Massage for diseases of the female genital organs Massage is used for menstrual irregularities, painful menstruation, amenorrhea and hypomenorrhea, after adnexitis and endometritis, for complaints during pregnancy and after childbirth, in menopause

Diseases of the female genital organs Objectives of massage Reducing pain, improving blood circulation in the pelvic organs, reducing congestion in the circulatory and lymphatic systems of the pelvic organs, increasing the tone of the uterus and its contractile function,

Inflammatory process of female genital organs Powdered propolis – 50 g, honey – 1 tbsp. spoon, butter (unsalted) - 100 g. Heat in a boiling water bath for 45 minutes, strain, mix 2:1 by volume with powdered activated carbon.

The normal (typical) position of the genital organs is considered to be their position in a healthy woman.
an adult woman in an upright position with the bladder empty and erect
gut.

Normally, the fundus of the uterus is turned upward and does not protrude above the plane of the entrance to the pelvis, external
the opening of the cervical canal is at the level of the spinal plane, the vaginal part of the cervix
the uterus is facing posteriorly and downward. The body and cervix form an obtuse angle, open anteriorly. This situation is
Name anteflexion. The fundus of the bladder is adjacent to the anterior wall of the uterus in the area of ​​the isthmus,
the urethra is in contact with the anterior wall of the vagina in its middle and lower third. Rectum
located behind the vagina and separated from it by loose fiber.

The normal position of the uterus and other female genital organs is maintained
check:

• own tone of the genital organs;
• supporting apparatus - pelvic floor muscles;
• suspensory apparatus - round, wide and proper ligaments of the ovary;
• anchoring apparatus - uterosacral ligaments, cardinal ligaments.

The uterus with tubes and ovaries has limited physiological mobility.

The reasons for the incorrect position of the female genital organs are usually varied.
The most common cause is damage to the pelvic floor muscles, vagina or ligaments,
most often due to birth trauma. The position of the internal genital organs can be disrupted
tumors of the abdominal organs or genitals, inflammatory processes in the pelvis with the formation
adhesions, endometriosis.

Less commonly, the cause of abnormal position of the genital organs is associated with severe somatic
diseases accompanied by exhaustion or myasthenia.

We can talk about the incorrect position of the genital organs if there are displacements coming out
beyond normal topographic boundaries and having a stable character. Among the anomalies
the position of the genital organs, the leading place is occupied by the displacement of the uterus and vagina. Ovarian displacement and
fallopian tubes, as a rule, is secondary in nature and depends on the displacement of the uterus.

The following forms of abnormal positions of the genital organs are distinguished:

Retroflexion of the uterus.

In this case, the body of the uterus is deflected posteriorly, between the uterus and the cervix there is an open angle
posteriorly Unlike the normal position - anteflexion, the body of the uterus is located in the posterior half
pelvis, and the neck is in the anterior. As a result, the topography of the location of intestinal loops changes,
ureters, which ultimately leads to prolapse of the uterus and vagina. The cause of retroflexion may be
serve endometriosis, complicated by adhesions, or inflammatory processes in the pelvis. At
Asymptomatic retroflexion does not require treatment. Treatment is resorted to when pain occurs,
menstrual irregularities, miscarriage. Among the methods of surgical treatment, the leading place is
Laparoscopy takes place.

Pathological anteflexion.

It differs from physiological anteflexion by its most acute angle. Occurs
very rarely and most often accompanies severe infantilism. As a rule, after restorative
treatment, the situation normalizes.

The normal position of the female genital organs is ensured by the suspensory, fastening and supporting ligamentous apparatus, mutual support and pressure regulation by the diaphragm, abdominal press, and its own tone (hormonal influences). Disruption of these factors by inflammatory processes, traumatic injuries or tumors contributes to and determines their abnormal position.

Anomalies in the position of the genital organs are considered to be such permanent conditions that go beyond physiological norms and violate the normal relationships between them. All genital organs are interconnected in their position, therefore abnormal conditions are mostly complex (at the same time the position of the uterus, cervix, vagina, etc. changes).

The classification is determined by the nature of the violations of the position of the uterus: displacement along the horizontal plane (the entire uterus to the left, right, forward, backward; incorrect relationship between the body and the cervix in terms of inclination and severity of bending; rotation and torsion); displacement in the vertical plane (prolapse, prolapse, elevation and inversion of the uterus, prolapse and prolapse of the vagina).

Displacements along the horizontal plane. Displacement of the uterus and cervix to the right, left, forward, backward occurs more often due to compression by tumors or the formation of adhesions after inflammatory diseases of the genitals (Fig. 19). Diagnosis is achieved using gynecological examination, ultrasound and radiography. Symptoms are characteristic of the underlying disease. Treatment is aimed at eliminating the cause: surgery for tumors, physiotherapeutic procedures and gynecological massage for adhesions.

Pathological inclinations and bends between the body and neck are considered simultaneously. Normally, in terms of bends and inclinations, there can be two variants of the position of the uterus: inclination and bending anteriorly - anteversio-anteflexio, inclination and bending posteriorly - retroversio-retroflexio (Fig. 20). The angle between the cervix and the body of the uterus is open anteriorly or posteriorly and averages 90°. In the standing position of a woman, the body of the uterus is located almost horizontally, and the cervix at an angle to it is almost vertical. The fundus of the uterus is located at the level of the IV sacral vertebra, and the external os of the cervix is ​​at the level of the spinal plane (spina ischii). In front of the vagina and uterus are the bladder and the urethra, and behind is the rectum. The position of the uterus can normally change depending on the filling of these organs. Pathological inclinations and bends of the uterus occur during infantilism at an early age (primary) and due to inflammatory and adhesive processes of the genitals (secondary). The uterus can be mobile or immobile (fixed).

Rice. 19.

: a - anteriorly by the myomatous node; b - to the left with a tumor of the right ovary; c - posteriorly with adhesions resulting from pelvioperitonitis.

Fig.20.

: a - anteflexio-anteversio; b - retroflexio-retroversio.

Rice. 22.

(a) and pathological bend of the uterus posteriorly (b).

Rice. 23.

to the left (a) and posterior displacement of the uterus (b).

Rice. 24.

: a - appearance; b - diagram.

Hyperanteversion and hyperanteflexion of the uterus is a position where the anterior inclination is more pronounced, and the angle between the body and the cervix is ​​acute (
Hyperretroversion and hyperretroflexion of the uterus is a sharp deviation of the uterus posteriorly, and the angle between the body and the cervix is ​​acute (
The inclination and bending of the uterus to the side (to the right or left) is a rare pathology and determines the inclination of the uterus and the bending between its body and the cervix to one side (Fig. 23).

The clinical picture of all variants of horizontal displacement of the uterus has much in common and is characterized by painful sensations in the lower abdomen or in the sacral area, algodismenorrhea, and prolonged menstruation. Sometimes there are complaints of dysuria, pain during bowel movements, and increased leucorrhoea. Since this pathology is a consequence of inflammatory processes or endocrine pathology, it can be accompanied by symptoms of these diseases and cause infertility and pathological pregnancy.

Diagnosis is based on data from gynecological and ultrasound examinations, taking into account symptoms.

Rice. 25.

: a - appearance; b - diagram.

Rice. 26.

: a - appearance; b - diagram.

Treatment should be aimed at eliminating the causes - anti-inflammatory drugs, correction of endocrine disorders. FTL and gynecological massage are used. In case of severe pathology, surgical intervention may be indicated, with the help of which the uterus is removed from the adhesions and fixed in the anteversio-anteflexio position.

Uterine rotation and torsion are rare, are usually caused by tumors of the uterus or ovaries and are eliminated simultaneously with the removal of the tumors.

Displacement of the genital organs along the vertical axis. This pathology is especially common in women of the perimenopausal period, less often in young women.

Uterine prolapse is a condition when the uterus is below the normal level, the external os of the cervix is ​​below the spinal plane, the fundus of the uterus is below the IV sacral vertebra (Fig. 24), but the uterus does not come out of the genital slit even with straining. Simultaneously with the uterus, the anterior and posterior walls of the vagina descend, which are clearly visible from the genital slit.

Uterine prolapse - the uterus is sharply displaced downwards, partially or completely comes out of the genital slit when straining. Incomplete uterine prolapse - when only the vaginal part of the cervix emerges from the genital slit, and the body remains above the genital slit even with straining (Fig. 25). Complete uterine prolapse - the cervix and body of the uterus are located below the genital slit, and at the same time the vaginal walls are everted (Fig. 26). Vaginal prolapse and prolapse most often occur simultaneously with the uterus, which is due to the anatomical connection of these organs. When the vagina prolapses, its walls occupy a lower position than normal, protruding from the genital slit, but do not extend beyond it. Vaginal prolapse is characterized by complete or partial exit of its walls from the genital fissure located below the pelvic floor. Prolapse and prolapse of the vagina are usually accompanied by prolapse of the bladder (cystocele) and the walls of the rectum (retrocele) (Fig. 27). When the uterus prolapses, the tubes and ovaries simultaneously descend, and the location of the ureters changes.

The main factors for prolapse and prolapse of the genital organs: traumatic injuries to the perineum and pelvic floor, endocrine disorders (hypoestrogenism), heavy physical labor (lifting heavy objects for a long time), sprain of the uterine ligaments (multiple births).

The clinical picture is characterized by a protracted course and steady progression of the process. Prolapse of the genital organs increases with walking, coughing, and lifting heavy objects. Nagging pain appears in the groin areas and sacrum. Possible disturbances in menstrual function (hyperpolymenorrhea), the function of the urinary organs (urinary incontinence and incontinence, frequent urination). Sexual life and pregnancy are possible.

Diagnosis is carried out according to anamnesis, complaints, gynecological examination, and special research methods (ultrasound, colposcopy). When examining the mucous membrane of the vagina and cervix of a prolapsed uterus, trophic (decubital) ulcers are often noted due to injury and changes in flora (Fig. 28).

Fig.27.

1 - pubic bone; 2 - bladder, 3 - uterus; 4 - rectum, 5 - prolapsed intestinal loop, 6 - prolapsed posterior vaginal wall; 7 - vagina.

Treatment for prolapse and prolapse of the genital organs can be conservative and surgical. Conservative treatment boils down to the use of a set of gymnastic exercises aimed at strengthening the pelvic floor and abdominal muscles. It can be acceptable only with unexpressed prolapse of the uterus and vagina. It is very important to follow a work schedule (excluding heavy physical work, lifting weights), a diet rich in fiber, urinating “on the clock,” and avoiding constipation. These conditions must be observed during both conservative and surgical treatment. If there are contraindications to surgical treatment (old age, severe concomitant pathology), the introduction of pessaries or rings into the vagina is indicated, followed by training the woman in the rules of their processing and insertion. The patient should regularly visit a midwife or doctor to monitor the condition of the mucous membranes of the vagina and cervix (prevention of inflammation, bedsores, trophic ulcers). Treatment of trophic ulcers and bedsores involves the use of anti-inflammatory and antibacterial local therapy (levomekol, dimexide, antibiotics in ointments and suspensions), healing ointments (actovegin, solcoseryl), and preparations with estrogens. Reduced position of the genital organs is desirable.

There are many methods of surgical treatment, and they are determined by the degree of pathology, age, and the presence of concomitant extragenital and genital diseases. When treating young women, methods that do not interfere with sexual and reproductive functions should be preferred. If there are old perineal tears, surgery is performed to restore the pelvic floor. Prolapse of the vaginal walls can be eliminated by plastic surgery of the anterior and posterior walls with strengthening of the levators. If necessary, the bladder sphincter is strengthened, an operation is performed to fix the uterus to the anterior abdominal wall, or lift it by shortening the round ligaments.

In old age, with uterine prolapse and prolapse, vaginal hysterectomy with vaginal and levator plastic surgery is used. If an elderly woman is not sexually active, then vaginal suturing surgery is recommended. After the operation, you cannot sit down for a week, then for a week you can only sit on a hard surface (chair), the first 4 days after the operation you must maintain general hygiene, diet (liquid food), take a laxative or a cleansing enema on the 5th day, treat the perineum 2 times a day day, sutures are removed on the 5-6th day.

Uterine inversion is an extremely rare pathology, occurring in obstetrics at the birth of an unseparated placenta, and in gynecology at the birth of a submucosal myomatous uterine node. In this case, the serous membrane of the uterus is located inside, and the mucous membrane is located outside (Fig. 29).

Treatment consists of taking immediate measures to relieve pain and realign the inverted uterus. In case of complications (massive edema, infection, massive bleeding), surgical intervention to remove the uterus is indicated.

The elevated position of the uterus (Fig. 30) is secondary and can be caused by fixation of the uterus after surgery, vaginal tumors, and accumulation of blood in the vagina during atresia of the hymen.

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The internal genital organs occupy a certain position in the pelvis, which is ensured by a number of factors. At the same time, the uterus and the associated ovaries and fallopian tubes have physiological mobility. Physiological mobility creates conditions for the normal functioning of the bladder and intestines, for the normal course of pregnancy and childbirth. The physiological nature of the mobility of the uterus is determined by the fact that after displacement it returns to its original position.

With some diseases of the reproductive system, it is possible to develop limited or excessive mobility, or, less commonly, complete immobility. Limited mobility of the uterus can develop with advanced genital cancer, as a result of an inflammatory process, with atypical forms of uterine fibroids, with large tumor sizes. Excessive mobility of the uterus is observed with a decrease in the tone of the genital organs and ligamentous apparatus.

The position of the genital organs changes with age. During childhood, the uterus is located higher than during puberty. In old age, on the contrary, it is lower and often deviates posteriorly.

The typical position is conventionally considered to be the position of the genital organs in a healthy, sexually mature, non-pregnant and non-lactating woman, who is in an upright position with the bladder and rectum emptied. In this case, the uterus occupies a mid-position in the small pelvis, the fundus of the uterus does not protrude above the plane of the entrance to the small pelvis, the vaginal part of the cervix is ​​at the level of the plane passing through the ischial spines. The fundus of the uterus is directed upward and anteriorly, the vaginal part of the cervix is ​​directed downward and posteriorly. The entire axis of the uterus is slightly inclined anteriorly (anteversio). A curve forms between the body and the cervix. The resulting angle is obtuse and open anteriorly (anteflexio).

The vagina is located obliquely in the pelvic cavity, directed from above and behind, down and anteriorly. The bladder is adjacent with its bottom to the anterior wall of the upper part of the vagina and the anterior wall of the uterus in the isthmus region, the urethra is in contact with the anterior wall of the vagina in its middle and lower third. In the normal position of the uterus, its anterior wall is in contact with the bladder.

The rectum is located behind the vagina and is connected to it by loose fiber. The upper part of the posterior wall of the vagina - the posterior fornix - is covered with the peritoneum of the rectal-uterine space.

Factors ensuring the normal position of the female genital organs, are:

1) own tone of the genital organs;

2) the relationship between the internal organs and the coordinated activity of the diaphragm, abdominal wall and pelvic floor;

3) suspending, securing and supporting the uterine apparatus.

The proper tone of the genital organs depends on the proper functioning of all body systems. A decrease in tone may be associated with a decrease in the level of sex hormones, disruption of the functional state of the nervous system, and age-related changes.

The relationships between the internal organs (intestines, omentum, parenchymal and genital organs) form a single complex due to their direct contact with each other. In this case, capillary cohesion is formed, which, together with the gaseous contents of the intestine, helps to balance the heaviness of the internal organs and limits their pressure on the genitals.

In addition, intra-abdominal pressure is regulated by the friendly function of the diaphragm, anterior abdominal wall and pelvic floor. When you inhale, the diaphragm lowers and puts pressure on the internal organs. However, outward movement of the anterior abdominal wall restores balance. When lifting weights or coughing, the pelvic floor muscles take part in the regulation of intra-abdominal pressure - they contract and close the genital gap.

The suspensory apparatus consists of the round and broad ligaments of the uterus, the ligament proper and the suspensory ligament of the ovary. The proper and suspensory ligaments together with the ovary form a single whole (the ovarian ligament is located between the ovary and the angle of the uterus, and the suspensory ligament of the ovary is between the opposite pole of the ovary and the pelvic wall). The broad ligaments of the uterus, the proper and suspensory ligaments of the ovaries hold the fundus of the uterus in the middle position. The round ligaments pull the fundus of the uterus anteriorly and ensure its physiological inclination.

The anchoring apparatus includes ligaments located in the loose tissue of the pelvis and extending from the lower part of the uterus to the lateral, anterior and posterior walls of the pelvis. These ligaments contain smooth muscle fibers and are directly connected to the muscles of the lower uterus. The anchoring apparatus includes the uterosacral, main, uterovesical and vesico-pubic ligaments. The fixing apparatus fixes the uterus in the central position of the pelvis and makes it almost impossible for it to move to the sides, back and front. But since the ligamentous apparatus departs from the uterus in its lower section, the uterus can tilt in different directions. So, for example, in the supine position, the fundus of the uterus deviates posteriorly, and the cervix deviates anteriorly. Posterior deviation of the uterus also occurs when the bladder is full.

The supporting apparatus is represented mainly by the pelvic floor muscles - the lower, middle and upper (inner) layers. The lower layer consists of three paired and one unpaired muscles. The unpaired muscle forms the external sphincter of the anus. This muscle surrounds the lower rectum. Some of the fibers start from the top of the coccyx and end in the tendon center.

The lower layer of the pelvic floor muscles includes the bulbocavernosus, ischiocavernosus and superficial transverse perineal muscles. The bulbocavernosus muscle covers the entrance to the vagina and is attached to the tendinous center of the perineum and the clitoris. The superficial transverse perineal muscle also starts from the tendon center, goes to the right and left and attaches to the ischial tuberosities. The cavernous muscle is located between the lower branch of the ischium and the clitoris.

The middle layer of muscles is represented by the urogenital diaphragm and occupies the anterior half of the pelvic outlet. This is a triangular-shaped muscular-fascial plate through which the urethra and vagina pass. In the anterior section between its leaves there are muscle bundles that form the external sphincter of the urethra, in the posterior section there are muscle bundles running in the transverse direction - the deep transverse muscle of the perineum.

The upper layer of the pelvic floor muscles is formed by the paired muscle that lifts the ani (m. levatior ani). The muscle starts from the lower part of the rectum, goes dome-shaped upward and outward and attaches to the inner surface of the walls of the pelvis. This layer of muscle is also called the “pelvic diaphragm.”

The supporting apparatus of the genital organs includes the vesicovaginal septum (fascia of the vagina), the rectovaginal septum and dense connective tissue located at the lateral walls of the vagina.

Displacement of the uterus can occur along a vertical plane (up and down), around the longitudinal axis and along a horizontal plane.

Displacement of the uterus along the vertical plane includes elevation of the uterus, prolapse, prolapse and inversion of the uterus. When lifted, the uterus moves upward, its bottom is located above the plane of the entrance to the pelvis, and the vaginal part of the cervix is ​​above the spinal plane. Pathological elevation of the uterus occurs when menstrual blood accumulates in the vagina due to atresia of the hymen or lower part of the vagina, with voluminous tumors of the vagina and rectum, with encysted inflammatory effusions in the pouch of Douglas. Lifting (elevation) of the uterus can also occur when it is fused with the anterior abdominal wall after laparotomy (caesarean section, ventrofixation).

When felt (decensus uteri), the uterus is located below the normal level, but the vaginal part of the cervix does not protrude from the genital slit even with straining. If the cervix protrudes beyond the genital opening, they speak of uterine prolapse (prolapsus uteri). There are incomplete and complete uterine prolapse. In case of incomplete uterine prolapse, only the vaginal part of the cervix emerges from the vagina, and the body of the uterus is located higher outside the genital slit. With complete prolapse of the uterus, the cervix and body of the uterus are located below the genital slit. Prolapse and prolapse of the uterus are accompanied by vaginal prolapse.

Uterine inversion is extremely rare. With this anomaly, the serous membrane is located inside, and the mucous membrane is located outside, the inverted body of the uterus is located in the vagina, and the cervix, fixed in the fornix, is located above the level of the body.

Uterine inversion in most cases occurs due to improper management of the postpartum period (squeezing the placenta, pulling the umbilical cord to remove the placenta) and less often when expelling a tumor with a short, inextensible stalk from the uterus.

Displacement of the uterus around the longitudinal axis has two forms: rotation of the uterus (rotation of the body and cervix from right to left or vice versa) and torsion of the uterus (torsio uteri). When the uterus is torsioned, the body of the uterus rotates in the area of ​​the lower segment while the cervix is ​​motionless.

Displacement of the uterus in the horizontal plane can be of several types: displacement of the entire uterus (antepositio, retropositio, dextropositio and sinistropositio), abnormal inclination of the uterus (retroversio, dextroversio, sinistroversio) and pathological inflection of the uterus.

Displacement of the entire uterus can be in four forms: antepositio, retropositio, dextropositio and sinistropositio.

Normally, an obtuse angle is formed between the body and the cervix, open anteriorly. However, with a pathological bend, this angle can be acute, open anteriorly (hyperanteflexio) or posteriorly (retroflexio).

Of all the types of anomalies in the position of the genital organs, the most important clinical significance is downward displacement of the uterus (prolapse), retrodeviation (posterior displacement, mainly retroflexion) and pathological anteflexion (hyperanteflexia).

Selected lectures on obstetrics and gynecology

Ed. A.N. Strizhakova, A.I. Davydova, L.D. Belotserkovtseva

As you know, during gynecological examinations in women, not only infectious and inflammatory diseases of the reproductive system are detected. After examining the patient, the doctor may also detect an abnormal location of the genital organs. One of these is the bend of the cervix.

What is cervical flexion?

Cervical flexion is a common disease of the female reproductive system. Characterized by deviation of an organ from its normal location. The doctor can detect the pathology when examining a woman in a chair.

Normally, in the small pelvis, the uterus occupies a mid-position, and its body and cervix are at an obtuse angle relative to each other. The uterine fundus is directed anteriorly and upward, and the cervical part (vaginal) is directed downward and posteriorly.

For certain reasons, an organ can change its position. This is not always a pathology. If a girl has such signs from birth (especially when her mother and grandmother had the same thing), we can assume that this is an individual genetic feature.

Classification: bending of the organ posteriorly, anteriorly, to the sides

Bends can be observed:

• with lateral displacement of the uterus;
• its inclinations (versions);
• bends (flexions).

Variants of the norm are considered:

1. Anteversion: the uterus is located in the center of the small pelvis, the body and the cervix are on the same axis.
2. Anteflexion: the uterus is located in the center of the small pelvis, the cervix is ​​located down and posteriorly, the bottom of the organ is directed upward and anteriorly.
3. Retroversion: the body and neck are on the same axis so that the organ occupies a posteriorly deflected position in the small pelvis.

The pathologies are:

1. Hyperanteflexia: bending of the uterine body forward, with the fundus strongly inclined towards the bladder.
2. Retroflexion: the body of the uterus is bent backwards, the fundus is shifted towards the rectum.
3. Sinistroflexia: bending of the uterine body to the left.
4. Dextrumflexion: bending of the uterine body to the right.

In addition to classification according to the position of the uterus in the pelvis, there are:

• fixed deviations (occur due to adhesions in the pelvis or tumor formations);
• unfixed deviations (they do not cause any particular concern, they are a consequence of sudden weight loss, delivery of a large fetus and some gynecological diseases).

Options for the location of the uterus in the pelvis - photo gallery

Position of the uterus anteversio Position of the uterus anteflexio Position of the uterus retroversio Retroflexio position of the uterus Hyperanteflexio position of the uterus

Causes and development factors

In approximately one in ten women with a similar diagnosis, an anomaly in the position of the uterus is considered a variant of the norm (anatomical feature of the body). Basically, organ displacement is a pathology and can be caused by a number of reasons:

• anatomical features of the structure of the reproductive organs;
• early drop-off of girls;
• adhesions in the pelvis;
• tumor process;
• ovarian cysts;
• inflammatory processes in the pelvic organs;
• weakening of the muscle tone of the uterus;
• weakening of the ligamentous apparatus that holds the uterus in its normal position in the pelvis;
• intrauterine surgical interventions (abortions, curettage, etc.);
• pregnancy pathologies;
• difficult childbirth;
• improper obstetric care;
• uterine subinvolution (poor contraction after childbirth);
• chronic constipation;
• untimely emptying of the bladder (overflow);
• hard physical labor.

If a woman has a history (information about the course of the disease) of any of the above, then she should be classified as a risk group.

Symptoms of a retracted uterus

Clinical symptoms with a changed position of the uterus are associated not so much with the anomaly itself, but with the reasons that caused this displacement.

What to pay attention to:

• painful menstruation. When blood and blood clots leave the cavity of the curved uterus, hypertonicity of its muscles occurs, which leads to quite painful sensations;
• constipation or increased frequency of urination due to squeezing of the intestines or bladder by the bent uterus;
• miscarriage due to impaired stretching of the uterine walls;
• infertility, which is associated with the inability of sperm to pass into the uterine cavity at the point of its inflection.
• pain during sexual intercourse (mostly occurs with fixed bends due to tissue overstretching);
• profuse leucorrhoea.

Diagnosis and differential diagnosis

Determining the abnormal location of the uterus is not difficult. The diagnosis is made on the basis of a gynecological examination and diagnostic methods.

Already during a bimanual (two-handed) examination of a woman in a chair, the doctor can detect a deviation of the uterus from its normal location. After this, he will give directions for additional research (depending on complaints and manifestations) to establish the exact causes of uterine inflexion, as well as to differentiate the pathology from other conditions:

• Ultrasound examination of the pelvic organs will help determine the size, position, location of the uterus and the condition of the appendages (the presence of tumors and cystic formations);
• magnetic resonance imaging (MRI) and computed tomography (CT) make it possible to more accurately see in several projections the location of the uterus in the pelvis and the position of the bend, the condition of the appendages, determine the presence of tumors and cysts, and adhesions;
• hysterosalpingography allows you to study the structure of the uterus and fallopian tubes, and also serves as a way to check tubal patency;

Treatment of uterine curvature

Treatment comes down primarily to eliminating the causes that caused the displacement of the organ. As a rule, this process is long. In some cases, the anomaly can only be eliminated through surgery. If nothing bothers the woman and no other pathologies have been identified, then she is put under dispensary observation to monitor her condition.

Drug therapy

Drug therapy is aimed at eliminating inflammatory and infectious processes in the pelvic organs and alleviating the symptoms of the pathology. For these purposes the following is used:

• antibacterial/antiseptic therapy. Used in the presence of bacterial infections (for example, Hexicon vaginal suppositories, Chlorhexidine solution);
• antiprotozoal drugs. Necessary if a fungal infection is present (for example, drugs Metronidazole, Trichopolum);
• non-steroidal anti-inflammatory drugs. Prescribed to relieve pain and relieve inflammation (Ibuprofen, Paracetamol);
• analgesics. Used for pain relief (Analgin, Tempalgin);
• enzyme proteolytic preparations. Used to improve nutrition and tissue permeability, resorption and elimination of adhesions (Longidaza drug).
• m-anticholinergics. Necessary to relieve pain during menstruation (they reduce the tone of the uterine muscles, thereby promoting the normal outflow of blood and blood clots from the uterine cavity). Such remedies include Buscopan rectal suppositories.

Medicines for the treatment of cervical flexion - photo gallery

Buscopan relaxes the uterine muscles, relieving pain Tempalgin is an excellent pain reliever Ibuprofen relieves pain and relieves inflammation in the pelvis Metronidazole is a broad-spectrum drug with antibacterial and antiprotozoal activity Longidaza promotes resorption of adhesions Hexicon belongs to the group of antiseptics; it is used for sexually transmitted diseases, as well as for infectious and inflammatory pathologies

Gymnastic exercises

If the cause of the pathology is weakening of the pelvic floor muscles, then Kegel gymnastics will help. Quite effective exercises are:

The gynecologist should draw up a set of necessary exercises and explain the exact technique of execution.

Gymnastics is practiced in different positions: sitting, lying, standing, on all fours and squatting.

Physiotherapeutic methods

Physiotherapeutic methods are not the only method of treatment and should only be used in combination. Very often, when the uterus is bent, gynecological massage is used. It helps with muscle weakness, adhesions and ovarian dysfunction. As a result of its implementation, blood circulation in the uterus and pelvic cavity improves, the tone of both the pelvic and uterine muscles increases, the adhesive process decreases (and in some cases is completely eliminated), which helps return the uterus to its normal position.

The course of treatment is individual and varies from 4 to 20 procedures.

It is also advisable to use:

• electro- and phonophoresis with drugs;
• acupuncture;
• hirudotherapy;
• mud therapy.

Surgical treatment

Surgical treatment is used extremely rarely and in extremely advanced cases. Using laparoscopy with minimal trauma, adhesions are dissected, tumor and cystic formations that have led to a change in the position of the uterus are removed, and its normal position is restored.

It should be noted that surgical treatment is not a 100% guarantee that relapse will not occur.

Folk remedies

Folk remedies cannot be regarded as a panacea. They are only additional aids in treatment.

Here are some recipes that can be used for this pathology:

Treatment prognosis and possible complications

Many women are concerned about the possibility of conceiving with an abnormal position of the uterus. In general, the prognosis is favorable, but difficulties may arise. After the treatment, the question of pregnancy and pregnancy disappears by itself, since fertility is completely restored. After childbirth, the uterus, as a rule, takes its proper position in the pelvis.

In severe cases and if a woman does not want to be treated (especially if there are complications), infertility may occur.

Prevention

Prevention comes down to normalizing lifestyle and eliminating provoking factors.

What is needed:

• eliminate heavy physical labor;
• carry out proper rehabilitation after childbirth;
• empty your bladder and bowels regularly (don’t tolerate it);
• regularly visit a gynecologist (at least 2 times a year) for timely detection and treatment of inflammatory processes (they provoke the formation of adhesions);
• girls in infancy should not be dropped off prematurely;
• sleep on your stomach;
• exclude physical inactivity;
• To prevent constipation, eat regularly, consume at least two liters of fluid per day, food should contain a large amount of fiber.
• strictly observe intimate hygiene.

Bend of the cervix-video

Deflection of the uterus is a completely curable pathology. Most often, conservative therapy is sufficient to relieve unpleasant symptoms. The main thing is not to neglect the problem and start treatment on time to avoid complications.