Continuous pressure, pain in the lower abdomen and the lower back, frequent inflammations and recurrent urinary tract infections - these are symptoms of depletion of the reproductive organs or, more simply, uterine prolapse. The lowering of the genitals is caused by stretching of the muscles that support the vagina, rectum, and bladder, which most often happens after childbirth. How is uterine prolapse treated? Is surgery the only option?

Prolapse of the uterus , i.e. its movement into the vagina, is caused by weakening of the pelvic muscles. If the disease is very advanced, the uterus may even slide out. In extreme cases, there is the so-calledto evolve the vagina , means as if it curls inside out. Genetic causes of genital reduction include congenital disorders of collagen metabolism.

Uterine prolapse: causes

Stretched and weakened muscles are usually found in women who gave birth to a large child (over 4 kg), gave birth frequently or had very heavy births. In menopausal women reduction of pelvic organs is caused by a deficiency of estrogens - their lack reduces the firmness and elasticity of tissues. However, this condition can also apply to women who did hard physical work, e.g. lifted weights, worked in the field or practiced male sports, e.g. weightlifting.

Uterine prolapse: symptoms

Women with pelvic lowering usually complain of a feeling of pressure or pain in the vagina, difficulty passing urine or stools, and significant discomfort during intercourse. Constipation, hemorrhoids, urinary incontinence (in 20% of women) and recurrent urinary tract infections develop over time. Bladder and large intestine diverticula, i.e. invaginations into the vaginal lumen of the back wall of the bladder and / or the anterior rectal wall, are responsible for some of these problems. Urine may remain in the diverticulum of the bladder, which is conducive to urinary tract infections, which are manifested by burning during urination and frequent urge to urinate. Anal diverticulum gives a feeling of pressure on the stool and can make it difficult to pass it.

Uterine prolapse will be stopped by Kegel exercises

If you suspect something is wrong with your perineum, see your gynecologist. This is important because before the disease develops,it can be treated without surgery and can only focus on strengthening the pelvic muscles. Kegel exercises, because that's what they are about, do not take time and can be performed in any situation - standing in a traffic jam, waiting for a bus or sitting at a desk. There are many variations of these exercises. First you need to locate these muscles. How is it done? When you are on the toilet, stop the urine stream for a few seconds and try to feel which muscles are working. Remember, however, that stopping voiding should not be repeated many times, because it may cause urine stagnation, which promotes infection. But it is the easiest way to learn how to separate the muscle groups (the muscles of the urogenital diaphragm) that are responsible for proper pelvic floor support. Exercises should be performed with the use of special vaginal cones, the size of which will be determined by the gynecologist. To be successful (you will notice the first effects after 3 months of exercise), you need to exercise regularly, doing 50-100 repetitions every day.

Estrogen vs uterine prolapse

Doctors most often prescribe tablets, special creams or gels containing this hormone to mature women, for whom the decrease in the production of female sex hormones is responsible for the loss of elasticity of the pelvic muscles. Creams with estrogens firm the vaginal walls, while hormone pills work comprehensively: they improve the elasticity of tissues in all parts of the reproductive organ and prevent unpleasant menopausal symptoms, such as hot flashes, night sweats or mood disorders. Taking preparations containing hormones also slows down the aging process, which makes the skin and body look younger for longer.

Important

Correct positioning of the uterus

The uterus is a muscular organ. It lies in the pelvis between the bladder and the rectum. Properly built, it resembles a pear, which is fixed in the uterine cavity by the folds of the peritoneum, i.e. ligaments. During the childbearing period, when the woman is not pregnant, the uterus is approximately 7.5 cm long and 5 cm wide at its widest point. The figure shows the correct position of the uterus. Depending on the degree of bladder filling and body position, her natural position changes. But when the ligaments and muscles that support the uterus are flaccid or damaged, it begins to lower and travels into the vaginal canal.

Uterine prolapse: surgical methods

If the symptoms are very severe and the lowering of the pelvic organs is accompanied by urinary incontinence, diverticula develop - surgical treatment is necessary. How the procedure is performed depends on how serious the condition isfemale patients. Until recently, surgical treatment of depressed organs was usually based on a hysterectomy, i.e. removal of the uterus. However, it turned out to be unsatisfactory as the vagina was lowered after the hysterectomy. Many surgical techniques are used today. Lifting operations, which use a special polypropylene mesh, are popular. The mesh replaces the damaged ligaments and attachments of the muscles in the smaller pelvis as it grows into the tissues. The biomaterial from which it is made is indifferent to the body. Implants are inserted through the vagina using a special set of tools. One part of the implant is attached to the cervical area, and the other parts to the lower edges of the vagina and bone-ligament structures. This method can be used even after the uterus has prolapsed. The mesh lifts all organs and the operator can place them in the right, natural position. The procedure is performed under general or regional anesthesia. But it happens that the body rejects the implant after a while. Another method is to suspend the apex of the vagina from the ventral surface of the sacrum. Another that can be used for the diverticulum of the posterior vaginal wall is the introduction of a polypropylene tape in the shape of an inverted U letter. The tape recreates the function of damaged sacro-uterine ligaments.

  • Advantages and disadvantages of the operation

Each method has advantages and disadvantages, therefore new solutions are sought. Operations are at risk of complications. There may be times when a hematoma forms between the mesh and the tissue, the mesh is rejected due to infection. During the procedure itself, there is a risk of damage to the ureters and urethra. The operation is not performed in women in a serious condition, e.g. due to serious diseases of the circulatory system or acute inflammation of the protruding reproductive organ. Age is not critical. The operations are reimbursed by the National He alth Fund.

  • Return to normal life after surgery

You can get out of bed the day after the procedure. Postoperative wound healing takes 6-8 weeks. Follow-up visits are necessary during this time so that the doctor can assess how the mesh is growing. For 4 weeks after the procedure, you need to lead a sparing lifestyle - do not lift, do not play sports and refrain from intercourse. In order to improve the structure of the vaginal wall, a woman needs to use estrogen vaginally.

You must do it

Train your muscles

The resilient muscles of the perineum and the pelvic floor allow not only to maintain good he alth, but also to increase sexual sensations, and at the same time prevent the vagina from lowering, problems with incontinence,formation of diverticula.

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Female diseases