Prolapse of the walls of the moisture, causes and treatment
Organs located in the lower part of the peritoneum in women (bladder, ureter, small intestine and rectum) do not have fixed form and retain a normal position with some support. Ligaments, fascia, muscles, create a movable frame, reminiscent of a suspension bridge, where the violation of one point leads to imbalance of the design. The domed shape of the vagina to the uterus at the top captures all the chords, providing the mutual displacement of organs to perform different functions.
As a result of trauma, weakening of muscles, violation of the elasticity of the ligaments develops prolapse of the vaginal walls, the causes of disease, treatment and prevention of this pathology will be analyzed next.
Prolapse of the vaginal walls is diagnosed in almost half of women after menopause. The reason are mainly age-related changes: natural weakening of the pelvic floor muscles, peritoneum, lowering the level of estrogen in menopause, sprains.
In women older than 30 such violation occurs less frequently and is associated with complicated childbirth or heavy physical loads (both permanent and one-time).
Girls and nulliparous women susceptible to the disease. Prolapse of the vagina in the antenatal period due to hereditary factors or congenital irregularities in the structure of connective tissue.
Modern gynecology notes a number of reasons that contribute to the development of pathology:
- chronic diseases causing a significant increase in intra-abdominal pressure (bronchitis, asthma, constipation);
- long, traumatic childbirth, improper suturing in episiotomy or tearing, mechanical injury of the perineum;
- the birth of every next child (after the second) increases the likelihood of prolapse of the vagina;
- obesity, as well as any sudden weight change;
- tumors of the genital organs (malignant and benign);
- unstable hormones, lack of estrogen during menopause;
- lack of exercise, sedentary work – in trained women, the incidence of disease is extremely rare.
The likelihood of prolapse of the vagina and prolapse of the uterus is much higher for the burdened heredity. If in the family there were cases of the disease, you should visit the gynecologist at least once every six months, carefully note any symptoms prolapse of internal organs.
Prolapse of the walls of the uterus and prolapse (prolapse) of the female genital organs, do not occur suddenly. The process takes years. With proper attention to their health, it can be timely detected and eliminated at an early stage. In the absence of treatment, the illness is exacerbated and accelerated. Diagnose this pathology in the four stages according to the international classification:
- Minor prolapse of the anterior vaginal wall or posterior wall, at least – of the vagina entirely. Anatomical defect is still not visible, the uterus is partially offset.
- The disease progresses: the cervix descends to the level of the genital slit, vagina protrudes out in the lower third.
- The vagina it falls to half of its length. If the prolapse accompanied by prolapse of the uterus, at this stage, the cervix is beyond the borders of the vagina.
- Complete prolapse of the vagina, often accompanied by prolapse of the entire uterus.
Practicing gynecologists use a simplified classification, as minor prolapse, not burdened with uterine prolapse, can be easily corrected without surgery.
The type of lesion are distinguished:
- with prolapse of the anterior wall of the vagina, respectively, occur prolapse of the bladder and urinary canal cystocele;
- if you roll the rear wall and the rectum falls towards the vagina – rectocele;
- prolapse of the uterus – ureterocele;
- loss of the dome and the whole of the vagina.
The front wall of the vagina is deformed more often, which inevitably leads to a prolapse, extrusion or prolapse of the bladder in women. Urine diversion is difficult, when it is stagnant a big risk of infections.
Stretching the back wall leads to the fact that through weakened fascia rectum partially bulges to the side of the vagina, forming a kind of pocket. This disrupts the normal process of defecation. In complex cases, evacuation is possible only after reduction of the intestine.
In most cases, prolapse of the uterus occurs simultaneously with rectocele or cystocele. Loss of the dome of the vagina is only possible after a hysterectomy (complete removal of the uterus), if not the proper fixation of the top of the vagina.
Even complete prolapse of the uterus is an undisputed indication for its removal. Developed many surgical techniques of fixation of the pelvic organs with their loss. Lack of a uterus makes it difficult to further fixation of the vagina, because you will loose the highest point of tension of the walls. Removal is indicated only when additional indications and complications.
How to recognize illness
In the early stages of prolapse of the vagina and a small change in the position of the cervix do not cause any specific symptoms. Common complaints in this period – the loss of sensitivity of the vagina, feeling its extensions, the inability to reach orgasm during sex. Periodic spasmodic pains in the lower abdomen, lower back women tend to attribute features of the monthly cycle.
When the disease progresses, note the hiatus (dysphonia) gender gap because of the increased pressure on the walls of the vagina. This condition greatly increases the risk of infection is accompanied by leakage of urine at any voltage. Heaviness, pain in the vulva (the external genitals) become permanent, the sexual act causes pain. The vaginal walls are dry, mucous hipertrofiada and cease to perform their protective functions. Develop inflammation, ulcers, polyps, erosion.
Depending on the type of prolapse of the vagina, the further symptoms vary with cystocele symptoms of cystitis, urethritis, with rectocele – constipation, inflammation of the rectum. A characteristic feature that the displacement or prolapse of the uterus, the pelvis was the cause of all these complaints is a feeling of foreign body inside the vagina, celebrated by most women.
Diagnosis of the disease is simple. Regular gynecological techniques can determine the presence of the process in the early stages. The later stages are determined visually when vaginal examination. But why did the omission of the authorities, find out through thorough examination, including a consultation of the urologist and the proctologist sure. Even surgical suturing prolapse of vaginal walls without addressing the causes of the disease, making the treatment short-lived, and relapses threat.
Treatment: conservative and surgical
With prolapse of the vaginal walls you must find the cause of this condition. Knowledge of the causes of the disease determines the treatment. If weakening of muscle tone have led to pathology, it will help the active lifestyle and special training. The presence of chronic diseases requires a serious and integrated approach. On 3 – 4 stages without the aid of a surgeon is not enough.
In the initial stages prescribed exercises, is effective in prolapse of the vaginal walls. While the process is only delineated and slow, it really is to stop using conventional physical education.
Training is to alternate tightening and relaxing of all the muscles of the perineum. At the same time strengthens the circular muscle of the sphincter and muscles that provide support to all organs in the pelvic region.
- The maximum involve in itself and to close the perineal muscles (not forgetting to stretch the anus), then relax. Repeat up to 15 times in one run. With enough training you can start to increase the speed force, each compression to produce more power and hold longer than the previous one.
- Urinary retention several times during a single emptying of the bladder. Gradually bring the time of one circuit of muscles to 20 seconds.
- Alternate the tightening of the perineum, with a slight straining effort to increase gradually during the training.
To perform the exercises at any time of the day: standing, sitting, lying, even on the go. Gradually going into the habit, exercise becomes easy and effective daily prevention of loss of sexual organs, intestines, bladder in women. Useful such exercises for men to prevent hemorrhoids and improve blood flow of small pelvis.
Strong pelvic floor muscles make sustainable the whole musculo-ligamentous frame the peritoneum and prevent the displacement of other organs in women: prolapse of the ovaries, small intestines, stomach, fallopian tubes. Improves blood flow to the vagina increases its sensitivity.
To strengthen internal muscular frame a little strong muscles of your intimate areas, you will need other exercises to maintain the tone of the abdominal muscles and peritoneum. Exercises can be divided into the following groups:
- maximum abduction feet to the side, forwards, backwards, in different positions: standing, lying, on all fours, relying on his hands;
- strengthening the muscles of the upper and lower press: the rise of straight or bent legs lying on back (starting with arms along the body, further training, hands behind head);
- the combination of regular exercise practice Kegel: when tension or strain press is to tighten and relax the muscle, closing the entrance of the vagina and the anus.
The number of repetitions of each exercise in the beginning can be arbitrary, it is unacceptable to overload the muscles when there is at least a slight prolapse or displacement of the uterus. Gradually bring the number of repeats from a few at a time to 10.
Conservative (non-surgery) methods of fixing the normal position of the uterus are pessary is a special ring is introduced into the vagina. They are made of synthetic materials and are selected individually. The rings hold the uterus in position only if the muscles are strong enough. Otherwise, selecting each time the diaphragm of larger diameter, there is a risk of stretching the vagina, which will further weaken it.
With weak vaginal muscles are used sisterfor device from the vaginal ring with a support bandage. The bandage thus put on the waist. For a long period of wearing the brace it is impossible for hygienic reasons.
Gynecological ring – short-term and is not a treatment in the literal sense, it is only a temporary support for displaced body. Resort to them often, when surgical methods cannot be used. Pessary cause many side effects and complications:
- suppuration and ulceration of the vagina;
- swelling and inflammation of the mucous membrane;
- the ingrowth of the pessary into the tissue with a long presence in the vagina;
- the necessity of daily douches.
The only effective way to cure prolapse of the vagina on the last two stages of the disease is surgical intervention.
In surgical practice used dozens of types of operations that help to strengthen the inner frame of the female organs. Each case requires a special approach to the choice of methodology.
By type of access are distinguished:
- operations performed through the abdomen (classic or with the use of laparoscopy);
- surgery transvaginally (through the vagina).
The second option is used more often, it is less traumatic and leaves no visible scars. The method of operation is elected by the physician based on the severity of the disease, the condition of the connective tissue, age and health of each woman individually.
To strengthen the walls of the vagina in the traditional surgery uses your own tissue: the stretched fascia is gathered into folds and put on their joints. Due to the large number of recurrences (50%), this conventional method cannot be called effective. It is recommended for young women, subject to the application in parallel with other methods of correction.
The types colpoplasty (suturing of the vaginal walls):
- Colporate (front, back) – restore the normal position of the organs, with prolapse of the bladder or rectal prolapse in the space of the vagina, by removing the stretched tissues and their alterations.
- Median colporate is performed for women older than reproductive age at complete uterine prolapse.
- Colpoperineorrhaphy – suturing prolapse of the posterior wall of the vagina after childbirth, tightening of the muscles to hold the rectum in its normal anatomical position.
When the reason for vaginal deformation is a prolapse of the uterus, carried out operations for its mounting on the top of the vagina with organ preservation, partial amputation of (“Manchester” operation) or complete removal.
Modern prosthetic surgery uses to correct prolapse of internal organs special mesh materials. With their help strengthen weakened ligaments, replace damaged fascia. Particularly indicated for this kind of operations after relapses and gives the highest (95%) performance indicator.
Progressive method of surgery, a combination of synthetic mesh and native tissue for the reconstruction of the shape of the vagina, the surgeon requires great experience and skill. After a successful operation of an artificial mesh material becomes the basis for fouling its own tissues and can fully reconstruct a support unit of the vagina.
A vaginal prolapse during pregnancy
The growth of the fetus, the vaginal walls and the pelvic floor, and pressure is growing. Even strong healthy muscles and ligaments can be subjected to deformation. But if omitted the uterus were before pregnancy, prolapse occurs rapidly.
What to do in this case is decided by the gynecologist, because such a condition is dangerous, womb to the last trimester may fall to the lumen of the perineum. Natural childbirth in this case are contraindicated.
If prolapse of the uterus or vagina during pregnancy in the early stages, you can help vaginal ring, wearing the brace, special gymnastics. Training the muscles of the perineum will ease childbirth, prevent prolapse of the bladder, and intestine in the future.
What are the risks for women to neglect their own health and the desire to endure the uncomfortable symptoms arising from the reproductive organs? A condition that can be corrected easily in the early stages, becomes in the course of the disease, depriving the joy of motherhood, or even life-threatening. To avoid this, it is just time to visit the gynecologist. Timely detection of prolapse of the vaginal walls, the causes of disease, his treatment of modern and traditional methods allows you to return the woman’s health, working capacity, to improve the quality of life to a ripe old age.