II. Displacement of the female genital organs in the vertical plane: prolapse and prolapse of the vagina and uterus, prolapse of the ovaries and tubes, eversion and elevation (elevation) of the uterus. Uterine prolapse and ovarian cyst

Prolapse (omission, prolapse) of internal female organs- a very common disease in gynecology, ending in more than 10% of cases with serious operations. It is generally accepted that this disease overtakes women in old age, but in fact, the onset of the development of the disease falls on the fertile age and then only progresses.

Disease statistics

Prolapse of internal organs is widespread throughout the world. No less than 15 million women in the United States have this disease, and in India, for example, almost every woman is affected by this disease.

amazing disease statistics in women genitalia:

ten out of a hundred women are diagnosed with the disease at a relatively young age;
forty percent of women suffer from this disease in middle age;
more than half of older women have prolapse.

According to epidemiological data, more than ten percent of women undergo surgery due to the high risk of organ prolapse. More than a third of patients experience a relapse of the disease, which leads to repeated operations.

The structure of the genital organs of a woman

The uterus is a hollow, pear-shaped organ made up of several layers of muscles. The main and main purpose of the uterus is the development and bearing of the fetus for the prescribed period, followed by childbearing.

Normally, the uterus is located in the center of the pelvis along its longitudinal axis, which runs from the person's head to his legs. The uterus forms an angle to the anterior wall of the peritoneum due to the fact that it is tilted forward, this position of the uterus is called Anteversio. Between the cervix and near the vagina, another angle is obtained, this angle is also open forward.

For the normal functioning of organs during gestation and childbirth, both the uterus and appendages have the function of physiological mobility, but at the same time, to prevent prolapse, the uterus is very firmly fixed in the small pelvis.

Attachment of the uterus occurs with the help of ligaments and muscles:

ovarian ligaments- suspension ligaments. With their help, the appendages with the uterus are securely attached to the walls of the pelvis;
tight ligaments in order to fix the uterus with neighboring organs, as well as the bones of the pelvis;
muscles of the anterior wall of the peritoneum and fascia of the pelvis. As soon as these muscles stop being flexible and tight, then there is a prolapse of the genital organs. Normally, with normal tone, these muscles firmly fix the pelvic organs in the desired position.

The prolapse of the female genitals is called their omission, while in fact these organs are displaced or fall out of their boundaries. The location of the uterus or the vaginal walls, or both, may also be disturbed. In addition, very often formed cystocele is a protrusion of the bladder and rectocele- protrusion of the rectum. For ease of understanding, genital prolapse can be compared to a hernia.

Causes of prolapse of the genital organs

Various causes cause prolapse of the genital organs:

pelvic injury,
chronic diseases with impaired blood supply,
lack of estrogen in the body.

pelvic injury often occurs in difficult childbirth with perineal ruptures. It is also possible to prolapse of the genital organs during heavy physical work.

The large intestine can also suffer due to prolapse, constipation, colitis, increased gas formation due to stagnation of feces are possible.

Due to impaired blood circulation in the veins, varicose veins often occur on the legs, which can lead to serious consequences in the future.

Treatment

Prolapse treatment is divided into conservative and surgical. It depends on several factors: the severity of the development of the disease, age, the desire to maintain reproduction, concomitant diseases.

In the initial stages of the disease, conservative treatment is possible., which is aimed at strengthening the abdominal muscles, eliminating concomitant diseases, and adjusting the hormonal background if necessary.

In the third and fourth stages surgery is indicated. The type of operation depends on the degree of prolapse and is selected by the surgeon individually.

Prevention

In order to prevent the omission of organs and their further prolapse, it is necessary to observe preventive measures:

do exercises to strengthen the muscles of the pelvic girdle and abdominals;
try to refrain from hard physical work and heavy lifting, especially at an early age, when the genitals are forming;
follow recommendations for the proper management of pregnancy and childbirth;
stick to a diet ;
control chronic diseases.

Video: what is prolapse and prolapse of the uterus?

Dear women! To avoid prolapse and prolapse of the genital organs, regularly undergo a gynecological examination, listen to your feelings and lead a healthy sports lifestyle.

The ovaries are a paired organ of the female reproductive system, in which the maturation of eggs and the synthesis of sex hormones occur. The well-being of a woman, her appearance and state of health largely depend on their work. The production of a small amount of hormones occurs in the ovaries throughout life, and the peak of their activity falls on the childbearing age, which on average lasts 35-37 years.

After the menopause comes - the natural extinction of the female reproductive function. Such changes happen to a woman not by chance. With age, not only the body ages, but also the genetic material transmitted with the egg to offspring. Age-related changes in germ cells lead to numerous errors in DNA, which often ends in serious illnesses of the child. So, the frequency of having a baby with Down syndrome grows exponentially after the age of 40.

Ovarian exhaustion syndrome is a pathological condition in which a woman's menopause occurs much earlier than the aging process. It usually occurs at the age of less than 40 years on the background of normal reproductive function. The syndrome is rare - according to statistics, its prevalence in the population does not exceed 3%. There is a hereditary transmission of ovarian failure syndrome: in most cases, there are indications of such problems in the mother or close blood relatives.

Causes of pathology

To date, there is no consensus on what causes premature ovarian failure syndrome. Only a consequence is known - a sharp cessation of the maturation of follicles, respectively, and the synthesis of sex hormones. During the prenatal development of a girl, a strictly defined number of primordial follicles is laid in her gonads, and on average it is 400,000. After birth and until puberty, they are in an inactive state, since their maturation requires a signal from the outside - the hormones of the hypothalamus and pituitary gland.

These structures are located in the brain and are responsible for the work of the endocrine glands of the body like a conductor. At the time of puberty, the amount of gonadoliberin increases, which, in turn, stimulates the synthesis and release of follicle-stimulating (FSH) and luteinizing (LH) hormones into the blood. Under their influence, the growth of primordial follicles inside one of the ovaries begins. From 5 to 15 vesicles develop at the same time, but only one of them will reach final maturity and release an egg at the time of ovulation. As it develops, structures are formed in it that synthesize female sex hormones - estrogens.

During ovulation, the follicle bursts, the egg enters the fallopian tube, and the membrane remaining from the vesicle transforms into the corpus luteum. The latter synthesizes progesterone, the hormone of pregnancy. Under its influence, the female body prepares for conception and bearing a child. The described processes are also controlled by the hormones of the pituitary and hypothalamus in a negative feedback manner. This means that with a high content of estrogen or progesterone in the blood, the production of FSL and LH is suppressed, the ovaries reduce the activity of the synthesis of their own hormones, and the endocrine balance in the body is restored.

As already mentioned, the supply of primordial follicles is laid during fetal development and is not replenished throughout life. Therefore, after each menstrual cycle, it decreases and as soon as it reaches a certain minimum, a woman begins menopause. On average, the ovarian reserve lasts up to 45-55 years of age. Early ovarian failure syndrome has the same morphological basis - the number of follicles is not enough to further maintain reproductive function, however, it occurs much earlier than this age.

Among the provoking factors of the syndrome note:

genetic defects - in women whose mothers suffer from this pathology, it develops much more often than on average;
negative factors affecting the intrauterine development of a girl - mother's illness, severe psycho-emotional stress during pregnancy, poisoning, trauma disrupt the process of laying primordial follicles in a female fetus, and therefore their number can be sharply reduced compared to the norm;
ovarian resection during surgery to remove a tumor or gonadal cyst - a sharp decrease in the amount of ovarian tissue sometimes leads to premature ovarian exhaustion and menopause;
the influence of adverse environmental factors (poisons, toxins, viral infections, drugs) - affecting the ovarian tissue, they lead to an inflammatory process, as a result of which functional cells are replaced by connective tissue.

Manifestations

Symptoms of ovarian failure syndrome are identical to the manifestations of menopause. First of all, a woman pays attention to the irregularity of the menstrual cycle. Menses do not come every month, become scarce and gradually disappear altogether. On the same background appear:

Hot flashes and sweating - they occur suddenly, usually at night, after stress, plentiful food, changes in ambient temperature. The woman suddenly throws into a fever, she sweats profusely, the skin of the face and the upper half of the chest turns red. There may be a feeling of palpitations, pain behind the sternum, darkening in the eyes and a short-term loss of consciousness.
Changes in psycho-emotional status - a woman becomes irritable, tearful, prone to depressive thoughts. Any existing deviations in the psyche are aggravated, whether it be manic-depressive psychosis, psychopathy, depression. Night sleep is disturbed, anxiety appears, libido decreases.
Violations in the urogenital tract - a lack of estrogen in depleted ovaries entails atrophy of the mucous membrane of the vagina and vulva, a feeling of dryness, itching in the genitals and urethra, chronic inflammatory processes (colpitis, vulvitis, urethritis). Sexual life becomes unpleasant due to dryness and burning during intercourse.
Skin aging - in the presence of ovarian failure syndrome, it loses its elasticity, becomes thinner, numerous wrinkles appear on the face and hands. Hair becomes dull, brittle, dry, their density decreases due to heavy loss. Nails change: the nail plate exfoliates, grooves, bumps, white spots appear on it.
Metabolic disorders - the concentration of other hormones in the blood changes. Possible insufficiency of the thyroid gland or its excessive activity, leading to thyrotoxicosis. The latter is manifested by trembling hands, anxiety, outbursts of anger, palpitations, increased blood pressure and body temperature. In some cases, type 2 diabetes mellitus develops, metabolic syndrome, hyperadrogenism - a partial change in the body of a woman according to the male type due to the predominance of testosterone.

Without appropriate treatment, the symptoms of ovarian failure syndrome progress, which complicate the life of a woman and disrupt her activity.

Required Research

Diagnosis of the syndrome is within the competence of a gynecologist, gynecologist-endocrinologist. The doctor collects an anamnesis, paying special attention to heredity and harmful factors. He studies the complaints, the time of their appearance and examines the patient. Outwardly, the woman looks older than her age, age-related changes in the skin and hair are visible. When examined on a chair, the doctor reveals a decrease in the size of the uterus and its appendages, dryness of the vaginal mucosa.

To clarify the diagnosis, hormonal blood tests are performed, which reveal:

elevated levels of FSH and LH;
insufficient concentration of estrogen and progesterone;
low level of prostaglandin E2.

Since only the function of the ovaries suffers, the hypothalamic-pituitary system adequately responds to a decrease in sex hormones by increasing its activity. Trial administration of estrogen-progestin drugs reduces the level of FSH and LH up to the norm, causing a menstrual-like reaction.

Among the imaging methods, ultrasound of the uterus and its appendages is used, during which the following is detected:

reduction in the size of the uterus;
thinning of the endometrium to 0.5 cm or less;
a decrease in the size of the ovaries, the absence of large maturing follicles in them.

One of the reliable ways to diagnose early ovarian failure syndrome is. The surgeon observes small shriveled ovaries in the pelvic cavity, without signs of ovulation. During the examination, the doctor takes a small piece of gonadal tissue for cytological examination - a biopsy. The resulting material is studied in the laboratory, the replacement of the ovarian tissue with connective tissue, the absence of maturing follicles is revealed.

Therapy

The only possible treatment for ovarian failure syndrome today is hormone replacement therapy. Its essence lies in the fact that the introduction of female sex steroids from the outside to maintain a normal hormonal background. In rare cases, such measures lead to spontaneous restoration of reproductive function.

The task of a gynecologist is to choose the optimal drug that will reliably reproduce cyclic fluctuations in the concentration of hormones in a woman's body. To do this, use oral contraceptives containing estrogen and progesterone, such as Femoden, Marvelon, Regulon, Novinet. They should be taken under the supervision of a gynecologist with laboratory control of a biochemical blood test. They are prescribed for a period before the onset of physiological menopause, that is, up to 45-50 years.

Possibility of pregnancy

The main question that worries childless women: is pregnancy possible with ovarian failure syndrome? It is impossible to get pregnant naturally, since there are no mature eggs necessary for conception and no corpus luteum is formed in the ovary. The only way to become a mother with ovarian failure syndrome is. For the procedure, a donor egg and partner's sperm are used. A woman is prepared for bearing with increased doses of progesterone: under its influence, the endometrium reaches a sufficient thickness for implantation of the embryo.

Throughout pregnancy, the patient takes hormonal drugs that mimic the normal functioning of the ovaries. If it is impossible to prepare her body for bearing, they resort to surrogate motherhood.

When the vagina is lowered, one of its walls hangs down into the lumen of the vagina. 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 a cystocele. The rectum is located behind the vagina, therefore, when the posterior wall of the vagina is lowered, a prolapse of the rectal wall, or rectocele, is also observed.

When the uterus is lowered, its downward displacement is observed, and with a pronounced prolapse, the uterus can even “fall out” of the vagina. Of course, when we talk about “prolapse”, we do not mean that at one moment the uterus will come off the body and fall to the floor. Despite everything, the uterus remains securely attached to the body, however, when the uterus prolapses, it begins to “peep” out of the vagina.

Why does the prolapse of the vagina and uterus occur?

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

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

Who can develop prolapse of the vagina and uterus?

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.)
Is overweight or obese.
There are frequent constipation.
There is a chronic cough (chronic bronchitis, bronchial asthma).
The woman smokes.
There is a violation of the liver with the accumulation of fluid in the abdominal cavity (ascites).
There is marked enlargement of the spleen.
A woman lifts weights.

Is there a prolapse without symptoms?

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

How is the prolapse of the vagina and uterus manifested?

Sensation of a foreign body in the vagina, as if there were a small ball deep in the vagina.
Dull pain in lower abdomen.
Sensation as if something were falling out of the vagina.
Difficulty walking.
Difficulty in urination and defecation.

With a cystocele (drooping of the bladder wall), symptoms such as frequent urination, urinary incontinence, involuntary urination, and urinary retention may appear. .

With a rectocele (drooping of the wall of the rectum), there are difficulties in defecation, when more effort is needed to empty the intestines than before.

What are the degrees of uterine prolapse?

1 degree of prolapse of the uterus: the cervix is not above the vagina, as it should be normal, but descends into the vagina.

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

3 degree of prolapse of the uterus: the cervix "peeps" out of the vagina.

4 degree of prolapse of the uterus: the entire uterus "peeps" out of the vagina. This condition is also called uterine prolapse.

What tests are needed?

The diagnosis of prolapse of the genital organs can be made during the examination by a gynecologist. The doctor will examine you in the supine position and in the standing position. Because the prolapse of the vagina or uterus becomes more noticeable when the intra-abdominal pressure increases, the doctor will ask you to cough or strain.

The gynecologist may also order the following tests:

Ultrasound of the uterus
If there is a malfunction 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 is prolapsed?

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

If you have symptoms of prolapse, then you will need treatment: some you can do at home on your own, and some can be done by your doctor.

What can be done at home

If you have a prolapse of the walls of the vagina or uterus, heed the following advice from gynecologists:

Avoid prolonged standing. 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, inhale, tighten your pelvic muscles (as if you are trying to hold in gases), draw 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 a bowel movement, you can not strain or push hard. If you are having trouble passing a bowel movement, on the exhale, "inflate" your belly so that it becomes round and say "shhh", but don't hold your breath. Give yourself enough time to go to the toilet so you don't rush anywhere, but don't spend more than 15 minutes on the toilet. If you have not had 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

When the vagina or uterus is prolapsed, conservative treatment (pessaries and hormone replacement therapy) or surgery may be prescribed.

Pessary

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

If the gynecologist considers that you can remove and install the pessary yourself, then he will teach you how to do it correctly. In some cases, the pessary has to be worn all the time, in other cases it will need to be removed at bedtime. With a slight prolapse of the vagina or uterus, the pessary will need to be installed only before long walks, physical exertion, etc.

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

estrogen hormone replacement therapy

Surgery for prolapse of the vagina and uterus

If conservative treatment does not help, or there is a prolapse of the uterus of 3-4 degrees, then an operation 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 are supposed to be normal. In some cases, the gynecologist may recommend removal of the uterus. Our website has .

After the operation, you will not be able to lift weights for at least 6 weeks, and for another 3 months you should avoid any situations that increase the prolapse of the genital organs: 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).

The prolapse of the uterus is the displacement of its neck and bottom below the anatomical boundary, which occurs due to the weakening of the ligaments of the organ and muscles of the pelvic floor. Pathology gives a woman great discomfort and, developing, can lead to complete prolapse of the penis from the vagina.

Causes of pathology

According to statistics, this pathology is diagnosed in 50% of women after 50 years, in 40% of 30-40-year-olds, in 10% of young girls under 30 years old. The older a woman gets, the more likely she is to have a sexual problem.

The main provoking factors

Most often, the uterus changes its position in the small pelvis due to the weakening of its muscles and its own ligamentous apparatus. The following factors contribute to this:

Heredity.
Congenital pelvic defects.
Connective tissue dysplasia, as a result of which the synthesis of elastin and collagen proteins is disrupted.
Regular lifting of weights over 10 kg.
Hard physical labor.
Increased pressure inside the abdominal cavity caused by frequent constipation, chronic cough and obesity.
Menopause causing estrogen deficiency.
when the connective tissue is stretched and the muscles atrophy and cannot support the organs.

Psychological problems

Representatives of such a direction in medicine as psychosomatics believe that a woman's problem arises under the influence of psychological disorders (stress, anxiety, resentment, anger, depression).

Other reasons

The appearance of prolapse is preceded by violations of the anatomical integrity of the pelvic muscles as a result of bruises, blows to the abdomen, ruptures, car accidents, etc. Injuries can occur after surgical operations on the genitals.

Often, the appearance of pathology is affected, which are complicated by the large size of the fetus or its incorrect location before birth. There is a high probability of developing the disease after a cesarean section, an abortion. The ligamentous apparatus weakens due to frequent pregnancies and childbirth.

With an increase in intra-abdominal pressure, a downward displacement of the anterior wall of the rectum occurs, called a rectocele. If the bladder changes its position and moves down, a cystocele develops. Since these organs are located next to the vagina, a change in their localization leads to its omission. The exit of the vagina beyond the anatomical boundaries often precedes the appearance of uterine pathology.

Characteristic symptoms

The initial stage of the problem is characterized by pulling pains in the lower abdomen, radiating to the sacrum and lower back. A woman feels the presence of a foreign body in the vagina. Sexual intercourse is accompanied by unpleasant discomfort (). There are milky and bloody discharge from the genitals. There is a violation of menstrual function. The cycle becomes longer, the bleeding is more abundant. With this pathology, pain during menstruation becomes stronger than it was before.

Later, half of women with uterine prolapse begin to have problems with urination (miction): incontinence or stagnation of urine, rapid or difficult urination.

In 30% of cases, defecation disorders occur (fecal incontinence or persistent constipation), flatulence increases. With the pathology of the uterus in the pelvis, blood circulation is disturbed, which leads to the development of varicose veins of the lower extremities.

Diagnosis

Sometimes the prolapse of a muscular organ is detected by a proctologist or urologist, to whom the patient turns when problems with micturition and defecation appear. But more often, a gynecologist diagnoses a pathology during an examination of the internal genital organs of the patient. To determine the degree of development of the disease, the doctor asks the woman to push. Examining the vagina and rectum, the gynecologist reveals the displacement of their walls.

If pathologies are detected, colposcopy is performed (examination of the organs of the reproductive system using a colposcope device). This method allows you to clarify whether the patient, in addition to the underlying disease, has polyps or cervical erosion.

If a woman is diagnosed with other diseases of the muscular organ and surgical treatment of prolapse is planned, she is prescribed additional diagnostic procedures:

Ultrasound of the pelvic organs;
hysterosalpingography (examination of patency of the fallopian tubes);
urography (to exclude obstruction of the ureters).

Patients take swabs for microflora and atypical cells in order to exclude or detect inflammatory processes in the muscular organ.

CT and MRI methods make it possible to differentiate prolapse from diseases such as uterine inversion, vaginal cyst, and fibroids.

When all the studies have been carried out and the correct diagnosis has been established, they begin to treat the pathology.

The degree of development of the disease

Normal is the position of the uterus, in which it is located at the same distance from the walls of the pelvis, between the bladder and the rectum. The body of the organ is tilted forward, and its lower segment (neck) is tilted back. It is located at an angle of 70-90 ° with respect to the vagina, adjoining the external pharynx to its back wall.

If the hollow organ is affected by the above factors, the pelvic muscles and ligaments that hold the uterus in place are stretched. She begins to shift towards the vulva.

There are 4 degrees of female disease:

The longer a woman does not go to the doctor, the more violations occur in the uterus. Sexual intercourse becomes impossible, the patient experiences both moral and physical suffering, because the protruding organ bothers her not only with her appearance, but also with severe discomfort when moving.

Treatment Methods

In gynecology, 2 directions are used in the treatment of a female disease: conservative and surgical. Their choice depends on the following factors:

degrees of pathology.
clinical picture.
Gynecological diseases associated with prolapse.
Violations of the activities of neighboring organs.
The need to preserve childbearing function.
The age of the patient.
Degrees of risks at operations.

conservative methods

Drug and alternative therapy are effective at the initial stage of prolapse, when there are no disorders in the bladder and rectum. Women are recommended drug treatment with drugs containing estrogens, which strengthen the ligamentous apparatus and increase muscle tone. These medicines (Cilest, Duphaston, Fimuden) can be taken orally (in tablets) and topically (in the form of ointments or suppositories).

To relieve pain and normalize the menstrual cycle in the initial period of pathology, women use herbal decoctions of echinacea, chamomile, lemon balm, take baths with the addition of these plants.

To strengthen the pelvic floor muscles, patients should contract and relax them while doing Kegel exercises. The medical complex can be done. Patients are also prescribed gynecological massage, which improves blood circulation in the pelvic organs and has a positive effect on the ligamentous-muscular apparatus. The procedure is carried out by an experienced doctor in the clinic.

Older women are advised to use pessaries. These are elastic rubber rings filled with air for elasticity. They are inserted into the vagina, where they rest against its arches and are fixed on the cervix. Devices create an obstacle to the displacement of the body down.

Pessaries should not be worn continuously for more than 3-4 weeks, as they can injure the mucous membranes and lead to bedsores. To prevent negative consequences, patients are recommended to douche daily with a solution of potassium permanganate (potassium permanganate) or a decoction of chamomile and take a 14-day break after 3-4 weeks of use.

A special bandage has a good effect, which supports the muscles from below, from the sides, in front and behind. It is worn for no more than 12 hours and, after removal, they take a supine position so that the uterus does not move.

Surgery

For women with pathologies of 2-4 degrees and their accompanying rectocele or cystocele, a surgical solution to the problems is recommended. The following operations to eliminate the omission are distinguished:

In some cases, surgical treatment is carried out using several types of operations. The intervention is performed through the wall of the peritoneum by laparotomy or laparoscopy, or by vaginal access. After the operation, the patient is shown a diet that prevents constipation. A woman is prescribed therapeutic exercises, hard work and carrying heavy loads are contraindicated.

Possible consequences

The disease can lead to infertility and vein thrombosis. With prolonged pressure of the uterus on the organs of the excretory system, hydronephrosis occurs (atrophy of the renal parenchyma), urinary incontinence develops. With this pathology, infringement of intestinal loops or a muscular organ can occur.

The victim will often be disturbed by colitis (inflammatory processes in the large intestine), manifested by rumbling and pain in the abdomen, alternating diarrhea and constipation. There is a risk of uterine bleeding. The sensitivity of the vaginal walls may decrease or disappear, which will affect the intimate life of a woman.

Prevention

Prevention of omission should begin from a young age: the girl should not carry weights. Women and girls are not recommended to lift objects over 10 kg. It is necessary to treat diseases of the reproductive organs in a timely manner, to avoid their injury. At any age, it is necessary to eat right so that constipation does not occur, which increases intra-abdominal pressure.

Doctors should properly conduct childbirth, qualitatively sew up the tissue ruptures that have arisen during their course, and if injuries occur, prescribe laser therapy to women in labor.

Women need to do gymnastics, yoga, pump the press and strengthen the muscles of the pelvic floor with Kegel exercises. During menopause, estrogen replacement therapy is recommended.

And everything is connected with the fact that the walls of the vagina go beyond the boundaries of the genital gap, constantly in contact with the underwear and the rectal area.

The main reasons that bring women to the doctor are the following:

Ruptures of the vagina and perineum during childbirth;
Congenital pathology of the connective tissue (dysplasia).

Figure 2

Prolapse of the genital organs (in particular, prolapse of the uterus) is their downward displacement. The whole organ or any of its walls can be displaced.

Figure 3

And according to the literature, the lifetime risk of undergoing surgery to correct prolapse of the vagina and uterus is 11%.

The position of the pelvic organs (from prolapse of the vagina and prolapse of the uterus to its extreme degree: uterine prolapse) is usually assessed subjectively, using a scale from 0 to 3 or from 0 to 4 points. Zero points corresponds to the norm, the highest score corresponds to the complete prolapse of the organ. When prolapsed, the uterus goes beyond the genital gap completely (complete prolapse) or partially, sometimes only the cervix (incomplete prolapse).

the walls of the vagina reach the entrance to the vagina,

the body of the uterus is located above it

Prerequisites for the omission of the pelvic organs may be the following factors:

The problem of prolapse and prolapse of the vagina and uterus continues to be the focus of attention of gynecological surgeons, since, despite the variety of different methods of surgical treatment, relapses of the disease often occur. The solution of this problem is especially important in the treatment of patients of reproductive and working age. If there are minimal signs of prolapse of the walls of the vagina, it is already necessary to take preventive measures.

Consultation d.m.s. professor obstetrician-gynecologist
Surgical treatment (vaginal surgery, sacropexy)
Prevention recommendations

An ovarian cyst in women is a fluid-filled protrusion that forms on the surface of one or both of a woman's ovaries, usually from a follicle. Anatomically, the cyst looks like a thin-walled cavity in the form of a sac. The size of this formation ranges from a few to 15-20 centimeters in diameter.

A cyst forms when the follicle does not rupture but fills with fluid and remains in the ovary. Sometimes its size begins to create inconvenience, blocking the exit into the fallopian tube and causing discomfort. But most often, the follicular cyst resolves during the next menstruation, leaving no visible traces.

A functional cyst can also be provoked by the expansion of the corpus luteum. It has the same principles of formation, and is called a corpus luteum cyst.

Another type of functional cyst is a hemorrhagic cyst, when blood vessels rupture inside the follicle or corpus luteum and a hemorrhage occurs, accompanied by pain.

There is also a dysontogenetic cyst, which is formed as a result of disorders in the growth and development of the ovaries during puberty, as well as a tumor cyst. which gives rise to ovarian cancer.

Signs and symptoms of an ovarian cyst in women

Usually, an ovarian cyst does not make itself felt and decreases until it disappears completely in a few monthly cycles. You can find it with the help of ultrasound of the pelvic organs. Only occasionally the appearance of a cyst is marked by one or more of the following symptoms:

pain in the lower abdomen, sometimes very strong and sharp;

Tests and tests for ovarian cysts

For the diagnosis of this pathology use:

1. CT (computed tomography) and MRI (magnetic resonance imaging).

5. Puncture of the pocket of Douglas (posterior fornix of the vagina) with suspicion of internal bleeding due to rupture of the cyst.

According to statistics, the formation of an ovarian cyst occurs in 7% of sexually mature women, including after menopause. The appearance of this pathology is associated with the menstrual cycle and does not depend on the age and health of the woman, so it is logical that after menopause, an ovarian cyst is a very rare occurrence. However, the effect of a cyst on a woman's body is different in nature and depends on many factors. For example, cysts that appear due to taking drugs that stimulate the ovaries, despite the large number, disappear in several menstrual cycles without consequences.

In the case when the cyst is reinforced by risk factors: stress. sexual infections, artificial termination of pregnancy, obesity, smoking, early menarche, late onset of menopause, consequences such as tumor processes, a decrease in reproductive function up to infertility are possible. miscarriage.

Therefore, we can conclude that the risk of cysts increases due to:

the onset of early menstruation (before the age of 11 years)

Perineal prolapse syndrome (omission of the walls of the vagina, prolapse of the uterus) is a very common phenomenon. However, many simply think that this is a variant of the norm, you can live with it, and, most importantly, that it is a shame to say about it. You just get used to this state.

Indeed, at the initial stages, nothing worries. Only during sexual activity do sensations change (the vagina becomes wider). Over time, complaints of urinary incontinence join, chronic inflammatory diseases of the vagina, cystitis, and pathological discharge from the genital tract occur. Long-term conservative treatment does not bring the desired result.

Let's try to explain a little what happens and what leads to such a change in anatomy:

The causes of prolapse and prolapse of the female genital organs (omission of the walls of the vagina, prolapse and prolapse of the uterus) are as follows:

Both in the first and in the second case, there is a weakening of the relationship between the muscles of the pelvic floor, they weaken and cease to support the pelvic organs from below. This leads to the fact that the walls of the vagina begin to gradually descend downwards (omission of the walls of the vagina), leaving the genital slit. Subsequently, there is a prolapse and prolapse of the uterus, which, as it were, stretches behind the vagina.

The plane of the pelvic floor is shifted downward, and this leads to prolapse of the pelvic organs (vagina, uterus, rectum), anal incontinence, urinary incontinence. Despite the fact that the disease is common and seriously studied, the mechanism of its occurrence is practically unknown. Also, there is no unambiguous definition of the syndrome of prolapse of the perineum and a clear classification.

Picture 1

As can be seen in the figure, the bladder is in front of the vagina, and the rectum is behind. The basis of the pelvic floor is the muscles, which are normally tightly fused together in the center of the perineum.

The frequency of uterine and vaginal prolapse is 12-30% in multiparous women and 2% in nulliparous women!

In medical terms that refer to prolapse of the genitals, there is an ending "cele". And quite often this raises a number of questions in patients. Translated from Greek, this word means "swelling, swelling." To facilitate understanding of medical terminology, you can read

Cystocele - bulging (as if protrusion) of the posterior wall of the bladder into the lumen of the vagina.

Cysto-urethrocele - a combination of cystocele with displacement of the proximal part of the urethra.

Rectocele - bulging of the rectum into the lumen of the vagina.

Enterocele is a bulging of a loop of the small intestine into the lumen of the vagina.

The most common combination of cysto- and rectocele, which requires additional correction.

There is a classification of prolapse and prolapse of the vagina and uterus (M.S. Malinovsky)

I degree prolapse:

there is a prolapse of the uterus (the external pharynx of the cervix is below the spinal plane).

Grade II prolapse:

the cervix extends beyond the genital slit,

III degree prolapse (complete prolapse):

the entire uterus is below the genital slit.
Determination of tactics of conducting and volume of surgical intervention

Causes and symptoms of a cyst of the left and right ovary in women

Disease Definition

In 90% of cases, the cyst is functional, or follicular. The reason for its appearance is the "overripeness" of the follicle - a special formation in which the female germ cell develops. The thing is that each menstrual cycle, one of the two ovaries normally produces one egg, which, when mature, must exit the follicle into the fallopian tube, and the ruptured follicle becomes a corpus luteum. producing the hormone progesterone. This is the essence of ovulation.

2. Transvaginal ultrasound examination.

3. Laparoscopy, with associated removal of the cyst upon detection.

4. Hormone analysis: LH and FSH, estrogen and testosterone.

6. Analysis for the CA-125 tumor marker to exclude ovarian cancer.

7. Pregnancy tests are also mandatory, not only because the treatment of pregnant and non-pregnant women is different, but also to rule out an ectopic pregnancy, the symptoms of which are similar to those of an ovarian cyst.

Causes of ovarian cysts in women

Unfortunately, the physiological mechanisms of the appearance of ovarian cysts are not yet fully understood. Most doctors are inclined to believe that pathology occurs with hormonal disruptions. inflammatory processes and apoptosis (programmed cell death).

irregular menstrual cycles;

hormonal disorders (eg, hypothyroidism);

6 modern ways to treat uterine cysts

In many women, during a gynecological examination, a uterine cyst is often found, which causes great anxiety in the patient, because she does not know whether this condition is dangerous to health. In fact, the danger is not the cyst itself, but possible complications. Therefore, the treatment of pathology is of great importance in the further development of the disease and the state of health of the patient.

When a cyst appears in the genital organ and in a woman, small inflammations appear in the vaginal cavity and cervix - this causes blockage of the excretory ducts of the glands that produce mucus. As a result, the gland increases in size due to the mucus accumulated in it, which is easily determined during ultrasound or colposcopy. All this leads to the appearance of a benign tumor, which often becomes the main cause of infection of the appendages, ovaries or the uterus itself due to infection in them. Therefore, if uterine cysts appear, treatment may involve the removal of neoplasms that have appeared and the treatment of diseases that have developed against their background.

Uterine cysts - what is it

The cyst can be of different types, depending on the location and other factors. One of the diagnoses often happens - nabothian cysts of the uterine neck, but not everyone knows what it is. In fact, they got their name from the name of the author - Nabotov, who first described the work of the glandular cells of the female genital organs. With this disease, follicles appear in women, which are small yellow-white neoplasms.

Often, Naboth cysts do not cause discomfort, so patients believe that the pathology is not dangerous and will pass on its own. However, this is not the case, therefore, Nabothian cysts require mandatory therapy.

The exact causes of this disease are still not known, but many doctors believe that a naboth cyst may appear as a result of the following problems:

deterioration in the quality of the hormonal background;
chronic inflammation occurring in the genitals;
erosion of the uterus.

If the uterine cysts are small, then the patient does not undergo surgery: the patient regularly visits the doctor to monitor the condition of the neoplasm. If the cyst begins to increase in volume, then surgery may be prescribed to remove it so as not to cause a further increase in the tumor.

Often, the retention cyst is congenital, so it can manifest itself at any time. Often this occurs when the endocrine system is affected.

It is difficult to identify a retention neoplasm, because it almost does not give characteristic symptoms. Therefore, a woman learns about the presence of a cyst only when she visits a gynecologist for a routine examination.

Treatment of cervical cysts implies an individual approach, which should take into account the degree of development of the disease and the characteristics of the woman's condition. The main goal of treatment is to prevent pus from appearing in the neoplasm, because this leads to serious health problems. If the therapy was chosen correctly, then the cyst will soon disappear completely, and the patient will not experience problems with sexual activity and pregnancy in the future.

Cyst symptoms

At the initial stage of the disease, a cyst on the cervix has no symptoms. If you look at the neck from the outside, then in the affected area the doctor sees dense, white, mucous formations that are small in size - 3 mm.

If a cyst in the uterus has formed for a long time, then the patient has the following symptoms:

vaginal discharge;
pain during intercourse;
bleeding during a non-menstrual period;
pain in the lower abdomen;
profuse menstruation;
prolonged menstruation.

Most often, a uterine cyst occurs in patients older than 25 years, often already giving birth.

It is worth knowing that the uterine cyst, its symptoms and treatment, are interconnected, since the absence of pain does not mean that this disease can be ignored and it goes away on its own. The most dangerous cyst is that inside it is mucus or blood, which, if infected, will fester and cause inflammation of the genital organs.

The inflammatory process contributes to the appearance of symptoms such as:

lower abdominal pain;
uncharacteristic discharge;
elevated body temperature.

As a result of these complications, infertility often develops.

Causes of pathology

What is a uterine cyst is now clear. After that, it is worth knowing the causes of the pathology, often leading to negative health consequences.

Abortion. Artificial removal of the embryo, or an unprofessional approach to "cleaning" the uterine cavity can cause a cyst.
Childbirth. If the neck is damaged at the birth of a baby, then it will quickly begin its recovery, as a result of which there may be disturbances in the functioning of the glands and blockage of their ducts. All this contributes to the emergence of neoplasm.
Menopause. When a woman reaches adulthood, her uterine membrane becomes thinner, and the gonads become more susceptible to various effects. They begin to react more strongly to external stimuli, and also produce an increased amount of mucus, which, in the absence of a normal exit, can cause blockage.
infectious diseases. All infectious pathologies localized in the organs of the reproductive system can cause cysts, since the glandular ducts are clogged with mucus produced in large quantities.

In addition to these reasons, the following factors can affect the development of uterine cysts:

inflammation in the appendages;
aggravation of the hormonal background;
installation of an intrauterine device for a woman;
metabolic deterioration.

It is impossible to say with certainty that any of the above reasons can cause the appearance of neoplasms in the uterine cavity, but they are considered provoking factors and contribute to the onset of the disease.

How to treat a cyst in the uterus

Since cysts are often endowed with small sizes and do not cause discomfort to the patient, treatment with medical drugs is not carried out. If the diameter of the neoplasm increases by 2 or more times, and there is a change in the structure of the uterine cervix, the patient is prescribed surgical removal of cysts, which is carried out using modern methods. It is imperative for a woman to undergo this type of treatment, otherwise the neoplasm will regularly grow and increase its own size.

Methods of surgical treatment:

Electrocoagulation. This method involves cauterization of cysts with current. The procedure is carried out after the introduction of a woman into anesthesia. Often this method is used in the treatment of patients who have already had labor. Indeed, after electrocoagulation, small scars remain on the neck - because of them, the organ will not be able to stretch during childbirth, which will not allow the patient to give birth naturally.
Cauterization of cysts. During cauterization, the neck is completely anesthetized, and then the inflamed area is covered with a layer of Solkovagin. This is a medicine that contains acetic and nitric acid. There are practically no consequences of this treatment for the health of the patient.
Cryocoagulation. It implies cauterization of the neoplasm with nitrogen used in liquid form. A positive feature of this type of treatment is the operation using local anesthesia, which is more gentle on women's health.
Laser cyst removal. The advantage of such treatment is the complete absence of direct contact of the affected area of the genital organs with the instruments. This will help to avoid infections of various kinds and other complications of treatment. The operation is performed without blood, while the woman does not have scars on her neck at all - that is why the use of a laser is prescribed for women who want to become a mother. Often, the operation is performed a week after the end of menstruation.
The use of radio waves. When using this method, the cyst is gently punctured, and then mucus is pumped out of its cavity. After that, radio waves eliminate bleeding and decontaminate the cervix to prevent infection. This method does not cause negative consequences and does not require anesthesia.
Removal of the cyst with an endoscope. This is a special device, endowed with light and a small camera, which helps the doctor to fully explore the affected area. Such a device helps to make an incision, and then fully examine the treated area.

It is important to note that if the neoplasm is less than 0.5 cm in size, and the number of such "rashes" is not more than 3, the operation is not required.

Dangerous symptoms of uterine fibroids and ovarian cysts

What are the symptoms of uterine fibroids and ovarian cysts? Myoma is a benign disease that often appears along with an ovarian cyst. Benign tumors inside the uterus are very common in gynecology. Myoma inherently develops slowly, while the tumor does not have metastases, while the ovarian cyst develops most rapidly and most often affects the right side, which sometimes confuses doctors, as they think that this is a fibroid from the right ovary. How to figure out which of these problems bothers you, whether fibroids and cysts are different, we will tell you all this in this article.

Ovarian cyst

An ovarian cyst is considered a disease with signs of a benign lesion. The clinic of this condition is very small and manifests itself in the last stages of the disease.

signs

Symptoms of this pathology include the following:

Pain in the lower abdomen.
The cycle breaks from time to time.
Unexpected bleeding may occur.
A large tumor can put pressure on nearby organs.

The reasons

The reasons for the appearance of such an ailment are not fully understood today, but we will try to talk about the most basic ones:

Some doctors believe that it is hormonal changes that cause this disease.
genetic predisposition. Heredity can lead to a tendency to this pathology.
Strong stress.
Incorrect levels of progesterone and estrogen.
Hard physical work.
Chronic infectious diseases.
Excess weight.

The causes of this pathology to this day have not been fully unraveled, although scientists have conducted a huge amount of research. Many argue that such a disease manifests itself against the background of hypergonadotropism. It has been established for certain that there is more progesterone in the tumor than in other places. The most important role in this matter is played by the immune system of the body, it is especially important for chronic problems, as well as for congestion in the pelvis.

A cyst on the genitals is a neoplasm located inside the uterus, it occurs most often with some kind of hormonal failure. A cyst can both appear quickly and disappear instantly.

Sometimes it is not even required to carry out treatment, since the disease and its symptoms go away forever, but most often it is able to rebuild into a malignant tumor. This pathology can tear and twist, thereby poisoning a person from the inside and can cause other more serious diseases, such as infertility.

Signs of uterine fibroids

Due to the fact that the disease is constantly formed, the symptoms of fibroids are primary or secondary. The first stage of the disease at first may not manifest itself in any way. During this period of time, small deviations can be diagnosed by a doctor with experience in a gynecological examination. Due to the fact that the cyst is small in the first stage, it is quite difficult to recognize. She is able to leave after a cycle or after a month of hormone use. The only clear sign of this ailment is abdominal pain.

The malaise manifests itself:

Huge blood loss during menstruation;
anemia;
Squeezing of organs;
Frequent urination;
Constipation.

In some cases, pain in the groin area is observed.

The second symptoms are characterized by hemorrhages of various frequencies, intestinal obstruction. Acute pulling pain can lead to rupture of the cyst itself, severe bleeding and even infection.

Ladies usually complain during this period of time of pain in the abdomen, varicose veins and stomach problems.

Sometimes patients may vomit and increase body temperature. In such cases, the girl will simply need surgical intervention. The tumor, as a rule, leads to failure in critical days. As a result, such days can proceed with complications and become unstable, or vice versa, there will be too many of them. If the formation appeared against the background of male hormones, then, as a rule, the girl's vocal cords become very coarse, the growth and amount of hair increase in those places where there were not many of them, and the clitoris may even change in external parameters. If the tumor has become huge, then the stomach will increase.

Diagnostics of education

The detection of a benign neoplasm often occurs at the gynecologist's chair. An experienced doctor is able, with the help of palpation, to determine whether a problem develops on the side of the right or left ovary and detect uterine myoma.

In addition, there are other ways to detect this pathology:

ultrasound. This technique uses ultrasonic waves to track the progress of the disease. In addition, this type of diagnosis allows you to accurately determine the size of uterine fibroids and its shape.
Computed tomography is also very popular for uterine diseases. The essence of this examination is the X-ray scanning of the affected areas. All results are then subjected to good digital processing to obtain high-quality images. Such diagnostics is used when it is necessary to determine the nature of the tumor and its location.

Research in the field of medicine has shown that in women who have given birth to at least one child, the risk of fibroids of the right ovary is reduced several times. However, it has not been established whether childbearing protects girls from fibroids.

In order for the disease to develop, it is necessary that the patient's body has various adverse factors such as: abortion, improper use of contraception, chronic diseases of the appendages, stressful and conflict situations, excessive exposure to sunlight and much more.

Treatment

When deciding on a surgical intervention, the age of the lady, the presence of other diseases, the type and stage are taken into account. The doctor can decide whether to remove part of the uterus or the entire uterus. During the treatment of small neoplasms, it is recommended to use phototherapy only in combination with homeopathy. The progressive development of pathology can really be stopped by blocking biogenic elements. Not every drug used in this case has a similar effect. At the moment, pharmacists have developed various methods for restoring immunity, a completely new direction has been opened in removing formations - this is immunotherapy, which is able to form strong immunity.

Defects in the uterine area are also due to various hormonal changes. This problem is often diagnosed in girls over 30 years old.

It is with such diseases of the uterus as fibroma that the likelihood of a cyst increases. Therefore, these two ailments are so often considered in combination.

In order to avoid such a hormonal failure, you just need to follow some simple rules:

Whatever treatment you are prescribed, follow the doctor's recommendations;
Use in your diet only food rich in vitamins, iodine, iron and silicon;
Do not be upset over trifles, the nervous system is very fragile, and it is impossible to restore it;
Start to slowly engage in some kind of sports and lead a proper lifestyle;
Move more on foot, as they say - movement is life, and in your case, movement improves blood circulation.

In case of danger to health and directly to life, the sick doctor prescribes treatment by the surgical method. Whatever treatment you are prescribed, the main thing is that you yourself are tuned in to a good result. It has long been known that a person is able to heal himself, you just need to set yourself up and go towards the intended goal, and then everything will turn out as it should!

A woman at any age wants to preserve her femininity, so the doctor's recommendation - to remove the uterus or do a hysterectomy for many of the fairer sex introduces into a stupor. “How will I live in the future, how will I look my man in the eye, what will others think of me ?!” Although this part of the body is not visible to others, this is a very serious moral burden. However, if there is no other option, as soon as in this way to solve health problems or even save the life of a woman, you should not hesitate and take this step, because you can live, and fully and without this organ.