Vaginal prolapse, or prolapse of the vaginal walls, is a complex pathological process. It is most often observed in women who have given birth after 50 years. The prevalence between the ages of 30 and 45 years is 40%, before 30 years 10%. In some cases, this disease manifests itself at a young age, even in nulliparous women.
This pathology is possible due to weakening of the pelvic floor muscle. As a result, both the anterior and posterior wall of the vagina may fall out. If the anterior wall prolapses, the urethra and bladder simultaneously shift. With pathological prolapse back wall displacement occurs, and in more severe cases, prolapse of the rectum.
Vaginal muscles - their necessity
The muscles and tendons of the vagina are involved during the period of conception, during pregnancy, and during childbirth. And the physiological course of pregnancy and the period of childbirth depends on the state in which they are.
During pregnancy, the muscle layer of the vagina hypertrophies, and increased tissue hyperplasia occurs. This helps give the muscle fibers special elasticity. This has a beneficial effect on the biomechanism of childbirth, in which the vagina acts as the birth canal.
The passage of a newborn through the birth canal directly depends on the muscular state of the vaginal walls.
Causes of prolapse of the vaginal walls
This pathological condition is not one-time, it develops over a long time. This occurs due to an increase in the pressure of the internal organs (uterine body, bladder, rectum) on. The result of this long process is the drooping of the vaginal walls, sometimes their complete loss.
This disease may be accompanied and cause development by the following abnormal conditions:
Most often, the anterior wall prolapses. Dropping or falling out of both walls is rare.
Degree of development of prolapse of the vaginal walls
In the development of this process, it is customary to distinguish 3 degrees of the disease:
If pressure is exerted by a displaced bladder, this leads to cystocele disease. Less commonly, a rectocele occurs, which is caused by displacement of the posterior vaginal wall.
Symptoms of vaginal wall prolapse
The development of this pathological process can occur over several decades. And only sometimes, due to a difficult birth or improper obstetric care, the process can be more rapid.
The patient may feel the first symptoms in the form.
As the disease progresses, the following signs appear:
On early stage, the woman does not go to the doctor because nothing bothers her. However, during a vaginal examination, which is carried out during a medical examination, the gynecologist may see a slight sagging of the vaginal wall.
More late dates lead to the development of hernial protrusion. In this process, the vaginal wall is a hernial sac, and contains a section Bladder.
Similar clinical picture, can also develop with the posterior wall of the vagina. With this development of pathology, part of the rectum will end up in the hernial sac.
Diagnosis of prolapse of the vaginal walls
To make a correct diagnosis, in most cases, it is enough for the gynecologist to do a preliminary examination using a vaginal speculum, as well as a palpation examination.
After these measures, the prolapsed organs are repositioned, and the condition of the pelvic floor muscles is simultaneously assessed. Additional examination methods are prescribed by the doctor.
- Cystoscopy.
- Excretory urography.
- examination (sometimes transvaginal ultrasound is prescribed).
- Consultation with a urologist, followed by a urodynamic study.
- In case of prolapse of the posterior vaginal wall, a mandatory consultation with a proctologist is required.
Prolapse of the vaginal walls pregnancy and childbirth
When pregnancy occurs, even in a healthy woman, the musculo-ligamentous system is subjected to great stress. This is due to the growth of the fetus. In the case when the patient is diagnosed with prolapse of the vaginal walls, a favorable pregnancy outcome is possible only at the initial stage.
At the same time, throughout the entire period of gestation, it is necessary to use a set of therapeutic Kegel exercises, be sure to wear a bandage, or use a pessary (this is a plastic ring that is inserted into the vagina and increases its muscle tone).
Features of treatment:
To avoid this pathology, it is enough to see a gynecologist once every six months, and without his appointment, do therapeutic exercises every morning.
Treatment of prolapse of the vaginal walls
To choose the right treatment tactics for this disease, its degree is determined. Only a doctor can do this.
If this pathology is in the first stage of the disease, then the patient can be treated with a conservative method of therapy. In the third or fourth degree, the main treatment tactic is surgical intervention, followed by preventive measures.
Conservative method of treating prolapse of the vaginal walls
This technique involves a set of measures to increase muscle tone. For this purpose it is prescribed:
- Physiotherapy.
- Massage.
- Wearing a bandage or pessary.
- Application of traditional healing methods.
- Switching to dietary nutrition.
- In old age, with the onset of menopause, hormone therapy can be used.
Physiotherapy
Complex therapeutic exercises selected individually, it is necessary to practice daily, preferably in the morning before breakfast.
To do this, you can use the following exercises:
The entire set of exercises should begin with a minimum amount of time and repetitions, and the load should be increased gradually.
Massage
To carry it out, a gynecological chair is used. With one hand, the gynecologist performs massage actions, inserting two fingers into the vaginal lumen, and with the other hand, performs massage movements along the anterior abdominal wall.
The number of sessions should be at least 10, after which a short break is taken and a second course of massage occurs.
A necessary condition during the entire course is that the patient should sleep only on her stomach. The session lasts no more than 15 minutes, when severe pain it is no longer appointed.
Wearing a bandage and pessary
A bandage is a special swimming trunk that has a high waist. Highly elastic knitwear is used in their production. Modern versions of this product make it invisible under clothing. Using special hooks located on the side, the degree of tension can be adjusted.
With the right tension, it does not restrict movement, is comfortable to wear and hygienic.
To prevent sagging of the vaginal walls, you can use a pessary. These products are made of plastic or silicone and come in various shapes, most often in the form of a ring. The shape and size are selected by the gynecologist individually, taking into account the physiological characteristics of the patient.
It is very important that the pessary is installed by a gynecologist for the first time.
After 2 weeks of wearing the pessary, you must see a specialist. It can be worn for no more than 1 month, after which a short break is taken. Be sure to treat with an antiseptic at each subsequent administration.
Correct use of the uterine ring will allow you to:
- In some cases, refuse.
- Will prevent prolapse of the vaginal walls.
- Avoid the unpleasant symptom of urinary incontinence.
- Save and bear the child.
Particular attention must be paid to proper diet. The food consumed should not lead to increased gas formation in the intestines. It is also necessary to avoid constipation.
To do this you need:
- Diversify your diet with vegetables and fruits.
- Food products must contain a large number of coarse fiber.
- Eliminate legumes from your daily diet.
- Do not eat fatty fried meat.
- If possible, use boiled food, liquid soups and cereals.
- Monitor the intestinal microflora, use laxatives if necessary medicines and prebiotics.
Application of traditional healing methods
Therapy medicinal herbs, with the help of which infusions are made, gives a positive effect only at the initial stage of this pathological process. Using Recipes traditional medicine cannot be the main type of treatment; it is used as an additional method. At the same time, the use medicinal herbs must be agreed with the gynecologist.
To improve muscle tone and strengthen ligaments, you can use:
Surgical treatment of vaginal wall prolapse
If conservative treatment did not lead to the appearance positive results, or this one is at the 3rd or 4th stage of its development. This provides a basis for carrying out an operable treatment method for this abnormal development.
Surgery can be performed using 2 methods:
The surgical intervention may consist of two stages. During the additional stage, internal organs are sutured, which exert excessive pressure (due to their prolapse) on the vaginal walls.
This makes it possible to restore the anatomical location of these organs, after which they will restore their physiological functions.
Anterior colporrhaphy
Front wall tightening is carried out through the vaginal lumen, this avoids an incision in the abdominal wall. As a result, surgical intervention becomes less traumatic and causes slight psycho-emotional discomfort to the sick woman.
Before surgery, older women, especially during menopause, are prescribed. They increase blood circulation and normalize the process of tissue restoration after surgery.
During the rehabilitation period it is prescribed antibacterial therapy, drugs from the analgesic group. The patient is given recommendations, including being warned to abstain from sexual contact.
Posterior colporrhaphy
Its main goal is to restore the septum between the rectum and the vaginal wall. The group of muscles holding the anus is sutured. This leads to strengthening of the rectovaginal septum. If necessary, removal (if any) of hemorrhoids, polypous growths, treatment of anal fissures and anal sphincter is carried out.
Colpopexy
This type of operation is used infrequently, since it removes the consequences of prolapse, only temporarily. But if it is used in combination with colporrhaphy, it gives good positive dynamics in the treatment of this pathology.
The essence of this surgical treatment is that the weakened walls of the vagina are sutured to the ligaments and fascia of the inner walls of the abdomen. This type of surgical intervention has received a “second life” due to the use of advanced technologies in medicine and the use of new materials (polypropylene mesh is used).
The rehabilitation period after surgical treatment
The recovery period can last from 5 to 20 days. This depends on the technique used during surgery.
Patients are prescribed:
Upon discharge from the hospital, a woman is given a number of recommendations that she must follow in order to prevent the recurrence of the pathological condition:
- Avoid eating foods that cause increased gas formation. If constipation occurs, take a laxative; if it does not help, resort to an enema.
- Monitor the condition of the external genitalia, maintain intimate hygiene in order to prevent infection of the sutures and the development of inflammatory processes.
- Prevent the occurrence of dyspeptic disorders in the form of diarrhea. It causes infection of the mucous membranes of the vulva and vagina, this leads to the development of inflammatory diseases and increases the rehabilitation period.
- To allow the sutures to heal for one and a half weeks, the patient is prohibited from sitting or squatting. Even when traveling by car, she should resort to a semi-sitting position. This will avoid stress on the perineum.
- Sexual activity is prohibited for 60 days after surgery.
- Avoid any physical activity for the first weeks, this also applies to homework.
- Any kind of sports is prohibited. They will be possible only after a follow-up examination by a gynecologist, approximately 2-3 months later.
- Baths, solariums, saunas, and swimming pools are prohibited in the first months.
- During the first six months after surgery wear a bandage.
- Be sure to visit your doctor on the dates indicated by him. If any anxiety symptoms, do not self-medicate, but go to the clinic.
A set of therapeutic exercises
During the rehabilitation period it is not allowed to use physical activity, but after 2 or 3 months the doctor prescribes therapeutic exercises. It should be dosed, and you should start using it gradually (records are not needed in this case).
You can use different types of exercises and create a complex of them that will be performed daily in the morning.
To do this, you can use the following exercises on all fours:
Exercises while lying on your back:
All exercises are performed at a slow pace, with mandatory breathing control. It is best to do this 2 hours before meals (before breakfast).
Kegel exercises to strengthen the vaginal walls
Basic Kegel exercises include:
Prevention of vaginal wall prolapse
Preventive measures to eliminate this pathology should be carried out upon reaching the age of 18 years. This will contribute to the normal course of pregnancy and the smooth passage of childbirth.
To do this, you must follow the following rules:
Medical workers play a major role in preventing this pathology.
Since it depends on them:
- Proper healing of the perineum during postpartum ruptures.
- Rational management of childbirth, and correct application obstetrics.
- Proper repair of perineal muscle tears.
This pathology can lead to the development of serious gynecological diseases. Therefore, in order to eliminate prolapse of the vaginal walls, in the early stages, use all possible conservative methods treatment.
If the disease was recognized only at a later date, agree on the date of the operation with the doctor and do not delay it.
Vaginal prolapse is positioned as a pathological condition of the female genital organs. The main cause of this disease is weakness of the pelvic floor muscles.
Recently, this disease has become younger. Thus, ten out of a hundred patients with such problems are under thirty years of age. About twenty percent of all cases are women aged 30 to 45 years. Moreover, not in every case the reason lies in the fact that the woman recently gave birth to a child. Thus, there are isolated cases when the disease affected young girls and even virgins.
Why does omission occur?
It looks like a visual and physiological change in the normal placement of internal intimate organs. At the same time, the muscles of the abdominal region and pelvic floor are weakened. This happens because too much pressure was recorded inside the abdominal area, which led to a deterioration in the elasticity of the ligaments. It turns out that they can no longer save internal organs in their normal position. This means that a woman loses muscle tone and the vaginal tissue begins to sag downwards.
There are many reasons for the development of pathology:
- Anomalies in the development of connective tissue may well be congenital,
- Intra-abdominal pressure was excessively increased (respiratory viral diseases, constipation),
- Birth complications (labor was too long, trauma to the vagina, the baby was quite large, obstetricians were forced to use forceps),
- Sudden loss of body weight,
- Surgical intervention to remove the uterus without subsequent fixation of the vaginal dome,
- Age-related changes. After sixty years, prolapse of the vaginal walls affects quite a lot of women, because at this age the elasticity of the tissues gradually deteriorates.
- Several births. If a woman gives birth two or more times, then the risks of prolapse of the vaginal walls become much higher.
How does the disease develop?
The disease is characterized by a rather slow pace of development at the very beginning and active progression, provided that it is not treated in time. In addition, this can lead to inflammatory processes.
The disease affects either the anterior or posterior wall of the vagina. However, it also happens that both walls go down at once. Practice shows that it is the prolapse of the anterior wall that is the most common. At the same time, in addition to everything, the woman’s bladder and urethra begin to descend. If the posterior wall of the vagina descends, parallel prolapse or even prolapse of the rectum begins. For this reason, the patient should be ready for a full examination by several specialists of different profiles at once, because this is the only way to achieve a complete recovery.
How to find out about prolapse and prolapse of the vaginal walls?
In the early stages, this disease does not manifest itself at all. The only thing a woman can pay attention to is pain during sexual intercourse. In addition, some heaviness and sensation may begin. high blood pressure in the vulva, after which inflammation begins, swelling of the vaginal opening, and unpleasant urination. Incontinence of urine, gas and feces may also be recorded. A nagging pain begins in the stomach, lumbar region experiences increased stress.
Prolapse of the anterior vaginal wall is often accompanied by chronic cystitis due to stagnation of urine. The posterior wall brings a foreign object (fullness) feeling to the vulva.
Diagnosis of the disease
Only a gynecologist can detect the disease in its early stages during an examination in a gynecological chair. The doctor can easily notice the walls protruding from the vagina. First, the gynecologist carefully adjusts them, and then assesses the condition of the pelvic floor muscles. After this, the patient is referred for additional examinations to determine whether there are additional problems.
Is it possible to get pregnant if the vaginal walls are prolapsed?
- this is not a death sentence for women who want to feel the joy of motherhood. There are many examples where both young and older women could still give birth to a child after such cases. However, it is necessary to focus on the stage of development of the disease. So, if the disease is in the first stage, you can get pregnant and give birth to children even without prior surgery. If the disease is at the second or more stages, an appropriate operation must be performed. Only under this condition can a woman become a mother. Otherwise, the risk of uterine prolapse cannot be avoided.
It is also important that after surgery to restore the vaginal muscles, a woman will not be able to give birth on her own: the child will be born exclusively by caesarean section.
Treatment of vaginal prolapse
Depending on the stage, such a disease can be treated both conservatively and surgically. The risk of complications with any of these approaches will be minimal.
Conservative therapy consists of certain exercises that are aimed at developing the pelvic floor muscles and strengthening them. In addition, the doctor prescribes a certain diet that must be strictly followed.
Surgery is prescribed for complex stages that conservative therapy cannot cope with. It is carried out mainly under general anesthesia, however, at the second stage local is also possible. Recovery after surgery takes several days.
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Prolapse of the vaginal walls (vaginal prolapse) is an anatomical disorder resulting from weakening of the pelvic floor tissues. The walls shift towards the perineum.
The pathology is common among women after 30 years of age.
The Center for Gynecology, Reproductive and Aesthetic Medicine www.ginekologi.pro employs specialists with extensive experience. They individually select a treatment method for each woman in accordance with the characteristics of the anatomical structure.
Structure of the vagina
The vagina is a distensible organ about 7-12 centimeters long. It connects the cervix and the entrance to the genital opening. Consists of an inner, middle and outer layer of tissue.According to the physiological structure, the vagina is divided into anterior and posterior walls, connected to each other.
The anterior wall connects to the cervix and borders the bladder and urethra. The posterior wall in the upper part borders the abdominal cavity and is located next to the rectum.
The organ is held in place by the muscular-ligamentous system. The upper and middle part of the organ is attached to the pelvic bones and the lower part of the uterus. The muscles are responsible for holding the vagina in the lower part near the pelvic floor and closing it.
With the development of prolapse of the vaginal walls, the functioning of surrounding organs is disrupted.
Causes of pathology
The following factors can provoke prolapse of the vaginal walls:Degrees and types of vaginal wall prolapse
The classification of vaginal prolapse divides the pathology into the following types:There are three degrees of omission:
1. Only the front or back wall moves a few centimeters, while being located within the vulva. There is incomplete closure of the labia due to the pressure of the uterus. The woman notes pain, similar to discomfort in the premenstrual period, unpleasant sensations.
2. Displacement provokes displacement of the bladder and/or rectum. The muscles relax greatly, the walls protrude outward a little. The cervix changes its position, the uterine os descends. A woman experiences signs of cystitis or constipation, pain when walking and sitting for long periods of time.
3. The vagina does not stay within the pelvic floor and completely falls out of the genital slit. The walls turn outward. The mucous membrane dries out, and ulcers, erosions, and cracks appear. The woman cannot sit or walk.
Pregnancy and childbirth with prolapse
Throughout the entire period of bearing a child, the risk of infection of the genital tract is increased. In addition, partial prolapse of the walls affects the ability to conceive. If pregnancy occurs, it may end in premature birth or miscarriage due to weakness of the ligamentous apparatus.
Experts recommend that pregnant women do Kegel exercises. They not only strengthen the tissues of the genital organs, but also stimulate easier labor. To reduce the load on the vagina, a rubber pessary is installed. A woman must wear a bandage for all 9 months.
When the vaginal walls prolapse, the process of delivery changes. The likelihood of injury to the muscular structures of the pelvis increases. The risk of developing ligamentous insufficiency increases.
Often, to prevent vaginal prolapse, a perineal incision is made, which is most often improperly sutured.
If episiotomy is not performed when weakened muscle tissue, then during childbirth not only the vaginal walls, but also the entire organ may fall out.
Often, childbirth serves as a provoking factor in the development of severe uterine prolapse due to a decrease in muscle and ligamentous tone, non-compliance proper nutrition and the occurrence of constipation, heavy lifting in the early postpartum period.
To avoid the above problems, it is necessary to eliminate the physiological disorder before planning pregnancy. initial stage allows you to bear a fetus without surgical treatment, but while strengthening the muscles of the intimate area and abdominals.
Diagnostics
Early degrees of prolapse are often similar to diseases of the urinary system. Vaginal prolapse is detected using:At an advanced stage, a urologist, surgeon and proctologist are involved in the diagnostic process to determine the degree of complications. As a rule, the pathology is visible to the naked eye.
Treatment methods
Based on the degree of prolapse, the specialist chooses different tactics to eliminate the disease.Conservative treatment
It is optimal at the first stage, when the organ is located within the small pelvis.
Often, a pessary is installed - a rubber ring that supports the woman’s genitals. The size is selected individually. The structure is inserted diagonally, then straightened out, resting on the bottom of the pelvis.
Surgery
The operation is prescribed when diagnosing the second and third degree of vaginal prolapse.
It is expected that measures will be taken to correct the intestinal cavity, restore sphincter functions, and strengthen the wall bordering the intestine.
The surgical procedure is called colporrhaphy. The procedure involves suturing excess tissue of the posterior vaginal wall to the muscular structures of the perineum and strengthening the septum. Stitching is necessary to remove compression of surrounding organs. It is performed transvaginally.
Another operation is called colpoperineorrhaphy. It involves resection of excess vaginal walls and tightening of the muscular structures of the perineum.
In some cases, a mesh implant is sewn in to prevent re-displacement.
Postoperative period
After the operation, antibacterial drugs, suppositories against inflammation, and the use of local ointments and antiseptics are prescribed.
During rehabilitation, it is important to follow the following recommendations:
For the first and second degrees of vaginal prolapse, the treatment prognosis is favorable. The anatomical position of the vagina is completely restored. In the third degree of pathology, in order to avoid relapses, it is necessary to strengthen the intimate muscles.
Gymnastics and exercises
Exercises are effective as a supplement to drug treatment. Kegel exercises involve alternating tension and relaxation of the muscles of the genital tract.
Exercises to strengthen the abs and back are also prescribed.
Prevention
Every woman wants to prevent pathology, not treat it. For this purpose it is recommended:
Vaginal prolapse is a condition in which the vaginal walls droop due to weakening of the pelvic floor muscles, which can lead to uterine prolapse.
A gynecologist can identify prolapse of the vaginal walls and assess the degree of decrease in muscle tone.
Regular examination at least once a year will tell you when the muscles begin to lose tone and require stimulation.
How does vaginal prolapse manifest?
Symptoms of vaginal prolapse are numerous and depend on the cause that led to the weakening of the muscles.
Women often complain about the following problems:
- frequent urination;
- pain in the lower abdomen and perineum;
- incontinence of feces, urine and gases;
- constipation;
- copious discharge of an unusual color with an unpleasant odor;
- itching in the vagina and external genitalia;
- feeling foreign body in the vagina;
- frequent infectious and inflammatory diseases of the genital organs.
What causes vaginal prolapse
Vaginal prolapse is caused by various reasons:
- In women over 50 years old, age-related muscle weakening occurs. Tissues lose elasticity and sag under pressure from internal organs.
- In sedentary young women, the muscles weaken due to the lack of the necessary range of movement. Prolonged stay in a sitting position, movement by transport, passive rest in free time contribute to a decrease in the tone of the vaginal muscles.
- During childbirth, the muscles of the perineum are stretched under the pressure of the fetus and do not always quickly restore their tone. Mothers with many children are at risk.
- Hormonal changes in the body lead to weakening of muscle tissue and accumulation of fatty tissue. This happens with age, as a result of diseases endocrine system or taking hormonal medications.
- Frequent constipation and a strong, lingering cough stretch the pelvic floor muscles and cause varicose veins. The accumulation of feces in the rectum increases its pressure on the vaginal walls and gives rise to hernias.
- Lifting weights leads to deformation of the vaginal muscles.
- Obesity also contributes to vaginal prolapse. The pelvic floor muscles find it difficult to support heavy weights and gradually become stretched. However, sudden weight loss can lead to the fact that the muscles do not have time to adapt to the new weight.
- A long absence of sexual relations leads to weakening of the pelvic floor muscles.
Stages of vaginal prolapse
The prolapse of the vaginal walls occurs gradually. First, there is usually a drooping of its front wall. It is connected to the urogenital diaphragm; weakening of the muscles of the anterior wall or rupture of the perineum leads to prolapse of the bladder. The result is a hernia called cystocele, which is often accompanied by inflammation of the bladder.
After the anterior one, the posterior wall of the vagina is usually weakened. The rectum depends on the posterior wall, which falls out after the muscles weaken. And again a hernia results, doctors call it rectocele.
When both walls weaken, the muscles slowly begin to fall down, followed by the uterus. If the muscles weaken completely, the uterus may fall out. abdominal cavity out. This is the most advanced version of the disease.
There are 3 stages of vaginal prolapse:
- weakening of muscles without the formation of hernias,
- weakening of muscles with the formation of hernias,
- complete prolapse of the vagina with prolapse of the uterus.
How is vaginal prolapse diagnosed?
If vaginal prolapse is suspected, the diagnosis is carried out by a gynecologist. At advanced stages of the disease, this pathology is noticeable even during an external examination without the use of instruments.
Additional information is obtained from an ultrasound, which shows how much the internal organs have shifted as a result of weakening of the pelvic floor muscles. It is important to determine the extent of the disease to choose treatment tactics.
Additionally, blood, urine, vaginal discharge, and hormonal screening are analyzed. Consultation with a proctologist, urologist and endocrinologist may be required.
Treatment of vaginal prolapse
Treatment always depends on the cause and extent of muscle weakness.
At the first stage (in the absence of hernias and uterine prolapse), the woman is recommended to naturally strengthen her muscles with the help of special exercises. The main assistant in this is physical therapy. Walking, swimming, yoga, gymnastics are useful. Forceful loads that cause pressure on the internal organs inside the abdominal cavity are contraindicated. You cannot lift weights or engage in wrestling.
There are special exercises to strengthen intimate muscles. The Kegel system is very effective. The main task of practitioners is to squeeze and unclench the pelvic muscles with different intensities, speeds and holding times. At first, you should work with all muscles at the same time: when they are equally weakened, it is difficult to work with one muscle group. Next, it is useful to isolate muscle groups and strain them alternately. You should work with the lower abdominal muscles, intimate muscles, buttock muscles and rectal sphincter. It is better to conduct classes in an inverted position, for example, in the “birch tree” position. This will prevent pinching of prolapsed organs and ensure the outflow of venous blood from the pelvis. It is useful to do this even for healthy women for prevention.
Gynecological massage and myostimulation of the uterus have a beneficial effect.
For hormonal problems, correction is prescribed hormonal levels. These can be tablets or local remedies in the form of suppositories, creams, gels.
In the presence of inflammatory process Antibacterial therapy is prescribed. Pelvic inflammatory disease often accompanies the later stages of the disease.
At stages 2 and 3 of the disease, when vaginal prolapse is complicated by hernias and uterine prolapse, surgery cannot be avoided. The vaginal walls are sutured to normal size - vaginal plastic surgery is performed. After surgery, it is important to undergo treatment and take measures to prevent relapses.
It is important to eliminate the causes of vaginal prolapse - constipation, flatulence, excess weight. This is the only way to make sure that the disease does not return again after treatment. Treatment of the digestive organs and nutritional correction are required: changing the composition of foods, the method of preparing them, and the diet.
If the operation cannot be performed, and the uterus is about to fall out, the gynecologist inserts uterine rings called pessaries into the vagina. A bandage is placed on the abdomen to relieve pressure from the organs. The ring holds the uterus in the abdominal cavity, but with this method there is a possibility of an inflammatory process. Prevention of complications using douching and strengthening of local and general immunity are indicated.
Without treatment, vaginal prolapse leads to uterine prolapse.
This disease reduces a woman’s intimate sensitivity, she does not enjoy sexual intimacy, and her personal life suffers. Lack of orgasm is often caused by this disease.
Quality of life is also reduced by urinary, fecal and gas incontinence, which occurs as a result of weakening of the anterior and posterior vaginal walls. In this case, women have to use special pads.
For women planning a pregnancy, it is especially important to keep the pelvic muscles in good shape. During pregnancy, weak pelvic floor muscles may not be able to withstand the growing pressure, which can lead to premature birth, weak labor and postpartum problems associated with decreased tone of the vaginal muscles.
The specialists at the Frau Klinik Department of Aesthetic Gynecology offer patients a full range of both non-surgical and surgical methods treatment of pathologies.
Non-invasive methods include:
As part of surgical treatment, patients undergo:
Uterine prolapse - what is it?
The disease occurs when the tone of the muscular structures of the pelvic floor decreases. The essence of the problem is the gradual displacement of the body of the uterus towards the vagina, while its cervix is in its previous position. In severe cases of pathology, even complete prolapse of the organ can occur.
Gynecologists distinguish three categories of disease:
- The location of the uterus is slightly changed, it is shifted closer to the vagina, and there is a slight deformation of the cervix.
- The position of the uterus is significantly changed, it sags inside the vagina, as a result of which it changes shape.
- Extreme stage: the uterus does not have a fixed position, it can move outside the vaginal cavity partially or completely.
Causes and factors contributing to prolapse of the uterus and vagina
Reduced amount of collagen in connective tissue
A slowdown in the rate of production of collagen fibers in the body entails a gradual stretching of the ligaments, and, as a result, leads to prolapse of the pelvic organs.
Decreased muscle tone
The disease occurs when the tone of the muscular structures of the pelvic floor decreases. The process may be due to both physiological changes in the pregnant woman’s body and overload on the pelvic muscles during childbirth, as well as neglect of the doctor’s recommendations regarding the nutrition and physical activity of the young mother. The correct (healthy) location of the uterus is between the rectum and bladder. If tone is lost, the muscles can no longer prevent the uterus from moving towards the vagina.
Mechanical damage and birth injuries
The position of the uterus is also affected by injuries to the perineum received by a woman during childbirth or for some other reason. In the case of a difficult birth and long-term stress, the abdominal muscles may also suffer.
Age-related changes
As a woman ages, the production of estrogen decreases, which leads to a gradual loss of muscle tone. IN menopause Symptoms of uterine prolapse bother women much more often.
Excess weight and gastrointestinal problems
In some cases, uterine prolapse can be provoked by: excess body weight, which creates a constant additional load on all internal organs, as well as chronic pathologies of the digestive system (constipation, etc.).
Symptoms of uterine prolapse
At an early stage, the disease practically does not manifest itself at all, so it is most often recognized during an examination by a gynecologist or using an ultrasound.
In some cases, the process of descent is uneven: for example, only the back or front wall can change location. Therefore, the choice of treatment must be made taking into account all the features of the course of the disease.
With significant prolapse of the uterus, the pain becomes more intense, sharp pain occurs even when trying to sit down.
Diagnostics
If the problem is detected in a timely manner, there is a high chance of preventing the appearance of painful symptoms and surgical intervention.
The set of diagnostic procedures includes:
- examination on a gynecological chair,
- instrumental diagnostics,
- lab tests.
If necessary, the doctor may additionally prescribe: urography, ultrasound of the pelvic organs, colposcopy, tomography, urinalysis. In some cases, the opinions of specialized specialists are required: a proctologist and a urologist.
Treatment of prolapse of the vaginal walls without surgery
Surgical treatment of uterine prolapse
The diagnosis of uterine prolapse does not always imply surgery. In most cases, it is possible to cope with the pathology using conservative methods.
Surgical treatment is indicated in cases of uterine prolapse. There are two options for solving the problem: hysterectomy (complete removal of the organ) or its fixation.
Young patients
Perineoplasty with thread- a minimally invasive procedure, the purpose of which is the aesthetic and functional correction of the female perineum. Solves problems such as genital gaping, genital prolapse. To perform perineoplasty, a bidirectional vaginal mesothread made of biodegradable material is used, which over time, disintegrating inside the tissue, is replaced by collagen fibers. Result: strengthening of the perineal area, formation of an organic frame inside the tissues. Depending on the indications, the vaginal thread is inserted into the muscle layer or directly under the skin.
The procedure lasts about 1 hour and is performed in outpatient setting. The patient returns home the same day.
Colpoperineolevatoroplasty- an operation that involves suturing the vaginal wall and muscles. It is performed in tandem using synthetic non-biodegradable meshes. Implants create a supporting and reinforcing effect on the pelvic tissues.
3 types of vaginal surgery:
- the anterior wall is strengthened (if it and the bladder prolapse);
- the posterior wall is corrected to strengthen the rectum;
- The installation of both implants is performed in case of complete prolapse of the uterus, the organ is fixed with special ligaments.
Colporrhaphy- an operation aimed at correcting the size of the vagina. Depending on the situation, the doctor sutures its front or back wall.
At the first stage, the part of the mucous membrane to be corrected is selected. It is excised longitudinally, after which the tissues are stitched together in layers. The vagina becomes narrower. By using this method removal of postpartum scars is possible.
Older patients
Median colporrhaphy- the operation is performed on elderly women. This intervention excludes the possibility of sexual activity, as well as gynecological examination and cervical biopsy. Therefore, the presence of cervical cancer pathologies is a contraindication to the use of this method.
Radical method- used for severe forms of uterine prolapse, when the only option is removal of the organ. A hysterectomy is performed if there is no need to preserve the woman's fertility. The method involves a subsequent special course of treatment, exercise therapy, diet, and minimizing physical activity.
Surgical techniques
Operations for prolapse of the walls of the uterus and vagina
Why can’t we delay solving the problem?
Uterine prolapse is a serious pathology. Without treatment, patients experience many associated problems:
- urinary incontinence;
- bladder pinching;
- chronic constipation;
- rectal prolapse;
- intestinal dysfunction;
- vaginal eversion, etc.
Dear women! Please don't put off taking care of your health. Listen to your body. The earlier the disease is diagnosed, the faster and easier it will be to treat. Be healthy!
Gynecologists treating uterine prolapse at the Frau Klinik