomen change.
• Digestive discomfort goes away.
• The pressure on the diaphragm is relieved. The shortness of breath goes away and the woman breathes easier.
• Frequent urge to urinate.
• Difficulty walking.
• Sleep disorders.

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

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

Diagnostic measures

Cervical prolapse and the degree of prolapse are determined by a gynecologist during an examination. Before treating uterine prolapse, the specialist takes into account complaints and anamnestic data (number of births and abortions, concomitant diseases, heavy physical labor).

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

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

1. Colposcopic examination.
2. Hysterosalpingoscopic examination.
3. Ultrasound examination, computed tomography.
4. Bacterial culture of vaginal flora.
5. Urine culture for bacterial flora.
6. Excretory urographic study.

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

A woman with a confirmed diagnosis is registered with a dispensary.

Therapeutic measures

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 complete uterine prolapse is observed 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 the pathology does not cause disturbances in the functioning of adjacent organs, the body of the uterus is located above the genital slit, conservative therapy is indicated. Treatment without surgery for uterine prolapse includes: gymnastics, massage, use of special tampons, pessaries. In conservative therapy, the doctor may include special replacement therapy, vaginal medications with metabolites and estrogens.

Physiotherapy

To strengthen the abdominal muscles with the pelvic floor muscles it is prescribed physiotherapy– a set of Kegel and Yunusov exercises.

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

• Difficult birth.
• 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 muscles and ligaments, and those with excess body weight.

Gynecological massage course

The procedure can only be effective if it is performed by a highly qualified specialist. Objectives 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 physical and psycho-emotional state, normalizes menstrual cycle and bowel function.

On average, the procedure lasts 15 minutes. The course of treatment is from 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? Typically, surgery is contraindicated for 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 the organs in a physiological position.

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

But this treatment has its disadvantages:

1. It is ineffective if the organ falls out completely.
2. Pessaries and tampons can cause bedsores.
3. Requires regular disinfection.
4. Requires regular visits to the doctor.
5. Only a doctor should insert and remove the pessary.

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

A woman should visit a specialist twice a month.

Home treatment

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

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

• Tincture of astragalus roots.
• Herbal collection of white claret, linden flowers, alder roots, lemon balm.
• Quince infusion.
• Herbal mixture of St. John's wort, calendula, burnet.

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

Surgery

When the uterus prolapses, surgery is inevitable if conservative methods cure the pathology were ineffective.

Possible surgical methods:

1. Plastic surgery with strengthening of the muscular system. Indications: uterine prolapse in women planning to give birth; prolapse of the uterus after childbirth.
2. An operation to strengthen and shorten the muscular and ligamentous apparatus, subsequent fixation to the uterine wall. Indications: incomplete uterine prolapse.
3. An operation to strengthen the muscular-ligamentous apparatus followed by circular stitching.
4. Fixation operation nearby authorities(to the sacrum, pubic bone, pelvic ligamentous apparatus). Indications: complete confluence of the cervix.
5. An operation to narrow the lumen of the vaginal wall. Indications: cervical prolapse in older patients.
6. Complete surgical removal organ.

After surgical treatment After uterine prolapse, a recovery period begins that lasts two months.

To avoid complications and prevent recurrent uterine prolapse, the patient is recommended during this period:

• Avoid sexual intercourse completely.
• Avoid physical activity and heavy lifting.
• Avoid baths for hygiene procedures use the shower.
• Don't use tampons.

For patients diagnosed with uterine prolapse, surgical treatment is supplemented with a course of conservative therapy: gymnastics, special dietary food, lifestyle adjustments with the exception of physical activity, compliance with the drinking regime.

Forecast

The prognosis can only be favorable if the woman consults a doctor on time and has fully undergone qualified therapy. If previously 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 carry a fetus to term. The main thing: the earlier cervical prolapse is diagnosed, the easier the treatment and recovery process is.

Vaginal prolapse or vaginal prolapse is an abnormal condition in the female reproductive system, which mainly occurs in women who have given birth after the age of fifty due to a weakening of the pelvic floor, but it can also occur in women aged 30 to 45 years (forty cases out of a hundred) , as well as up to thirty years (ten cases out of a hundred). Vaginal prolapse is not always associated with birth process, in three percent of cases, the abnormal condition develops in young and nulliparous girls.

Causes or mechanism of vaginal prolapse.
Prolapse of the vaginal walls (prolapse) is expressed in a change in the anatomical location of the pelvic organs against the background of weakening of the muscles of the abdominal region and pelvic floor. Why is this happening? Due to increased pressure inside the abdominal region, the elasticity of the ligaments is gradually lost, which is why they are unable to maintain the internal organs (in particular the bladder, uterus, rectum) in the required physiological position. Hence, the increase in organ pressure gradually leads to loss of muscle tone of the perineum and prolapse of vaginal tissue.

Many factors can contribute to the development of this condition, including:

• Congenital anomaly of connective tissue development.
• Increased intra-abdominal pressure (constipation in chronic form, frequent ARVI, accompanied by cough).
• Development of complications during childbirth (long labor, perineal trauma, large fetus, use of obstetric forceps during childbirth).
• Sudden weight loss due to obesity.
• Tumor changes in the genital organs.
• Hard physical labor.
• An operation to remove the uterus when the vaginal dome was not fixed.
• Changes in the body that occur with age (loss of tissue elasticity (after 60 years)).
• Number of births (after the birth of the second child, the risk of prolapse of the vaginal walls increases significantly).

During the development of the disease, either the anterior or posterior wall of the vagina can undergo prolapse, or both at the same time. IN clinical practice Most often, prolapse of the anterior wall occurs, which is inevitably accompanied by prolapse of the bladder and urethra. When the posterior vaginal wall prolapses, there is a high risk of rectal prolapse or rectal prolapse.

Degrees of vaginal prolapse.

• The first degree is prolapse of the posterior, anterior or both walls of the vagina, while the vulva itself does not extend beyond the boundaries of the entrance.
• The second degree is partial prolapse of the anterior wall of the vagina with part of the bladder (cystocele) or the posterior wall with part of the rectum (rectocele), accompanied by bulging of the walls outward.
• The third degree is complete prolapse of the vaginal walls, mainly accompanied by uterine prolapse.

Prolapse of the anterior vaginal wall most often manifests itself in the form of the development of chronic cystitis against the background of stagnation of urine, and the posterior wall - in the form of constipation and a feeling of the presence of a foreign object in the vulva.

A complication of prolapse of any of the vaginal walls is often prolapse and then prolapse of the uterus, which manifests itself in the form of excessive sanguineous or bloody discharge.

Diagnosis of prolapse and prolapse of the vaginal walls.
Detection of the disease is not difficult; when examined in a gynecological chair, the walls of the vagina and cervix protruding from the genital tract are noticeable. The doctor adjusts them and then assesses the condition of the pelvic floor muscles. In this case, additional consultation with a urologist and proctologist is required.

Prolapse of the vaginal walls and pregnancy.
Pregnancy with this state possible, but the degree of development of the disease should be taken into account. The first degree of the disease allows you to give birth without prior surgery. In this case, exercises to strengthen the pelvic muscles and abs will help. With a progressive degree of the disease, surgical intervention and recovery are necessary, only then can you become pregnant. Otherwise, prolapse of the vagina is fraught with prolapse of the uterus.

And one more nuance, after the operation you will no longer be able to give birth on your own; a caesarean section is indicated.

Conservative therapy.
Therapy is indicated for minor prolapse of the vaginal walls and is expressed in the use of a set of exercises, the purpose of which is to increase the muscle tone of the pelvic floor, including Kegel exercises (squeezing and relaxing the muscles of the perineum), exercises physical therapy. At the same time, therapy is prescribed for general strengthening the body, while nutrition is not the least important (no heavy foods that can cause constipation and complicate the problem).

During menopause, women are prescribed hormone replacement therapy to improve blood circulation and strengthen the muscles and ligaments of the pelvic organs.

If surgery is contraindicated for a woman for any reason, to prevent complete prolapse of the uterus, the patient is fitted with uterine rings (pessaries) - a device for supporting internal organs is inserted into the vulva. The pessary is selected for each patient individually, after which regular monitoring by a gynecologist is indicated to exclude the development serious complications(purulent and ulcerative processes, irritation and swelling of the mucous membrane, ingrowth of the pessary into the cervix or vulva). To prevent these phenomena, the doctor prescribes douching and washing the vagina. If weakness of the vaginal muscles does not allow insertion of a pessary, then a hysterophore is used - a device that holds the uterus by means of a pessary connected to a bandage attached to the waist.

Gymnastics (set of exercises) for prolapse of the vaginal walls at an early stage (can be used as a preventive measure for the disease).

Exercises while standing on all fours:

• While inhaling, we raise the straightened right hand and lower the left leg while exhaling. Do six repetitions. Then do the same thing, only with the left hand and right foot.
• As we inhale, we lower our head and draw in the muscles of the perineum; on the way out, we relax, raise our head and bend in the lower back. Do ten repetitions.
• Bend your elbows and alternately raise your right and left leg. Do twelve repetitions with each leg.

• Arms along the body, legs straightened and joined together. Slowly, while exhaling, we raise our legs, while inhaling, we spread them apart, while we exhale, we close them, and while inhaling, we return to the starting position. Do eight repetitions.
• Hands under your head, feet together. Raise the pelvis while simultaneously drawing in the muscles anus. Do ten repetitions slowly.
• At an average pace we make a “bicycle” of twenty revolutions.
• Raise straight legs one by one. Do eight times with each leg.
• We lift our legs off the floor, put them behind our heads, and stretch our toes to the floor. Do six approaches at a slow pace.
• Raise your straight legs (together) at an angle of 45° to the floor and return back. Perform slowly eight times.
• Bend your knees (foot on the floor, arms under your head) and spread them slightly. Raise your pelvis from the floor, spread your knees wide and pull the anus muscles inward. Do ten approaches.

Kegel exercises.

• We strain the pelvic muscles in steps, from low effort to maximum, each position should be fixed for several seconds. We relax in the same way.
• Hold urination for 10-20 seconds.
• Moderate straining (as during childbirth).

• Colporrhaphy - removal of “extra” tissue from the vaginal walls and stitching them together during prolapse and prolapse; the operation is aimed at restoring the anatomical location of the organs by strengthening the pelvic floor muscles. Can be front or back.
• Colpoperineorrhaphy is a reduction of the posterior wall of the vagina (against the background of overstretching after childbirth) by suturing it and tightening the perineal muscles.

Postoperative period.
After assessing the patient’s general condition after the intervention, the doctor discharges her, usually on the second day after the intervention. To prevent the development of complications and accelerate recovery period It is necessary to strictly follow all the doctor’s recommendations, namely:

• During the first five days, treat the perineum with an antiseptic.
• Take antibiotics prescribed by your doctor.
• For two weeks, to avoid overstraining the operated muscles, sitting is prohibited.
• In the first week, it is recommended to consume liquid or semi-liquid food to prevent the development of constipation.
• Eliminate physical activity, including sports, for at least a month.
• Resume sex life It is recommended no earlier than five weeks after surgery.

Prevention of prolapse of the vaginal walls.

• Correct suturing of ruptures or cuts of the perineum during childbirth.
• Mandatory physical education before, during and after childbirth.
• Do exercises to strengthen the pelvic floor muscles during pregnancy and after childbirth.
• Learn to urinate in portions, squeezing the stream several times during one urination.
• Protect yourself from carrying heavy objects.
• Balanced nutrition, including during pregnancy.
• Gentle conservative management of childbirth and prevention of maternal injuries.
• Learn to pull your vulva up while walking.

Quince can be brewed and drunk as tea; it gives tone to the muscles of the uterus. Brew 100 g of dried fruits and a liter of water using a water bath.

An alcohol tincture of astragalus root is also considered an effective traditional medicine against of this disease. Take nine parts of vodka for some of the chopped roots. Keep the mixture in a cool place for two weeks. dark place. Then strain. Take three times before the main meal (breakfast, lunch, dinner), with plenty of water. Treatment course includes thirty days, if necessary, the course can be repeated after two weeks.

Mix 50 g each linden color and lemon balm, add 70 g of white cherry and 10 g of alder root. Grind the mixture. Take two tablespoons, brew 200 ml of boiling water and leave until completely cool. Take half a glass three times a day before meals. The course of treatment is twenty-one days; after a two-week break, the course can be repeated.

Datura is effective as a remedy for sitz baths in cases of partial prolapse. Pour 20 g of herb into seven liters of boiling water and keep in a water bath for fifteen minutes. After this, the infusion should be cooled to 38 degrees. Use for a sitz bath, lasting no more than ten minutes.

The internal structure of the reproductive “apparatus” of the female body is complex, but harmonious. Disruption of interaction between parts of the system due to age-related and hormonal changes, external factors leads to the occurrence of gynecological pathologies. One of them is uterine prolapse. How does this disease manifest itself, what complications is it dangerous for? Find out how to treat the pathology and what to do to reduce the risk of its development.

Types of uterine prolapse

Inside female body The uterus is supported by the pelvic muscles - the ligamentous apparatus. When the ligaments weaken, the organ begins to descend, moving down the vagina. In gynecology, various degrees of pathology and its types are classified:

• partial prolapse - the uterus is completely or partially located in the vagina;
• complete prolapse (prolapse) – the entire body of the uterus extends beyond the vagina;
• rectocele - as the uterus descends, it pulls the wall of the bladder with it;
• cystocele - prolapse occurs along with the anterior wall of the rectum.

Complete

Such prolapse of the uterus is considered the fifth (last) degree of severity of the pathology and is diagnosed visually, because with complete prolapse the entire organ extends beyond the vagina. Complete loss occurs rapidly as a result of injury, difficult childbirth, or strain during heavy lifting. Perhaps with the connivance of the patient, when she does not see the doctor on time. Treatment is only surgical.

Partial

The prolapse of the uterus occurs with gradual advancement through the vaginal canal. Until the organ comes out completely, they speak of partial (incomplete) prolapse and are classified as follows:

1. Initial stage– prolapse of the cervix, its entrance into the vaginal canal.
2. Middle stage(partial prolapse) - the uterus enters the vagina and is visible from the vaginal opening only with tension (pressure).
3. Incomplete cervical prolapse – the cervix is ​​visible from the vaginal opening, but the body of the uterus remains in the vaginal canal even with straining.

Causes

This pathology is provoked by the following external and internal factors:

• age-related weakening of muscle tone;
• tumors;
• difficult childbirth, birth injuries;
• multiple pregnancy;
• obesity;
• chronic constipation;
• gynecological operations;
• chronic cough;
• hard physical labor;
• some sports (weightlifting).

Main signs and symptoms

Direct and indirect symptoms of pathology are possible. Often, symptoms are absent when at rest, but appear during exertion. Signs indicating uterine prolapse are as follows:

• pain in the lower back and lower abdomen;
• discomfort when urinating and defecating;
• sensation of a foreign body in the vaginal canal;
• the appearance of discharge;
• pain during sexual intercourse;
• menstruation disorders;
• incontinence of urine, feces, intestinal gases.

Diagnostics

Genital prolapse is diagnosed during the initial examination. If the doctor detects displacement of the uterus by palpation, he asks the patient to push, then conducts a study to determine the displacement of the walls of the vagina, rectum, and bladder. Qualitative diagnosis helps to distinguish this disease from a vaginal cyst, uterine inversion, or myomatous node. For this, an additional examination is carried out by a urologist and proctologist (the presence of rectocele, cystocele is determined).

To determine the extent of the disease, it is prescribed additional methods examinations:

• hysterosalpingoscopy;
• colposcopy;
• excretory urography;
• computed tomography;
• bacterial sowing;
• smears on the flora.

Methods for treating uterine prolapse

Patients are prescribed a specific treatment based on the severity of the pathology:

1. Conservative therapy. It is carried out at initial and intermediate stages of genital prolapse. Includes treatment with drugs that are prescribed for specific symptoms and associated diseases. This could be: a massage that strengthens the pelvic ligaments, a bandage, a pessary, tampons.
2. Surgery is the most effective treatment method. IN severe cases(in elderly patients) the uterus is removed, in case of pathologies medium degree use surgical methods to restore the ligamentous apparatus of the uterus.
3. Other methods. The use of traditional medicine (herbal medicine) has an auxiliary effect in the treatment of genital prolapse. Gymnastics are shown to strengthen the pelvic ligaments and vaginal muscles.

Conservative treatment without surgery

Therapeutic treatment of uterine prolapse is indicated in two cases:

1. When it remains possible to return the organ to its normal position without surgery. Uterine prolapse is treated without surgery. To do this, use means that strengthen the muscles of the pelvic floor: hormonal drugs, gynecological massage, special gymnastics.
2. When it is necessary to support the uterus at a certain stage of prolapse, so as not to aggravate the pathology before surgery. They use the method of introducing a uterine ring (pessary), which fixes the uterus. They prescribe wearing a bandage.

For any therapeutic treatment of genital prolapse, patients are prescribed a diet that relieves constipation. A gentle work regimen, limiting physical activity, and avoiding heavy lifting are often recommended. If the pathology is accompanied by other diseases (inflammatory processes, infections, etc.), then they are carried out drug treatment special drugs.

Surgical intervention

If conservative therapy is ineffective, or the patient consults a doctor at a severe stage of the disease, surgical treatment is used. For surgical intervention, vaginal (incision inside the vagina) and laparoscopic (punctures in the abdomen) access are used. Having determined the degree of uterine prolapse, the presence (absence) of rectocele, cystocele, and associated pathologies, the doctor selects a certain type of operation (there are more than a hundred of them). Some types of surgical treatment:

1. Uterus removal.
2. Colporrhaphy, during which the vaginal walls are strengthened.
3. Colpoperineoplasty is an operation for suturing the muscles of the vaginal canal and perineum.
4. Surgical shortening of the muscles of the ligamentous apparatus of the uterus.
5. Robotic correction of uterine position.
6. Installation of mesh implants that perform the function of a frame supporting the uterus (lightweight laparoscopic protofixation, plication of the uterosacral ligaments, mesh sacrovaginopexy).

Folk remedies

Alternative therapy is an auxiliary method of treating uterine prolapse. Decoctions and infusions of herbs are used for baths, tampons and douches, and taken orally. The main goal of treatment with folk remedies is to strengthen the vaginal muscles at home. Here are some recipes for such potions: auxiliary treatment:

1. Take gentian infusion (a spoonful of herb in a glass of boiling water) twice a day 30-40 minutes before meals.
2. Dandelion bath. 20 g of leaves are infused in a bucket of hot water for 10 minutes. Pour into the bath and lie in it for about 20 minutes.
3. Herbal collection (linden, alder, yasnoka, lemon balm). Pour two tablespoons of the mixture into a glass of boiling water. The entire infusion is drunk in three servings a day. They are treated with the collection for three weeks.
4. Crushed eggshell(5 eggs) with lemon (9 pieces). Finely chop the lemons, mix with the shells, leave for 4 days, and drain. Take 50 grams twice a day until the mixture runs out.
5. Quince infusion (1 part fruit to 10 parts water) is prepared in a steam bath and drunk as tea.
6. White lily roots (2 tablespoons of powder per 2 cups of boiling water) infuse for 12 hours, filter, drink three times a day an hour before meals.
7. Douching with oak bark (70 g per 2 liters of water). The mixture is boiled for 2 hours and used for daily douching for a month.
8. Bath with pine nuts. A glass of nuts is boiled in two liters of water for an hour. Pour the broth into the bath and lie in it for 15 minutes.

What to do if you have uterine prolapse in old age

Natural age-related weakening of the pelvic ligaments and insufficient estrogen levels provoke prolapse and complete prolapse of the uterus in older women. Doctors consider surgery to be the most effective treatment, including removal of the organ. If operations are contraindicated for any reason, then uterine rings are installed for patients. Drug (hormonal) treatment is often prescribed. It is recommended to avoid physical activity, adhere to a diet that excludes constipation, and do special gymnastics.

Possible complications and consequences

Untimely treatment of genital prolapse, neglect of the pathology, non-compliance with doctor’s recommendations after surgery, hard work, poor nutrition lead to possible complications:

• endocervicitis;
• swelling, ulcers of the vagina and cervix;
• risk of infection;
• contact bleeding;
• varicose veins;
• strangulation, ulceration of the body of the prolapsed uterus;
• development of cystitis;
• bedsores of the walls of the vaginal canal;
• infringement of intestinal loops.

Disease prevention

Age-related changes, difficult childbirth, high physical activity and other provoking factors do not exclude genital prolapse. In order to prevent, if possible, the occurrence and development of this pathology, it is necessary to undergo periodic gynecological examinations and follow preventive measures:

• regulate physical activity;
• adhere to a diet that excludes constipation;
• do not lift heavy objects;
• perform a set of exercises that restore the elasticity of the vaginal muscles and ligaments;
• be attentive to postpartum injuries and breaks.

Video: genital prolapse and uterine prolapse in women

Watch the video from which you will learn what is hidden behind the term “genital prolapse”, what is the likelihood of developing this pathology in women of different ages, and what can provoke it. A practicing doctor will tell you what treatment methods are used and how the organ is quickly returned to its normal state. Find out from the video what women should do to minimize the risk of pathology.

Uterine rings are a simple, convenient and absolutely safe way to treat uterine prolapse. Due to their versatility, pessaries allow you to solve specific problems very effectively, without the use of radical measures. gynecological problems women.

Being a strong smooth muscle organ, the uterus can sometimes change its position in the pelvic cavity and shift to the vagina or external genitalia. In this case, prolapse or prolapse of an organ occurs, which partially or completely comes out, causing the woman a lot of inconvenience. The most common complaints in such cases are nagging pain of varying intensity in the lower back, lower abdomen and sacrum, a sensation of a foreign body in the perineum, as well as great discomfort during normal hygiene procedures or during sexual intercourse.

There are four stages of prolapse:

• I - slight downward displacement of the uterus;
• II - initial prolapse, when, upon straining, the cervix appears from the genital slit;
• III - partial prolapse - part of the body of the uterus protrudes from the vagina already at rest;
• IV - complete loss.

Treatment is selected according to the type and severity of organ prolapse. However, the best therapeutic and alternative method, known to Hippocrates, for “reducing” the uterus is special uterine rings.

Main types, shapes and sizes of pessaries

Pessaries or uterine rings are flexible silicone medical products that are designed to create additional support, fix the organ when it is displaced, and also as a barrier to prevent prolapse of the uterus, rectum, bladder or sagging of the vaginal walls. Due to its elasticity, this device, after being inserted inside, easily takes the desired position and does not at all affect the woman’s freedom of movement and her usual rhythm of life.

Rings vary in shape and size:

• thin;
• curved (Hodge pessaries);
• mushroom-shaped;
• cup regular or perforated;
• tandem;
• urethral;
• calyx-urethral;
• cubic;
• adaptive.

The diameters of the pessaries are also uneven and vary from a minimum of 50 mm to a maximum of 100 mm. Moreover, according to the type of appointment they distinguish:

1. Obstetric rings. Indicated for pregnant women to avoid the threat of premature birth and for the prevention of ICI (isthmic-cervical insufficiency).
2. Gynecological rings. Used for prolapse/prolapse of the uterus and organs of the female reproductive system.

Definition and selection the desired type and the size of the pessary is solely a medical prerogative.

However, it is important to distinguish between vaginal and uterine rings. The former act as a barrier method of contraception, while uterine rings are a therapeutic and prophylactic device. You can buy the necessary pessary in pharmacies or medical equipment stores, but only after consulting a gynecologist.

Advantages:

• Effective therapy for uterine prolapse.
• Help in maintaining pregnancy and preventing the risk of premature birth.
• High performance at any stage of pregnancy and during varying degrees uterine prolapse.
• Hypoallergenic.
• Safety and ease of use.
• There is absolutely no risk of soft tissue injury.
• Good alternative surgical method treatment (various types of operations are discussed at the link).

Flaws:

Installation of a pessary

The primary insertion of the uterine ring is carried out exclusively by a gynecologist in an outpatient setting. In the future, a woman, with the help of simple manipulations, can carry out this procedure already on your own. Its installation is always preceded by an individual examination for infectious and bacteriological inflammation. Before direct insertion of the uterine ring, it is sterilized by boiling or rinsing in hot water. For smooth and easier installation, the device is treated vegetable oil or sterile Vaseline.

The pessary is always inserted in the supine position. During this process, the ring is compressed and inserted deep into the vagina so that, when unrolled, the convex surface of the pessary faces the cervix. During and after this procedure, provided correct selection shape and size of the ring, the woman should not experience any painful or uncomfortable sensations.

In this video you can see the technique for introducing one type of pessary:

Further, every two weeks for 1.5 months, an examination by a gynecologist is required for normal position device and the absence of possible associated complications. The average period of wearing the ring is from 2 to 6 months, depending on the history of prolapse. If the pessary is not intended to be worn continuously, it must be treated with an antiseptic before each subsequent insertion.

RumisPhoto/depositphotos.com, photography33/depositphotos.com, ruigsantos/depositphotos.com

When the vagina prolapses, one of its walls hangs into the vaginal lumen. Due to the fact that the bladder is located in front of the vagina, when its front wall hangs down, the bladder also begins to descend. This condition is called cystocele. The rectum is located behind the vagina, so when the posterior wall of the vagina prolapses, prolapse of the rectal wall, or rectocele, is also observed.

When the uterus prolapses, it moves downwards, and with severe prolapse, the uterus may even “fall out” of the vagina. Of course, when we talk about “prolapse,” we do not mean that the uterus will suddenly tear away from the body and fall to the floor. Despite everything, the uterus remains securely attached to the body, but when the uterus prolapses, it begins to “peek out” from the vagina.

Why does prolapse of the vagina and uterus occur?

Normally, the pelvic organs (ovaries, the fallopian tubes, uterus, vagina, bladder and rectum) are supported in a suspended state by the muscles and ligaments of the pelvis, which in turn are attached to the skeleton. The design is quite complex, and a separate lecture on anatomy can be devoted to the structure of the pelvic floor (the structure that holds all the listed organs in their proper place). But we will not go into details, it is enough just to understand that the vagina and uterus occupy the place that is allocated to them by nature for a reason, but thanks to the muscles and ligaments of the pelvis.

With age, the tone of the pelvic floor muscles decreases significantly, and the ligaments can stretch, so during menopause prolapse of the vagina or uterus is often observed. Among other things, the decrease in estrogen levels in the blood, observed during menopause, also contributes to relaxation and stretching of the ligaments.

Who can develop vaginal and uterine prolapse?

An increased risk of genital prolapse during menopause is observed if:

• The woman has given birth many times or had multiple pregnancies (twins, triplets, etc.)
• Are overweight or obese.
• Frequent constipation is observed.
• There is a chronic cough (chronic bronchitis, bronchial asthma).
• The woman smokes.
• There is a dysfunction of the liver with accumulation of fluid in the abdominal cavity (ascites).
• There is a pronounced enlargement of the spleen.
• A woman lifts weights.

Does prolapse occur without symptoms?

It happens, and even more than that: in most cases, early stages there are no symptoms of prolapse of the vagina and uterus. There is no need to doubt the correctness of the diagnosis if the gynecologist has discovered prolapse and you have no signs of this disease.

How does prolapse of the vagina and uterus manifest?

• Sensation of a foreign body in the vagina, as if there is a small ball deep in the vagina.
• Dull pain in the lower abdomen.
• Feeling as if something is falling out of the vagina.
• Pain during sexual intercourse.
• Difficulty walking.
• Difficulty urinating and defecating.

With a cystocele (prolapse of the bladder wall), symptoms such as frequent urination, urinary incontinence, involuntary urination, and urinary retention may appear. More information about urinary incontinence during menopause.

See a gymnastics complex with exercises against prolapse

With a rectocele (prolapse of the rectal wall), difficulties arise during bowel movements, when it is necessary to exert more effort than before to empty the intestines.

What are the degrees of uterine prolapse?

1st degree of uterine prolapse: the cervix is ​​not above the vagina, as it should be normally, but descends into the vagina.

2nd degree of uterine prolapse: the cervix descends towards the entrance to the vagina.

Stage 3 uterine prolapse: the cervix “peeks out” from the vagina.

4th degree of uterine prolapse: the entire uterus “peeks out” from the vagina. This condition is also called uterine prolapse.

What tests are needed?

The diagnosis of genital prolapse can be made during an examination by a gynecologist. The doctor will examine you in a lying and standing position. Because vaginal or uterine prolapse becomes more noticeable as intra-abdominal pressure increases, your doctor will ask you to cough or strain.

The gynecologist may also order the following tests:

• Ultrasound of the uterus
• If there is a problem with the functioning of the bladder, the doctor will prescribe an ultrasound or x-ray of the kidneys
• General urine analysis

What to do if the vagina or uterus prolapses?

Vaginal or uterine prolapse does not always need to be treated. If you do not feel any symptoms, nothing bothers you, and the gynecologist finds slight or moderate prolapse, then no treatment is prescribed. The gynecologist will recommend several exercises that strengthen the muscles and ligaments of the pelvis, and recommend that you return for a re-examination in 6-12 months.

If you have symptoms of prolapse, you will need treatment: some you can do at home, and some your doctor can do.

What can you do at home?

If you have detected prolapse of the walls of the vagina or uterus, listen to the following advice from gynecologists:

• Avoid standing for long periods of time. If this is unavoidable (for example, you need to stand in line), it is better to take a leisurely walk or sit down.
• Before getting up from a chair or lifting anything, take a breath, tense your pelvic muscles (as if trying to hold in gases), pull in your stomach a little and slowly exhale to perform the desired action.
• Avoid constipation. If you have frequent constipation, consult a gastroenterologist: until you get rid of constipation, prolapse of the vagina or uterus cannot be cured.
• During bowel movements, you should not strain or push too hard. If you have difficulty defecating, as you exhale, “inflate” your stomach so that it becomes round and say “shhh”, but do not hold your breath. Allow enough time to go to the toilet so that you are not in a rush, but you should not spend more than 15 minutes on the toilet. If you are unable to have a bowel movement within 15 minutes, try again later.
• If you are overweight, you need to get rid of it.
• Do Kegel exercises.

What can a doctor do?

If the vagina or uterus prolapses, conservative treatment may be prescribed (pessaries and replacement hormone therapy) or surgery.

Pessary

Your gynecologist may recommend wearing a special device that supports your uterus and prevents it from falling below a certain level. Such devices are called "pessaries", or simply uterine rings (although there are other forms of pessaries, not just in the form of rings).

If the gynecologist believes that you can remove and install the pessary yourself, he will teach you how to do it correctly. In some cases, the pessary must be worn constantly, in other cases it will need to be removed before going to bed. If there is slight prolapse of the vagina or uterus, the pessary will need to be installed only before long walks, physical activity etc.

A pessary does not cure uterine prolapse, but it can help relieve the symptoms of the condition and make your life much easier.

Hormone replacement therapy with estrogen

The leading cause of vaginal or uterine prolapse during menopause is a lack of estrogen hormones in the blood. Substitution treatment estrogen can be an effective method of strengthening the muscles and ligaments of the pelvis. Typically, when genital prolapse occurs, estrogens are used in the form of vaginal creams or suppositories, which must be inserted directly into the vagina.

Surgery for prolapse of the vagina and uterus

If conservative treatment does not help, or there is grade 3-4 uterine prolapse, then surgery is prescribed. The operation can be performed through an incision in the abdomen or through the vagina.

During the operation, the doctor can install a special implant - a structure that will hold the pelvic organs where they should be normally. In some cases, the gynecologist may recommend removing the uterus.

After surgery, you will not be able to lift anything heavy for at least 6 weeks, and for another 3 months you should avoid any situations that increase genital prolapse: constipation, coughing, smoking, weight gain.

How to prevent prolapse of the vagina and uterus during menopause?

• Maintain a normal weight for your height.
• Eat right to avoid constipation.
• Do Kegel exercises.
• Do not lift heavy objects (more than 5 kg).

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