The uterus falls out in an elderly woman. What to do with uterine prolapse in older women? Kegel exercises for uterine prolapse

The prolapse of the uterus is a change in the position of the organ and its partial exit to the outside, which occurs under the influence of abdominal pressure. This pathology can also occur in young women who have experienced difficult childbirth, but most often it is diagnosed in older people: 50-60 years old.

If you do not pay attention to the resulting problem and do not start timely treatment, then serious consequences may develop. In this article we will talk about the causes of this phenomenon, its consequences, methods of diagnosis and treatment.

Types, stages and causes of pathology in the elderly

The uterus inside the female body is supported by the muscles of the small pelvis, with the weakening of the ligaments, it begins to sink down. Gynecologists distinguish the following types of this pathology:

If you do not start timely treatment, the uterus can completely leave the vagina. Gynecology defines several stages of this pathology:

• the initial stage is characterized by a displacement of the organ just below the level of the interspinal line, while the uterus does not enter the vagina;
• the second stage is characterized by partial omission, in which the main part of the organ is located on the line of the genital fissure, but the pelvic area is considered to be its location;
• The final stage represents a complete omission of the organ from the genital slit.

The main cause of this pathology in women over 50 years old, after the onset of menopause, is an insufficient amount of estrogens responsible for blood supply, nutrition, elasticity of the ligaments that hold the organ. In addition, this disease is provoked by the following factors:

Symptoms and methods of diagnosing the disease

The symptoms of this pathology vary according to the degree of the disease. At the initial stage, the following symptoms appear:

• lower abdominal pain;
• lower back pain;
• when moving, there is a feeling of heaviness.

If you do not contact a gynecologist and do not start treatment, then the symptoms worsen, there are:

If timely treatment is not started, then women over 50 years of age may develop chronic kidney disease, erosion, chronic bladder damage, uterine edema, urethritis, bleeding, varicose veins.

The prolapse of the uterus is determined on examination by a gynecologist. During the examination, the doctor determines the degree of pathology at rest and under tension, for this he asks the woman to push. After that, the organ should be put back into place to assess the state of the tone of the ligaments, appendages. The gynecologist also prescribes:

How to treat uterine prolapse in old age?

Treatment of pathology at an uncomplicated stage involves the use of special rings. They are made from biological material and prevent further deterioration of the condition. These rings or pessaries must be worn at all times, because at this age the muscles are rather relaxed and cannot be restored. When using them, it is necessary to observe personal hygiene, remove at night. To prevent the development of a sexual infection, these devices must be regularly processed.

Also, the initial stage involves wearing special underwear, which has a supporting structure. Sometimes it is recommended to wear a bandage worn over underwear in a prone position.

Tip: many gynecologists advise combining this underwear with pessaries, therapeutic exercises and hormonal therapy.

In addition to the supporting device, the following medicines help treat pathology:

• hormonal drugs can increase the level of female hormones;
• hormonal ointments injected into the vagina. They increase the level of estrogen and have a beneficial effect on the condition of the ligaments.

conservative methods

With a slight omission, the following conservative therapy is indicated:

Surgical solution to the problem

Quite often, gynecologists recommend surgery for patients over 50 years of age who have crossed the line of childbearing age, who are not helped by conservative treatment. During surgery, the doctor can use the laparoscopic method, by punctures on the abdomen, and the vaginal, when the incision is made inside the vagina, access. Today, medicine offers to perform operations in different ways:

Treatment with traditional medicine

Traditional medicine helps to comprehensively treat this pathology. However, it must be remembered that it is only an addition to the main therapy and has the task of strengthening the vaginal muscles at home. The most used methods are listed below:

Prolapse of the uterus in women over 50 years old is a fairly common problem, in order to prevent complications and resolve the issue without surgery, you need to see a doctor as soon as possible and perform effective therapeutic exercises.

Prolapse or complete prolapse of the genital organs in adulthood is a common diagnosis. This is the end result of chronic genital displacement that goes unnoticed for a long time. what to do in old age? Let's talk about this topic in more detail.

Uterine prolapse is the complete or partial displacement of an organ outside the vagina.
Experts distinguish several stages of the disease:

• Omission - the uterus falls below the interspinal line and does not leave the genital gap;
• Incomplete prolapse - the uterus is within the genital gap, and the cervix remains in the small pelvis;
• Complete prolapse - the uterus and vaginal walls come out of the genital slit.

Prolapse of the uterus in old age - causes

• Consequences of labor activity. Numerous, pathological and multiple births lead to a weakening of muscle tissue, which makes itself felt only during menopause. Weakened muscles, unable to hold the uterus in an anatomical position, lead to its prolapse.
• Excess weight. Under the influence of various factors, the female body can greatly gain weight. Extra pounds put a lot of pressure on the pelvic muscles, thereby causing the prolapse of the uterus.
• Chair problems. Older women often complain of constipation. Disturbances in the work of the intestines and the strong attempts that accompany them increase intra-abdominal pressure and contribute to the development of the disease.
• Unhealthy Lifestyle. Long years of hard work, regular overload, poor nutrition - prolapse of the uterus is often the result of such unhealthy habits.
• Sports activities associated with weight lifting and tension of the abdominal muscles.
• Hernias and displacements of organs that are behind the small pelvis.
• Hormonal disorders.
• Deformation of the pelvic floor resulting from trauma.
• Obstetric manipulations - the use of forceps, manual removal of the child in breech presentation.
• Congenital malformations of the small pelvis.
• Violent and prolonged cough.
• Body features - infantilism, asceticism.
• Heredity.

This video talks about genital prolapse:

Important! The immediate cause of prolapse and prolapse of the uterus is a complex of reasons. One single factor cannot lead to the development of the disease.

Signs of uterine prolapse in older women

Partial or complete prolapse of the uterus in older women can be recognized by the following symptoms:

• Painful discomfort in the genitals and lower back. The pain is aching in nature, intensifies if a woman sits in one place for a long time, and subsides with a change in body position;
• Sensation of a foreign body in the vagina;
• Disorders of defecation and urination;
• False urge to urinate;
• Difficulty walking;
• Inflammatory processes in the pelvic organs - discharge from the genital tract, cystitis, pyelonephritis, urolithiasis, etc.
• Development of varicose veins of the lower extremities. Occurs as a result of impaired blood supply and venous outflow of blood.

Many women do not respond to the symptoms of the disease, drowning out the pain with pills and leaving a visit to the doctor for later. The result of such a delay is the complete prolapse of the uterus, which can only be eliminated surgically.

Diagnostics

In old age, the disease develops more intensively than in young people. Therefore, it is extremely important to diagnose it in time.
Patients with uterine prolapse undergo an ultrasound examination of the pelvic organs, colposcopy, smears and cultures to determine the vaginal flora, proctological and urological examination by specialists.

Medical treatment

Uterine prolapse treatment without surgery involves the use of supporting implants (pessaries or rings) made from bio-inert synthetics and biological material. A pessary inserted into the vagina actually props up the cervix and prevents it from falling.

This method is used in the early stages of the disease and is considered the most effective. A woman will have to walk with a support ring for the rest of her life, because self-healing of muscles in old age is almost impossible
When wearing an implant, you need to douche daily with disinfectant solutions and follow the rules of personal hygiene. At night, the ring must be removed and disinfected. Otherwise, inflammatory processes may develop. After receiving consultations, the woman will be able to remove the pessary on her own.

What else to do with the prolapse of the uterus in old age? At the first stages, drug therapy is practiced, which can only be prescribed by a doctor. These are mainly drugs with a high dosage of female sex hormones (estrogens), as well as hormonal ointments that are injected into the vagina.

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Prolapse of the uterus (prolapse, ICD code N81) is the loss of its normal position and protrusion into the vaginal cavity.

Pathology develops with weakening of the muscles of the pelvic floor, uterine ligaments. There are a number of measures that can slow the progression of the disease, but the only way to cure it is surgery.

Prolapse may be accompanied by the formation of cystocele and rectocele. A cystocele occurs when the wall of the bladder protrudes into the lumen of the vagina. In this case, the woman is concerned about complaints of difficulty urinating. Sometimes it is possible to urinate only when changing the position of the body.

With a rectocele, the anterior wall of the rectum protrudes into the lumen of the vagina and forms a pocket in which feces accumulate. A woman has constipation, a feeling of incomplete emptying of the intestine during defecation, a feeling of heaviness in the perineum.

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  1.
  

  2. Causes

  Uterine prolapse is more likely to develop in the presence of risk factors:

  1. 1 Age. Most often, pathology is diagnosed in women older than 40 years. With age, degenerative processes in the ligamentous apparatus accelerate, the uterus descends.
  2. 2 Heredity. The risk is higher if the mother has pelvic organ prolapse.
  3. 3 Multiple births, complicated course of pregnancy, childbirth and the postpartum period (large fetus, prolonged attempts, dissection of the perineum).
  4. 4 General depletion of the body(against the background of chronic diseases, starvation, cachexia).

  The main causes of the disease are:

  1. 1 . Changes in the hormonal background, a decrease in the production of estrogen leads to weakening and thinning of the ligaments.
  2. 2 Obesity.
  3. 3 Persistent increase in intra-abdominal pressure(heavy physical labor, abdominal tumors, pregnancy, chronic cough, constipation).
  4. 4 Perineal injury(most often perineal tears occur during childbirth).

  3. Symptoms of the disease

  Some patients may have no symptoms.

  Localization	Description
  From the side of the vagina	Feeling of pressure, fullness, especially when standing for a long time. With complete prolapse, the uterus is visible from the genital gap.
  	Jet weakening Repeated urinary infections
  From the side of the intestine	Incontinence of gas, stool. fecal retention. Chronic constipation
  	Pain and discomfort

  Table 1 - Symptoms of uterine prolapse

  4. Stages of descent

  There are 4 stages (POP-Q) and 4 degrees of prolapse, depending on the length of the displacement of the uterus. Incomplete (partial) omission includes 1-3 degrees (see table 2). corresponds to the fourth stage (see figure below).

  Table 2 - Degrees of uterine prolapse

  

  What does a prolapse look like?

  5. Complications

  The disease is most dangerous for its consequences:

  1. 1 The displacement of the uterus sometimes leads to, blockage of its lumen and impaired outflow of urine from the kidneys. Stagnation of urine and increased pressure in the lumen of the renal pelvis increase the likelihood, lead to gradual atrophy of the renal parenchyma.
  2. 2 cause kidney damage and threaten the development of sepsis.
  3. 3 Prolapse causes deformity and weakening of the septa between the vagina and the bladder, rectum. In this case, prolapse can be complicated by cystocele (there are problems with emptying the bladder) or rectocele (the woman complains of constipation, a feeling of heaviness in the rectum).
  4. 4 In rare cases, on the mucous shells are eroded.

  6. Examination

  The diagnosis is established after examination by a gynecologist. The doctor examines the patient with the help of vaginal mirrors and assesses the presence of signs of prolapse and its degree.

  The position of the organ is assessed at rest and when straining the patient. In the presence of signs, a consultation with a urologist is required.

  7. Treatment and observation

  The degree of omission does not always correlate with the severity of symptoms. At the initial stage, the most rational tactic is careful observation of the patient.

  Some women prefer observation even at later stages (in this case, it is necessary to monitor the development of new symptoms - impaired urination and stool retention, development of vaginal erosions).

  Conservative therapy includes two main methods of correction:

  1. 1 Active lifestyle: pelvic floor muscle training and Kegel exercises. The complexes are effective in treatment, but their role in eliminating prolapse is disputed.
  2. 2 Use of a vaginal pessary. It is the only non-surgical treatment for uterine prolapse.

  7.1. Setting up a pessary

  A vaginal pessary (uterine ring) is a silicone ring that is inserted into the vagina to hold the genitals in a normal position. His selection is carried out by a gynecologist.

  Insertion of retaining rings can cause mucosal irritation and discharge. The pessary does not cure the disease, but only relieves the symptoms. Every 3 months, an examination by a gynecologist and a replacement of the ring are required.

  Indications:

  1. 1 The need to reduce the severity of complaints.
  2. 2 Stop/slow the progression of the disease.
  3. 3 Early pregnancy.
  4. 4 The first 6 months of the postpartum period.
  5. 5 Presence of contraindications to surgical treatment or refusal of it.

  Complications:

  1. 1 Ulceration of the walls of the vagina, the appearance of.
  2. 2, discomfort.
  3. 3 (abundant).

  7.2. Is it possible to have sex while placing a pessary?

  Most often, sex is possible. In some cases, the pessary is temporarily removed before sex, and then put back in place by the woman. Some types of rings make it impossible to have sex, so it's important to discuss this with your gynecologist.

  8. Surgical interventions

  The type of surgery suggested depends on the age of the patient, her desire to preserve fertility, her general condition, the degree of prolapse, and the type of pathology.

  Depending on the access, operations are open, laparoscopic and transvaginal. Currently, open interventions are losing their relevance due to a higher likelihood of complications and a long recovery period.

  Goals of surgical treatment:

  1. 1 Relieve symptoms.
  2. 2 Restore the normal anatomy of the pelvic organs.
  3. 3 Restore normal sex life.
  4. 4 Prevent relapse.

  As a rule, surgical treatment is not performed for the first 6 months after childbirth, since the likelihood of a recurrence of the disease is high. In this group of patients, there is a good effect of conservative treatment (training of the muscles of the perineum, physiotherapy).

  Operations can not be done during pregnancy and the serious condition of the patient.

  Patient group	Options
  Up to 40 years old
  After 40 years	Manchester operation.

  8.1. Anterior colporrhaphy

  It is used for cystocele (protrusion of the bladder wall into the vaginal lumen) and is performed from the vaginal lumen. By strengthening the septum between the vagina and the bladder, the normal position of the latter is achieved and the symptoms from the urinary tract are eliminated.

  8.2. Posterior colporrhaphy

  It is performed to eliminate the rectocele and restore the normal anatomy of the perineum. For plastics, local fabrics are used. Reducing the likelihood of recurrence is achieved by suturing mesh prostheses into the back wall.

  8.3. Manchester operation

  This is the name of the anterior colporrhaphy with the removal of the cervix. It allows you to save the menstrual cycle and the ability to become pregnant.

  The operation is suitable for women under 40 years of age who wish to maintain menstruation and fertility. At the same time, amputation of the cervix increases the risk of miscarriage and preterm birth. After the intervention, a scar is formed, which can lead to a narrowing of the cervical canal and make it difficult to give birth naturally.

  8.4. Hysterectomy

  Removal of the uterus is performed in the later stages of prolapse. Intervention is indicated for patients over forty years of age who have children and who do not seek to have children again.

  8.5. Loop plastic (sling)

  These operations are indicated for young women and girls suffering from prolapse of 2-3 degrees and who want to preserve their childbearing function. The uterus is "suspended" by a synthetic tape to the sacrum. The method is most effective in the absence of childbirth in history.

  8.6. Suturing the walls of the vagina

  Performed in older women. The walls of the vagina are brought together with several sutures so that a small tunnel remains for the discharge of secretions from the uterine cavity.

  The main indications for the procedure: high risk of complications of other surgical interventions. The operation is not performed in women who are sexually active.

  9. Prevention

  To prevent the occurrence of the disease, it is necessary to perform the following preventive measures:

  1. 1 Antenatal physiotherapy, relaxation exercises and perineal muscle strengthening.
  2. 2 Normalization of body weight.
  3. 3 Proper management of childbirth.
  4. 4 Sewing up perineal tears immediately after childbirth.
  5. 5 Carrying out exercise therapy and physiotherapy among pregnant women, puerperas.
  6. 6 Restriction of loads for the first 6 months after the birth of a child.
  7. 7 Maintaining the interval between births (3 years) to restore muscle tone.
  8. 8 Family planning and limiting the number of pregnancies.
  9. 9 In menopausal women, hormone replacement therapy.
  10. 10 Lifestyle changes: changing jobs, limiting heavy lifting, certain physical activities (running, squats, static loads).

  10. Treatment with folk remedies

  No medicinal herbs and decoctions can eliminate prolapse. Independent attempts to treat the disease at home can lead to serious consequences. Incorrectly selected physiotherapy exercises will only accelerate the progression of the disease.
  Pain during sex.

  Decreased sensitivity of the genitals

  Organs of the urinary systemFrequent, painful urination.

  Feeling of incomplete emptying of the bladder.

  Jet weakening

  To start urination, a change of position is required, screwing back the protruding wall of the bladder with fingers inserted into the vagina.

  Repeated urinary infections

  From the side of the intestineIncontinence of gas, stool.

  fecal retention.

  The need for straining during defecation.

  Chronic constipation

  Lower abdomen and sacrumPain and discomfort

  Patient group	Options
  Pregnancy/postpartum; no history of childbirth	Setting a pessary for up to 16 weeks. Exercises to strengthen the muscles of the perineum. After / before childbirth - surgical treatment in the absence of the effect of conservative measures (loop plastic).
  Up to 40 years old	Fertility-preserving surgeries: removal of cystocele, rectocele (anterior/posterior colporrhaphy), Manchester operation, suspension of the uterus (loop plastic)
  After 40 years	Colporrhaphy (anterior / posterior). Manchester operation. Transvaginal hysterectomy and pelvic floor repair

The prolapse of the uterus is an incorrect position of the organ, in which its bottom and neck are displaced below the physiological level. This condition is due to the weakening of the pelvic muscles and ligamentous apparatus. When this problem occurs, a woman develops pulling pains, discomfort, pressure in the vagina. Often, patients are faced with a violation of urination and the appearance of pathological discharge.

How to treat uterine prolapse in old age? Depending on the severity of the changes, therapy can be conservative or surgical.

Risk factors

The following risk factors can lead to the development of uterine prolapse:

• a large number of births;
• heavy physical activity;
• elderly age;
• frequent lifting of heavy objects;
• genetic predisposition;
• excess weight;
• tumor formations in the abdominal cavity;
• cough;
• chronic constipation.

Quite often, uterine prolapse develops under the influence of a complex of factors that provoke weakening of the ligaments and muscles of the pelvic floor and internal organs. With an increase in intra-abdominal pressure, the uterus protrudes beyond the pelvic floor. As the disease progresses, there is a displacement of nearby organs - the bladder, intestines, vagina. This provokes even more prolapse of the uterus.

The reasons

This disease often develops with prolonged exposure to negative factors.

Degrees

The classification of this disease is based on an assessment of the localization of the uterus relative to the vulvar ring, since it can be visualized quite easily.

There are several degrees of uterine prolapse:

To determine the degree of prolapse of the organ, the doctor asks the patient to push. If the walls of the vagina do not protrude at this moment, this indicates a satisfactory condition of the muscle tissue.

Symptoms

Symptoms of uterine prolapse in the elderly include the following:

1. Pain in the lumbar region and genitals. The discomfort is aching. It can increase if a woman is forced to sit in one place for a long time. The pain subsides with a change in the position of the body.
2. Sensation of a foreign object in the vagina.
3. Problems with defecation and urination.
4. False urge to urinate.
5. Difficulties in movement.
6. Inflammation of the pelvic organs. The patient may develop abnormal discharge, develop pyelonephritis or cystitis.
7. Varicose veins of the legs. This disease is a consequence of problems with blood circulation and venous outflow of blood.

Many women ignore the symptoms of the disease and do not seek medical attention in a timely manner. As a result, complete organ prolapse may develop, which requires surgical intervention.

Diagnostics

The prolapse of the uterus can be detected by a doctor during a gynecological examination. To assess the degree of the disease, the gynecologist will ask the woman to push and, using a vaginal and rectal examination, evaluate the displacement of the organs.

Patients with such a pathology must undergo colposcopy. In the presence of concomitant gynecological diseases, additional examinations are carried out:

• hysterosalpingoscopy and curettage for diagnostic purposes;
• smears for flora;
• Ultrasound of the pelvic organs;
• bacteriological culture of urine;
• CT scan;
• excretory urography.

Treatment of uterine prolapse in the elderly

In older women, the disease progresses much faster than in younger women. Therefore, it is very important to start the treatment of this pathology in a timely manner.

Pessaries or rings

Conservative therapy of the disease consists in the use of supporting implants - rings or pessaries. They are created from biological materials and bioinert synthetics. When the pessary is inserted into the vagina, it supports the cervix, which prevents it from prolapsing.

This method is used at an early stage of the development of the disease and is highly effective. A woman with such a diagnosis is forced to use a support ring all her life, since in old age the muscles practically do not recover.

The use of the implant requires daily douching with disinfectant solutions. It is also very important to observe the rules of personal hygiene. Before going to bed, the ring must be removed and disinfected. Otherwise, there is a risk of developing inflammatory processes. After adequate medical advice, a woman can do it on her own.

Also, at an early stage of the development of the disease, medication is prescribed. Most often, doctors prescribe drugs that contain a large amount of estrogen. In addition, ointments can be used that should be injected directly into the vagina.

The most extensive category of treatments for this disease are surgical interventions. Each type of operation has certain advantages and disadvantages. In any case, there is always a risk of recurrence of the disease - the likelihood of this is greatest in the first 3 years after the procedure and is observed in approximately 30-35% of women.

The goal of surgical treatment of this pathology is to restore the normal position of the uterus, strengthen the pelvic floor and eliminate disorders in the work of the intestines and bladder. Sometimes, to solve these problems, several operations are required at once, which are carried out simultaneously or sequentially.

Any intervention involves the initial fixation of the uterus at the desired level and subsequent strengthening of the pelvic muscles. First, to fix the organ, the round ligaments are shortened or stitched into one whole. In particularly difficult situations, the uterus is attached to the pelvic bones. At the second stage, integrity is restored and the muscles of the pelvis are strengthened.

The most radical method of treatment is the removal of the uterus. After such an intervention, it is much easier to restore the pelvic muscles.

To prevent recurrence of the disease, the patient must adhere to the following rules:

• avoid increased physical activity;
• eat right to prevent constipation;
• in time to treat diseases that are accompanied by a persistent cough;
• give up cycling and exercise bikes.

Exercises

To maintain the normal tone of the muscle tissue that supports the uterus, you should do the following exercises:

1. Preventive Kegel exercises - help stop the process of displacement of the pelvic organs and eliminate the disease at an early stage of development. The essence of these movements is a strong tension and relaxation of the pelvic muscles. You need to repeat these exercises 50-100 times.
2. Walking is one of the most beneficial ways to strengthen the right muscles. To do this, it is enough to move around as much as possible.
3. Moving up the stairs - to strengthen muscle tissue, it is enough to move up the stairs as often as possible.
4. Exercise "bike" - just lie down on a hard surface and start to turn the "pedals".
5. Swimming is also a fairly effective method of strengthening the pelvic muscles.

Preventive actions

To prevent prolapse of the uterus, you need to follow certain rules:

• to live an active lifestyle;
• eliminate chronic diseases that provoke a strong cough;
• eat properly;
• normalize bowel function;
• avoid increased physical activity.

Doctors advise against cycling or exercise bikes. Also, do not do exercises that lead to strong tension in the muscles of the abdomen and perineum.

Uterine prolapse is often diagnosed in old age. This is a rather unpleasant pathology, which is accompanied by uncomfortable sensations and greatly reduces the quality of life of a woman. Therefore, it is so important to regularly undergo gynecological examinations and clearly follow all medical recommendations.

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

Types of uterine prolapse

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

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

Complete

Such prolapse of the uterus is considered the fifth (last) degree of severity of the pathology, it is diagnosed visually, because with complete prolapse, the entire organ extends beyond the vagina. Complete prolapse occurs rapidly as a result of trauma, difficult childbirth, anguish when lifting weights. Perhaps with the connivance of the patient, when she does not turn to the doctor in time. Treatment is shown only surgical.

Partial

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

1. The initial stage is the prolapse of the cervix, its entrance to the vaginal canal.
2. The middle stage (partial prolapse) - the uterus enters the vagina, is visible from the vaginal opening only with tension (strain).
3. Incomplete prolapse of the cervix - the cervix is ​​\u200b\u200bvisible from the vaginal opening, but the body of the uterus remains in the vaginal canal even with strain.

The reasons

Provoke this pathology, the following external and internal factors:

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

Main signs and symptoms

Possible direct and indirect symptoms of pathology. Often, symptoms are absent at rest, but appear with exertion. Signs indicating uterine prolapse are as follows:

• pain in the lower back and lower abdomen;
• discomfort during urination and defecation;
• sensation of a foreign body in the vaginal canal;
• the appearance of secretions;
• pain during intercourse;
• menstrual disorders;
• incontinence of urine, feces, intestinal gases.

Diagnostics

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

To determine the degree of the disease, additional examination methods are prescribed:

• hysterosalpingoscopy;
• colposcopy;
• excretory urography;
• computed tomography;
• bakposev;
• flora smears.

Treatment methods for uterine prolapse

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

1. conservative therapy. It is carried out at the initial and middle degrees of genital prolapse. Includes treatment with drugs that are prescribed for specific symptoms and comorbidities. These can be: a massage that strengthens the ligaments of the small pelvis, a bandage, a pessary, tampons.
2. Surgery is the most effective treatment option. In severe cases (in elderly patients), the uterus is removed, with moderate pathologies, surgical methods are used to restore the ligamentous apparatus of the uterus.
3. Other methods. The use of traditional medicine (phytotherapy) has an auxiliary effect in the treatment of genital prolapse. Gymnastics is shown that strengthens the ligaments of the small pelvis, the muscles of the vagina.

Conservative treatment without surgery

Therapeutic treatment of uterine prolapse is indicated in two cases:

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

With any therapeutic treatment of genital prolapse, patients are prescribed a diet that relieves constipation. Often recommend a sparing mode of work, limitation of physical activity, exclusion of heavy lifting. If the pathology is accompanied by other diseases (inflammatory processes, infections, others), then they are treated with special medications.

Surgical intervention

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

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

Folk remedies

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

1. Gentian infusion (a spoonful of herbs in a glass of boiling water) is taken twice a day 30-40 minutes before meals.
2. Dandelion bath. 20 g of leaves insist in a bucket of hot water for 10 minutes. Pour into the bath, lie in it for about 20 minutes.
3. Herbal collection (linden, alder, yasnooka, lemon balm). Pour two tablespoons of the mixture into a glass of boiling water. The entire infusion is drunk per day in three visits. Treated with a collection of three weeks.
4. Crushed eggshell (5 eggs) with lemon (9 pieces). Lemons are finely cut, mixed with the shell, insisted for 4 days, decanted. Take 50 grams twice a day until the mixture is over.
5. Quince infusion (1 part fruit to 10 parts water) is cooked in a steam bath, drunk as tea.
6. White lily roots (2 tablespoons of powder for 2 cups of boiling water) insist 12 hours, filter, drink three times a day an hour before meals.
7. Douching with oak bark (70 g per 2 liters of water). The mixture is boiled for 2 hours, used for daily douching for a month.
8. Bath with pine nuts. A glass of nuts is boiled in two liters of water for an hour. Pour the broth into the bath, lie in it for 15 minutes.

What to do with uterine prolapse in old age

The natural age-related weakening of the ligamentous apparatus of the small pelvis and insufficient levels of estrogen provoke prolapse and complete prolapse of the uterus in older women. Doctors consider surgery to be the most effective method of treatment, up to the removal of an organ. If operations are contraindicated for any reason, then uterine rings are installed for patients. Drug (hormonal) treatment is often prescribed. It is recommended to avoid physical exertion, adhere to a diet that excludes constipation, and engage in special gymnastics.

Possible complications and consequences

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

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

Disease prevention

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

• regulate physical activity;
• adhere to a diet that excludes constipation;
• do not lift weights;
• perform a set of exercises that restores the elasticity of the muscles of the vagina and ligamentous apparatus;
• be attentive to postpartum injuries and ruptures.

Video: genital prolapse and uterine prolapse in women

Watch a video from which you will learn what is hidden behind the term "genital prolapse", what is the likelihood of developing this pathology in women of different ages, which is able to provoke it. The practitioner will tell you what methods of treatment are used, how the organ returns to its normal state promptly. Learn from the video what women should do to minimize the risk of pathology.