Uterine prolapse is one of the forms of prolapse (displacement, prolapse) of the pelvic organs. It is characterized by a violation of the position of the uterus: the organ moves down to the entrance to the vagina or even falls outside of it. IN modern practice this disease is considered as a variant of hernia pelvic floor, which develops in the area of ​​the vaginal opening.

Doctors in describing this disease and its varieties use the concepts of “prolapse,” “prolapse,” “genital prolapse,” and “cystorectocele.” Prolapse of the anterior wall of the uterus, accompanied by a change in the position of the bladder, is called a “cystocele.” Prolapse of the posterior wall of the uterus involving the rectum is called “rectocele.”

Prevalence

According to modern foreign studies, the risk of prolapse, requiring surgical treatment, is 11%. This means that at least one in 10 women will have surgery for this condition during their lifetime. In women after surgery, more than a third of cases experience a recurrence of genital prolapse.

The older a woman is, the higher her likelihood of having this disease. These conditions account for up to a third of all gynecological pathologies. Unfortunately, in Russia after the onset many patients for many years They do not turn to a gynecologist, trying to cope with the problem on their own, although every second of them has this pathology.

Surgical treatment of the disease is one of the most common gynecological operations. Thus, in the USA, more than 100 thousand patients are operated on annually, spending 3% of the entire healthcare budget on this.

Classification

Normally, the vagina and cervix are tilted backward, and the body of the organ itself is tilted forward, forming an angle with the axis of the vagina that is open forward. Adjacent to the anterior wall of the uterus bladder, the posterior wall of the cervix and vagina is in contact with the rectum. Above the bladder upper part The bodies of the uterus and the intestinal wall are covered with peritoneum.

The uterus is held in the pelvis by the force of its own ligamentous apparatus and the muscles that form the perineal area. When these formations become weak, they begin to sag or fall out.

There are 4 degrees of the disease.

1. The external uterine os descends to the middle of the vagina.
2. The cervix, together with the uterus, moves lower to the entrance to the vagina, but does not protrude from the genital slit.
3. The external os of the cervix moves outside the vagina, and the body of the uterus is located above, without coming out.
4. Complete prolapse of the uterus into the perineal area.

This classification does not take into account the position of the uterus, it determines only the most prolapsed area, often the results of repeated measurements differ from each other, that is, there is poor reproducibility of the results. Does not have these shortcomings modern classification genital prolapse, accepted by most foreign experts.

The corresponding measurements are taken with the woman lying on her back while straining, using a centimeter tape, a uterine probe or a forceps with a centimeter scale. The prolapse of points is assessed relative to the plane of the hymen (the outer edge of the vagina). The degree of prolapse of the vaginal wall and shortening of the vagina are measured. As a result, uterine prolapse is divided into 4 stages:

• Stage I: the most protruding zone is located above the hymen by more than 1 cm;
• Stage II: this point is located within ±1 cm of the hymen;
• Stage III: the area of ​​maximum prolapse is more than 1 cm below the hymen, but the length of the vagina is reduced by less than 2 cm;
• Stage IV: complete prolapse, reduction in vaginal length by more than 2 cm.

Causes and mechanism of development

The disease often begins at a woman’s fertile age, that is, before menopause. Its course is always progressive. As the disease develops, dysfunction of the vagina, uterus, and surrounding organs occurs.

For genital prolapse to occur, a combination of two factors is necessary:

• high blood pressure V abdominal cavity;
• weakness of the ligamentous apparatus and muscles.

Causes of uterine prolapse:

• decrease in estrogen production that occurs during menopause and postmenopause;
• congenital weakness connective tissue;
• trauma to the perineal muscles, in particular during childbirth;
• chronic diseases accompanied by impaired circulation in the body and increased intra-abdominal pressure (intestinal diseases with constant constipation, respiratory diseases with prolonged severe cough, obesity, kidneys, liver, intestines, stomach).

These factors in various combinations lead to weakness of the ligaments and muscles, and they become unable to hold the uterus in its normal position. Increased pressure in the abdominal cavity “squeezes” the organ down. Since the front wall is connected to bladder, this organ also begins to follow it, forming a cystocele. The result is urological disorders in half of women with prolapse, for example, urinary incontinence when coughing or physical exertion. When the posterior wall subsides, it “pulls” the rectum with it, forming a rectocele in a third of patients. Uterine prolapse often occurs after childbirth, especially if it was accompanied by deep muscle tears.

Multiple births, intense physical activity, and genetic predisposition increase the risk of the disease.

Separately, it is worth mentioning the possibility of vaginal prolapse after amputation of the uterus for another reason. According to various authors, this complication occurs in 0.2-3% of operated patients with a removed uterus.

Clinical picture

Patients with prolapse pelvic organs– mostly elderly and senile women. Younger patients usually have early stages of the disease and are in no hurry to see a doctor, although the chances of treatment success in this case are much greater.

• feeling that there is some kind of formation in the vagina or perineum;
• prolonged pain in the lower abdomen, in the lower back, tiring the patient;
• protrusion of a hernia in the perineum, which is easily injured and infected;
• painful and prolonged menstruation.

Additional signs of uterine prolapse arising from pathology neighboring organs:

• episodes acute delay urination, that is, the inability to urinate;
• urinary incontinence;
• frequent urination in small portions;
• constipation;
• in severe cases, fecal incontinence.

More than a third of patients experience pain during sexual intercourse. This worsens their quality of life, leads to tension in family relationships, negatively affects a woman’s psyche and forms the so-called pelvic descent syndrome, or pelvic dysynergia.

Varicose veins often develop with swelling of the legs, cramps and a feeling of heaviness in them, and trophic disorders.

Diagnostics

How to recognize uterine prolapse? To do this, the doctor collects anamnesis, examines the patient, and prescribes additional methods research.

A woman needs to tell the gynecologist about the number of births and their course, previous operations, diseases of internal organs, and mention the presence of constipation and bloating.

The main diagnostic method is a thorough two-manual gynecological examination. The doctor determines how much the uterus or vagina has descended, finds defects in the pelvic floor muscles, and performs functional tests - a straining test (Valsalva test) and a cough test. A rectovaginal examination is also performed to assess the condition of the rectum and the structural features of the pelvic floor.

To diagnose urinary incontinence, urologists use a combined urodynamic study, but in case of organ prolapse, the results are distorted. Therefore, such a study is optional.

If necessary, endoscopic diagnostics are prescribed: (examination of the uterus), cystoscopy (examination of the bladder), sigmoidoscopy (examination of the inner surface of the rectum). Typically, such studies are necessary if cystitis, proctitis, hyperplasia or cancer is suspected. Often, after surgery, a woman is referred to a urologist or proctologist for conservative treatment of identified inflammatory processes.

Treatment

Conservative treatment

Treatment of uterine prolapse should achieve the following goals:

• restoration of the integrity of the muscles that form the pelvic floor and their strengthening;
• normalization of the functions of neighboring organs.

Stage 1 uterine prolapse is treated conservatively outpatient setting. The same tactics are chosen for uncomplicated genital prolapse of the 2nd degree. What to do in case of uterine prolapse in mild cases of the disease:

• strengthen the pelvic floor muscles with therapeutic exercises;
• give up heavy physical activity;
• get rid of constipation and other problems that increase intra-abdominal pressure.

Is it possible to pump up the abs when the uterus prolapses? When lifting the body from a lying position, intra-abdominal pressure increases, which further pushes the organ out. Therefore, therapeutic exercises include bending over, squats, and swinging legs, but without straining. It is performed in a sitting and standing position (according to Atarbekov).

At home

Treatment at home includes a diet rich in plant fiber and reduced in fat. It is possible to use vaginal applicators. These small devices produce electrical stimulation of the perineal muscles, strengthening them. There are developments in SCENAR therapy aimed at improving metabolic processes and strengthening ligaments. Can be done.

Massage

Gynecological massage is often used. It helps restore the normal position of organs, improve their blood supply, eliminate discomfort. Typically, 10 to 15 massage sessions are performed, during which the doctor or nurse lifts the uterus with the fingers of one hand inserted into the vagina, and with the other hand they make circular massage movements through the abdominal wall, as a result of which the organ returns to its normal place.

However, all conservative methods can only stop the progression of the disease, but not get rid of it.

Is it possible to do without surgery? Yes, but only if the prolapse of the uterus does not lead to its prolapse outside the vagina, does not impede the function of neighboring organs, does not cause the patient troubles associated with an inadequate sexual life, and is not accompanied by inflammatory and other complications.

Surgery

How to treat grade III–IV uterine prolapse? If, despite all conservative treatment methods or due to the patient’s late request for medical help, the uterus has moved beyond the vagina, the most effective method treatment – ​​surgical. The purpose of the operation is to restore normal structure genital organs and correction of impaired functions of neighboring organs - urination, defecation.

Warp surgical treatment– vaginopexy, that is, securing the vaginal walls. For urinary incontinence, strengthening of the urethral walls (urethropexy) is performed at the same time. If there is weakness of the perineal muscles, they undergo plastic surgery (restoration) with strengthening of the cervix, peritoneum, and supporting muscles - colpoperineolevatoroplasty, in other words, suturing the uterus during prolapse.

Depending on the required volume, the operation can be performed using transvaginal access (through the vagina). This is how, for example, removal of the uterus, suturing of the vaginal walls (colporrhaphy), loop operations, sacrospinal fixation of the vagina or uterus, and strengthening of the vagina using special mesh implants are performed.

During laparotomy (incision in the anterior abdominal wall) surgery for uterine prolapse involves fixing the vagina and cervix with its own tissues (ligaments, aponeurosis).

Sometimes laparoscopic access is used - a low-traumatic intervention, during which it is possible to strengthen the vaginal walls and sutured defects in surrounding tissues.

Laparotomy and vaginal access do not differ from each other in long-term results. Vaginal is less traumatic, with less blood loss and the formation of adhesions in the pelvis. Application may be limited due to lack of necessary equipment or qualified personnel.

Vaginal colpopexy (strengthening the cervix through the vagina) can be performed under conduction, epidural anesthesia, intravenous or endotracheal anesthesia, which expands its use in older people. This surgery uses a mesh implant to strengthen the pelvic floor. The duration of the operation is about 1.5 hours, blood loss is insignificant - up to 100 ml. Starting from the second day after the intervention, the woman can already sit down. The patient is discharged after 5 days, after which she undergoes treatment and rehabilitation in the clinic for another 1-1.5 months. The most common complication in long term– erosion of the vaginal wall.

Laparoscopic surgery is performed under endotracheal anesthesia. During it, a mesh prosthesis is also used. Sometimes amputation or hysterectomy is performed. The surgical field requires early activation of the patient. Discharge takes place 3-4 days after the intervention, outpatient rehabilitation lasts up to 6 weeks.

For 6 weeks after surgery, a woman should not lift weights exceeding 5 kg; sexual rest is required. Physical rest is also necessary for 2 weeks after the intervention, then you can perform light work around the house. Average term temporary disability ranges from 27 to 40 days.

What to do in the long term after surgery:

• do not lift weights exceeding 10 kg;
• normalize stool, avoid constipation;
• treat diseases in time respiratory tract accompanied by cough;
• long-term use of estrogen suppositories (Ovestin) as prescribed by a doctor;
• Do not engage in certain sports: cycling, rowing, weightlifting.

Features of treatment of pathology in old age

Gynecological ring (pessary)

Treatment of uterine prolapse in old age is often difficult due to concomitant diseases. In addition, often this disease is already in an advanced stage. Therefore, doctors face significant difficulties. To improve treatment results, at the first signs of pathology, a woman should contact a gynecologist at any age.

Therefore, a bandage will provide significant assistance to a woman with uterine prolapse. It can also be used by younger patients. These are special supportive panties that tightly cover the abdominal area. They prevent uterine prolapse, support other pelvic organs, and reduce the severity of involuntary urination and pain in the lower abdomen. Pick up good bandage It’s not easy, a gynecologist should help with this.

A woman must perform therapeutic exercises.

If the prolapse is significant, surgery is performed, often removing the uterus through a vaginal approach.

Consequences

If the disease is diagnosed in a woman of fertile age, she often has the question of whether it is possible to become pregnant if the walls of the uterus prolapse. Yes, there are no special obstacles to conception in the early stages if the disease is asymptomatic. If the prolapse is significant, then before a planned pregnancy it is better to undergo surgery 1-2 years before conception.

Maintaining pregnancy with proven uterine prolapse is difficult . Is it possible to carry a child to term with this disease? Of course, yes, although the risk of pregnancy pathology, miscarriage, premature and rapid labor, bleeding in the postpartum period. In order for the pregnancy to develop successfully, you need to be constantly monitored by a gynecologist, wear a bandage, use a pessary if necessary, exercise physical therapy, accept medicines prescribed by a doctor.

What are the dangers of uterine prolapse besides possible problems with pregnancy:

• cystitis, pyelonephritis – urinary system infections;
• vesicocele - a saccular expansion of the bladder in which urine remains, causing the sensation of incomplete emptying;
• urinary incontinence with perineal skin irritation;
• rectocele - expansion and prolapse of the rectal ampulla, accompanied by constipation and pain during bowel movements;
• infringement of the intestinal loops, as well as the uterus itself;
• uterine inversion followed by necrosis;
• deterioration in the quality of sexual life;
• decline overall quality life: a woman is embarrassed to go out into a public place because she is constantly forced to run to the toilet, change incontinence pads, it exhausts her constant pain and discomfort when walking, she does not feel healthy.

Prevention

Prolapse of the uterine walls can be prevented in this way:

• minimize prolonged traumatic labor, if necessary, by eliminating the period of pushing or performing a caesarean section;
• promptly identify and treat diseases accompanied by increased pressure in the abdominal cavity, including chronic constipation;
• if ruptures or cuts of the perineum occur during childbirth, carefully restore the integrity of all layers of the perineum;
• recommend hormone replacement therapy to women with estrogen deficiency, in particular during menopause;
• prescribe special exercises to strengthen the muscles that form the pelvic floor for patients at risk of genital prolapse.

Prolapse of the uterus is pathological condition, which is characterized by a downward displacement of the organ relative to the normal anatomical position. In the most severe cases, the uterus may prolapse outward.

Uterine prolapse is the most common clinical practice abnormal position of female organs reproductive systems s. Pathology is one of the special cases of pelvic organ prolapse. It can be detected at almost any age, but over the years the likelihood of developing prolapse increases.

More than half of the diagnosed cases occur in patients over 50 years of age. The uterus is held in the pelvis in the correct position by muscles, fascia and ligaments. The tone of the muscles of the walls of the organ itself, i.e. the myometrium, is also of certain importance. The cause of the pathology is failure muscle fibers and ligaments. For prolapse of the uterus the following are characteristic: clinical manifestations like a feeling of pressure and pain in the lower abdomen. Patients often experience dysmenorrhea, spotting, as well as dysuria and proctological complications.

Weakness of the musculo-ligamentous apparatus of the uterus can be caused by a number of factors.

The reasons leading to uterine prolapse include:

• congenital malformations in the pelvic area;
• family (genetically determined) predisposition;
• trauma during childbirth;
• surgical interventions on the organs of the reproductive system;
• age-related muscle weakening;
• hormonal imbalance during menopause;
• violations of the innervation of the pelvic floor muscles;
• significant and regular physical activity (weight lifting);
• pathologies of connective tissue of ligaments;
• neoplasms (cysts, fibroids).

During childbirth, significant ruptures of the perineum (in particular, with the breech presentation of the fetus) in some cases lead to serious muscle damage. Injuries can also be sustained by a woman in labor when obstetricians use a vacuum extractor and obstetric forceps.

Benign neoplasms increase the load on the ligaments of the pelvic area, which may well provoke prolapse of the uterus.

One of the predisposing factors may be a severe chronic cough, in which the muscles of the diaphragm are constantly tense.

Important:One of the reasons for uterine displacement is high intra-abdominal pressure against the background of and (or) chronic and flatulence.

Typically, the development of the disease involves a combination of two or more factors.

Degrees of uterine prolapse

It is customary to distinguish 4 degrees of development of pathology:

1. 1st degree– it is characterized by a very slight displacement of the organ or neck relative to the anatomical border. The cervix may be at the level of the vestibule of the vagina, but when tense it is not visible from the outside. The walls are slightly lowered, but there is a gaping of the genital slit;
2. 2nd degree of uterine prolapse– it reveals partial loss; when straining, the cervix comes out;
3. 3rd degree- This is an incomplete loss. Not only the cervix, but also part of the body of the organ protrudes from the genital tract;
4. 4th degree of prolapse– it is characterized by complete prolapse of the uterus.

There are many clinical manifestations, so it is difficult for a sick woman not to notice them, and diagnosing the disease is usually not difficult.

Typical symptoms of uterine prolapse include:

Important:at the earliest stages of development of the pathological process severe symptoms there may not be. They increase as the disease progresses.

With degrees 2-4 of prolapse, the patient herself can determine that the uterus partially protrudes outward.

Please note:The volume of blood loss during menstruation is in some cases so significant that it becomes the cause of anemia.

Dysuria with difficulty passing urine during uterine prolapse can provoke infectious complications. In this case, the urinary organs suffer; Patients with uterine prolapse are often diagnosed with symptoms of inflammation of the urethra, bladder, or renal pelvis caused by pathogenic or conditionally pathogenic microflora. Proctological complications are common; , constipation or incontinence of intestinal gases and feces are observed in every third case. The protruding part of the body of the organ becomes covered with cracks. When walking, the uterus is additionally injured as a result of friction, causing bleeding ulcers and bedsores to appear, and the likelihood of infection increases.

Prolapse of the uterus is accompanied by the appearance of cyanosis (cyanosis) and swelling of the surrounding tissues. Due to impaired microcirculation, blood stagnation develops.

Among possible complications– strangulation of the uterus with complete or partial prolapse and varicose veins of regional veins. It is also possible that a fragment of the intestine may be strangulated.

Medical tactics depend on the degree of prolapse, the presence accompanying pathologies and the need to preserve reproductive function.

Please note:All patients are certainly concerned about the question “is it possible to treat uterine prolapse without surgery?” Unfortunately, with grade 3-4, you definitely cannot do without the help of a surgeon. To strengthen the diaphragm and muscles of the pelvic area, massage and gymnastic exercises are indicated, but these techniques are effective for prevention, not treatment.

Conservative methods have a positive effect if the cervix or uterine body has slightly shifted beyond the anatomical boundaries. Drug treatment omission involves the use of products based on female sex hormones - estrogens. Ointments with estrogens and components to improve microcirculation and metabolism are prescribed locally (intravaginally).

In the early stages, a conservative technique is used, such as gynecological massage. Treatment involves regular sessions over several months (with breaks). Massage is performed only by a qualified specialist on a gynecological chair or a special table. The duration of each procedure is 10-15 minutes. If during the massage the patient feels intense pain, this is an indication to stop the manipulation.

There are a number of options for surgical intervention for uterine prolapse, and it is quite difficult to select the most effective treatment method. To return the organ to its normal position, the round ligaments are often shortened and sutured to each other and to the wall of the uterus. Often they also resort to fixing the uterus to the sacrum, pubic bone or pelvic ligaments, which are the walls of the pelvic floor. After surgery, there is always a certain risk of recurrence of the condition, which is due to the stretchability of the ligaments.

Please note:Currently, surgeons are increasingly resorting to operations using synthetic implants with a mesh structure, since these materials significantly reduce the risk of prolapse recurrence. Biologically inert reinforcing devices are installed during laparotomy, that is, through small incisions on the abdominal wall.

Operations are performed through the anterior abdominal wall or vagina. As a rule, in parallel with the strengthening of the ligaments, plastic surgery is performed ( surgical correction) the patient's vagina.

The presence of serious concomitant pathologies of the organ may be an indication for hysterectomy. But, since removal of the uterus can provoke prolapse of other pelvic organs, if possible, the organ should be preserved.

Please note: 15% of gynecological operations are performed precisely in connection with uterine prolapse.

After surgical treatment for uterine prolapse, patients are contraindicated in physical activity, especially those associated with lifting weights. To prevent recurrent prolapse, therapeutic exercises are prescribed. Great value To prevent relapses, constipation is prevented.

Elderly women with incomplete prolapse are often advised to install hollow rubber pessary rings in the vagina. These devices are needed as support for the displaced uterus. On for a long time pessaries cannot be installed, since the risk of developing local inflammation and bedsores is high. Installation of rings requires daily douching with anti-inflammatory drugs (infusion of chamomile) and antiseptics (solutions of potassium permanganate and furacilin).

With timely and adequate treatment of uterine prolapse, as well as strict adherence Based on the patient's recommendations from the attending physician, the prognosis is usually favorable.

Prevention of uterine prolapse

Only 10% of cases of the disease are diagnosed in women under 30 years of age, but it is recommended to start preventing uterine prolapse in adolescence. Girls should be taught to do physical exercises that help strengthen their pelvic and abdominal muscles. It is important for all women to avoid strenuous physical work.

Please note:according to special instructions According to labor protection standards enshrined in legislation, a woman’s work should not involve lifting objects weighing more than 10 kg!

To prevent uterine prolapse, it is necessary to take measures to prevent constipation (a special diet and laxatives may be indicated).

An important role in the prevention of pathology is played by qualified pregnancy management and proper obstetric care. Expectant mothers should undergo routine examinations V antenatal clinic, and give birth only in specialized hospitals– maternity hospitals or perinatal centers.

In the postpartum period, it is important to avoid physical activity and regularly do gymnastics to maintain the tone of the muscles of the pelvis and anterior abdominal wall. The intensity of the loads, the frequency of exercises and the timing of the start of training should be determined by the attending physician based on objective assessment physical condition female patients.

Preventive exercise is also recommended for women during menopause, as the risk of uterine prolapse increases significantly during this time. In addition to exercise therapy, the attending physician may prescribe medications that improve blood circulation and increase the tone of the organ itself and its ligaments. Often patients are prescribed replacement therapy with the use of hormonal agents.

Qualified management plays an important role in the prevention of pathology.

Exercises to prevent uterine prolapse

Gymnastics to prevent uterine prolapse involves performing the following simple exercises:

In the first stages, it is enough to perform the exercises 5-7 times, and then gradually increase the number of repetitions to 20.

Please note:Normally climbing stairs also helps strengthen the muscles of the pelvic area.

The total duration of daily training should be 30-40 minutes. By devoting half an hour to your health every day, you will greatly reduce the likelihood of uterine prolapse and the development of other diseases of the urinary and reproductive systems and lower digestive tract.

More detailed information You will learn about uterine prolapse, methods of treating pathology and its prevention by watching this video review:

Yulia Viktorova, obstetrician-gynecologist

It’s hard to believe, but every second woman over the age of 50 learns from her treating gynecologist that the cause of her constant pulling and pressing pain in the lower abdomen is prolapse of the uterus (in the words of medical textbooks - genital prolapse or uterocele). The pelvic floor muscles have weakened so much that they can no longer hold the uterus (and often neighboring organs - the bladder, rectum) in its natural position.

The pathology develops unnoticed and, most likely, the impetus for the disease was given in youth - difficult childbirth, carrying heavy loads, pelvic injuries and inflammation. Such situations are not uncommon; in India, for example, uterine prolapse is almost epidemiological in nature, and even in the prosperous United States, more than 15 million women suffer from this disease.

The uterus is the most mobile organ of the abdominal cavity. Even healthy woman it can constantly change its position depending on the filling of the colon and bladder - the uterus is located right between them. When it descends into the vagina, neighboring organs are forced to “move.”

Often the situation is aggravated by displacement of the bladder (cystocele) and rectum (rectocele), hence problems with urination and constipation. There is a persistent feeling as if something is pressing down below, interfering, bloody discharge and pain may appear, radiating to the lower back and sacrum. As prolapse occurs, either difficulty urinating or, on the contrary, urinary incontinence is possible.

The menstrual cycle often gets confused and throws up unexpected surprises every now and then, and bleeding is accompanied by intense pain.

As a rule, the more prolapsed the uterus, the heavier your periods. In some cases, the amount of blood loss is so significant that there is a real risk of developing anemia.

During sexual intercourse, a woman also feels discomfort. If the uterus drops so much that its cervix protrudes beyond the genital slit, then intimacy will be impossible at all.

Every second patient whose uterus is displaced downward also suffers from various urological disorders. Difficulty urinating provokes the development of the symptom of residual urine, and then infection various departments urinary tract. Cystitis, pyelonephritis, urolithiasis - this is an incomplete list of consequences that will have to be eliminated.

4 stages of pathology development

Stage 1– slight downward displacement of the organ. The initial stage of development of pathology is spoken of until the cervix is ​​not visible from the outside, even with high voltage. The walls of the vagina are also slightly lowered, the genital slit may not close.

Stage 2– most of the time the cervix is ​​hidden in the vagina, but when straining it can be seen outside the genital slit.

Stage 3- not only the cervix, but also some part of its body is constantly below the level of the entrance to the vagina.

Stage 4- complete prolapse of the uterus.

The insidiousness of the situation is that early stage the woman may not feel any discomfort at all. But uterine prolapse has already begun, and if it is not diagnosed in time, then soon the uterus will drop so much that it will be visible. Most often this occurs due to incompetence of the pelvic floor muscles. They stretch, lose tone and can no longer hold the uterus in its normal physiological position.

Regularly visiting a gynecologist and monitoring the position of the uterus is especially important if your medical history includes:

• injuries sustained during childbirth due to breech presentation, the use of obstetric forceps or a vacuum extractor;
• deep perineal lacerations;
• surgical operations performed on the organs of the reproductive system;
• benign formations - cysts, fibroids, fibroids;
• congenital malformations of organs located in the pelvic area.

Work associated with regular physical activity and lifting objects weighing more than 10 kg is contraindicated for women of any age. This provision is enshrined at the legislative level and is listed as a separate item in the set of instructions on labor protection.

A common cause of uterine prolapse is increased intra-abdominal pressure. It can develop due to obesity, chronic constipation and flatulence. Even a strong, prolonged cough can force the uterus to move - it creates increased pressure in the abdominal cavity.

Most often, not one, but several factors play a role in the development of pathology. The situation is further aggravated if a woman is going through menopause - the lack of female sex hormones (estrogens) in the body certainly affects muscle tone.

How is the problem diagnosed?

The fact that the uterus is not in place can be understood during a routine gynecological examination. To determine the stage of prolapse, the doctor asks the patient to push. But since prolapse of not only the vaginal walls, but also neighboring organs is often observed, two more specialists must assess the situation - a urologist and a proctologist.

In addition to superficial examinations, you will have to undergo another mandatory examination - colposcopy. If no concomitant diseases of the uterus are found, the need for surgical intervention will disappear, then the woman will be registered at the dispensary and conservative treatment will be prescribed.

But if it is determined that the only way to solve the problem is organ-preserving plastic surgery, then the day before the patient will have to undergo several additional examinations:

• curettage and diagnosis of the uterine cavity;
• smears on flora, bacterial culture;
• excretory urography;
• computed tomography, necessary to clarify the condition of all pelvic organs.

Prolapse of 1st and 2nd degree: conservative treatment methods

As long as the uterus has not yet descended below the genital slit and the functions of adjacent organs are not impaired, the situation can be corrected by conservative methods:

• physical therapy aimed at strengthening the abdominal and pelvic floor muscles (a set of gymnastic exercises according to Kegel or Yunusov);
• gynecological massage (performed regularly for several months);
• a course of medications containing estrogen (this hormone is necessary to strengthen the ligamentous apparatus);
• local administration of ointments into the vagina, with high content metabolites and all the same estrogens.

Gynecological massage has long been recognized as an effective method of restoring the tone of the perineal muscles. The main thing is that it is performed by an experienced gynecologist. Any painful sensations during a massage is a reason to abandon this technique and look for other ways of conservative treatment.

Important to consider individual characteristics the patient, her reactions and, based on this, select the optimal speed and intensity of movements. The duration of each session is individual. On average it takes about 10-15 minutes.

The impact on the uterus occurs through palpation. With one hand the doctor massages the organ from the inside, and with the other he feels through the abdomen. In this way, the uterus is thoroughly palpated from all sides. It is also recommended for a woman to sleep on her stomach.

The effect of this technique: it is eliminated, adhesions disappear, blood circulation in all pelvic organs improves, and overall tone increases. Many women experience a long-awaited pregnancy after a course of massage.

Prolapse of the 3rd and 4th degree: various types of operations

If conservative therapy does not produce results and the uterus is already visible outside the genital slit, then surgery remains the only way to solve the problem. This is a common practice - 15 out of 100 gynecological operations are performed due to uterine prolapse.

1. Vaginoplasty – complex plastic surgery, aimed at strengthening the muscles of the pelvic floor, bladder and vagina. Since these muscles are involved in the prolapse of the uterus, vaginoplasty is always performed as a primary or additional measure.
2. Fixation of the round ligaments of the uterus to its anterior or back wall. Such operations are not performed often - the relapse rate is too high. The fact is that it is possible to fix the uterus with its own round ligaments, but they stretch over time, which means the uterus can descend again.
3. Stitching the uterine ligaments together. Effective technique, but sometimes leads to loss of fertility function.
4. Fixation of displaced organs to the walls of the pelvic floor. Most often they are attached to the sacral or pubic bone, as well as the pelvic ligaments.
5. Strengthening ligaments and fixing the uterus using alloplastic materials. The method has its own risks - the body can reject the foreign alloplast, and fistulas can develop.
6. Another way to prevent the uterus from falling out is to partially narrow the vaginal lumen.
7. The last radical method used when it is simply impossible to return the uterus to its place is hysterectomy, that is, removal of the organ. This is an extreme measure that they try to avoid. Since, by removing the uterus, you can provoke a strong displacement of other organs of the pelvic floor.

Most often, surgeons use combined techniques, allowing you to simultaneously perform vaginal plastic surgery, fix the uterus, and strengthen the ligamentous-muscular apparatus of the pelvic floor. This is the only way to be sure that the genitals are securely attached and relapses will not occur.

After surgery, you must completely avoid physical activity and follow a diet to avoid constipation.

Laparoscopic method

Another method of surgical treatment of uterine prolapse involves securing it with a special mesh. The mesh is elastic and can stretch, for example, during pregnancy. The same mesh can be used to secure the bladder and rectum during surgery.

Intervention is performed with modern laparoscopic method, through a miniature (no more than 2 cm) incision in the abdominal cavity. After such an operation, there are no scars or adhesions left, which means it will not affect the condition of the vagina or the woman’s sex life.

This is the least traumatic and most effective method of treating pathology. Already on the 3rd day the patient was discharged home. Average duration The recovery period is about a month. Relapses and repeated organ prolapses are excluded.

Contraindications for the operation?

Often, uterine prolapse is a problem for older and elderly women, so surgical intervention is not always possible. If there are contraindications for surgical intervention, the situation can be controlled using vaginal tampons or pessaries.

- This is a thick rubber ring that serves as a temporary support for the displaced uterus. There is air inside it, thanks to which the ring can be both elastic and elastic, without creating discomfort for the woman. You cannot leave the pessary in the vagina for a long time - bedsores may appear. It is worn for 3-4 weeks, then a short break is taken and after 2 weeks it is inserted again.

To avoid inflammation while the ring is in the vagina, special douching must be done every day. To do this, you can use a decoction of chamomile and antiseptics - a solution of furatsilin or potassium permanganate.

Another way to fix the uterus at a normal physiological level is to wear a bandage. The design of the bandage designed to support the uterus is different from other bandage systems. It tightly encircles the thighs, supporting the uterus from the sides, and passes through the perineum, supporting it from below. Wearing a bandage for more than 12 hours a day is not recommended, so as not to put excessive stress on the pelvic organs.

Uterine prolapse and pregnancy

Uterine prolapse of the 1st degree is not a contraindication to pregnancy and, on the contrary, can contribute quick conception. Since mild forms of the pathology are practically asymptomatic, a woman can only find out that the uterus is not in place when registering, undergoing mandatory gynecological examination. Pregnancy and childbirth are possible in this case, but the expectant mother should immediately prepare for some difficulties.

1. She will often be bothered by pulling aching pain lower abdomen. Many pregnant women with uterine prolapse find it difficult not only to walk, but also to stand.
2. Prolapse can become a threat to the life of not only the unborn child, but also the mother.
3. Prolapse of the uterus during pregnancy is a direct indication for wearing a bandage. This is the only way to support the internal organs in the correct position and relieve excessive stress on the spine.
4. It is important for a pregnant woman with prolapse to control her weight. The more kilograms she gains, the heavier the fetus will be and the greater the load will be on the already weakened uterine ligaments. If the baby is too large, there is a high probability of premature birth.
5. The birth process also has its own specifics. The doctor must choose a special position for the woman that will ensure minimal stress on her genitals. In this case, you cannot pull the baby by the head, and the arms and legs should be pulled out especially carefully. The qualifications of the doctor in this case are crucial. If he allows ruptures and treats them unsuccessfully, then after childbirth the uterus will drop even lower, and the pathology will move to the next, more severe stage.

Prevention of uterine prolapse - physical therapy

Train your perineal muscles by doing the lift exercise.

First, you need to smoothly tense the muscles and hold in this position for 4-5 seconds, then just as slowly relax. Now tense your muscles again and try to stay in this position for a few seconds longer than the first time. Gradually increase the pace and duration. It’s great if you can stay tense for at least 20 seconds.

Exercise "bicycle"

Lie on your back and move your legs in a circular motion as if you were riding a bicycle. Turn the pedals as much as you can. After a minute, repeat the exercise and try to “ride” a little longer.

Make “scissors” with your feet

Remaining on your back, straighten your legs and then lift them up one at a time. The angle formed between the leg and the floor should be approximately 45 degrees. Try to keep your leg straight, do not bend it at the knee joint and hold it at an angle for 5-6 seconds. Then lower and lift your other leg. Each time, try to keep your leg up for as long as possible, gradually increasing this time to 20 seconds.

"Triangle"

When you're done with the scissors, bend your knees and place your feet on the floor. While remaining lying down, raise your torso and lean on your elbows. Now lift your pelvis and tense your perineal muscles with all your might. Freeze in this position for a few seconds, relax and repeat from the beginning.

"Boat"

Roll over onto your stomach, and now try to bend over and raise both your arms and legs at the same time. Count to 5, return to starting position and bend again, but this time try to count to 6. Repeat until you reach 20.

You need to increase the load gradually. Starting with 5-7 approaches, after a month of regular exercise, the number of repetitions of each exercise must be increased to 20 - only in this case there will be an effect. Such exercises will not take much time - only 30-40 minutes a day, but the benefits of exercise therapy are significant. With its help, you can not only reliably strengthen the uterus in place, but also prevent the development of a number of diseases genitourinary system and organs of the digestive tract.

Try to use the elevator as little as possible. Every time you climb stairs, your pelvic area muscles become stronger.

Such simple exercises are an important part of recovery after childbirth and effective prevention. gynecological diseases during menopause. Uterine prolapse is a serious problem, which is nevertheless easily solvable in the early stages. As soon as you feel that you are going to the toilet more often than usual, you cannot stand it for long and are afraid of coughing or sneezing again - this is the first, but very serious “bell”. The sooner you suspect something is wrong and consult a doctor, the greater your chances of avoiding surgery.

Uterine prolapse is a change in the location of the internal organs of the woman’s reproductive system with partial or complete exit of the uterus through the genital opening. During the development of pathology, the patient feels severe pain and tension in the sacral area, feeling of a foreign body in the genital fissure, impaired urination and bowel movements, increased pain syndrome during sex, as well as discomfort when moving.

Cervical and vaginal prolapse is characterized as a hernial protrusion, which occurs when the pelvic floor muscles do not function properly. Following the uterus, the vagina, bladder, and rectum begin to shift.

Before a doctor diagnoses a prolapsed uterus, the patient is first diagnosed with genital prolapse. Incomplete protrusion can be recognized by the outward displacement of only the cervix, and complete prolapse is characterized by protrusion of the entire organ from the genital slit.

The disease develops in the weaker half of humanity at any time age category. In girls under 30 years of age, the disease develops in 10% of cases; from 30 to 40 years of age, the pathology affects 40% of women. IN old age the anomaly is diagnosed in 50% of cases.

Etiology

Provoking factors for the appearance of uterine prolapse can be:

• pelvic muscle injuries;
• hereditary developmental anomalies of the genital area;
• violation of the innervation of the pelvic floor muscles;
• genital surgery;
• labor activity;
• old age of women;
• carrying heavy objects;
• genetic predisposition;
• early gynecological ailments.

Displacement and prolapse of the uterus are interconnected processes that develop sequentially. A pathological effect is formed due to weakening of the ligaments and muscles of the pelvic floor diaphragm. The disease begins to progress with damage to the perineum, multiple pregnancies, frequent childbirth, bearing large children, surgical interventions on the genitals.

Uterine prolapse in women also occurs with excess body weight, high intra-abdominal pressure and tumors in the abdomen. All these reasons provoke a deterioration in the functionality of the muscular-ligamentous apparatus.

Classification

The process of prolapse and protrusion of the uterus from the genital slit occurs in several stages:

• the first is characterized by weakness of the pelvic floor muscles, sagging vaginal walls and an open genital cleft;
• the second is partial loss of organs. Together with the walls of the vagina, the bladder and rectum descend;
• the third - occurs before the genital slit;
• fourth - incomplete uterine prolapse is manifested by the exit of part of the organ outside the vagina;
• fifth - a complete change in the location of the organ - prolapse from the genital slit.

Symptoms

There are not many clinical signs of the disease, however, the appearance of abnormal placement of the uterus or its cervix is ​​quite difficult to miss, so diagnosing the disease is not difficult. Symptoms of the disease are characterized by the following:

• pressure in the lower abdomen;
• , passing to the sacral part and lumbar region;
• sensation of a foreign object in the vagina;
• difficulty or excessively frequent urination;
• Bloody discharge may appear;
• pain attacks during sex;
• constipation;
• disruption of the menstrual cycle;
• increased pain during menstruation.

In the initial stages of the formation of organ displacement, symptoms may be very mild, or even not appear at all. It worries a woman when the disease begins to progress and at stages 2–4 of uterine prolapse, and the symptoms become more pronounced.

Diagnostics

If the above symptoms are detected, the patient should immediately seek help from a doctor. To examine the condition of a woman and her genitals, a gynecologist performs the following procedures:

• gynecological examination in mirrors;
• microscopy of vaginal discharge;
• cytological analysis of cervical smears;
• colposcopy;
• Ultrasound of the pelvic organs.

If a woman has discovered a displacement of the bladder into the area of ​​uterine prolapse, then the doctor needs to conduct an examination of the urinary system. A rectal examination is performed if pathological process the rectum and intestines are involved.

Treatment

After determining the disease and its etiology, doctors can begin therapy. Diseases of the female genital organs can be treated conservatively or surgically. To prescribe a course of therapy, the physician needs to know the following nuances:

• stage of development of the anomaly;
• concomitant diseases;
• the importance of preserving reproductive function;
• surgical and anesthetic risk;
• damage to the colon, its sphincters and bladder.

After identifying these indicators, the therapy technique is determined. Treatment of uterine prolapse initial stages carried out using conservative methods without radical intervention. A woman needs to use special drugs, which contain estrogens.

Within conservative therapy, the woman is also prescribed physical education and massages. However, it is worth remembering that in therapeutic exercises there should be light movements that do not greatly strain the lower abdomen, since with such a disease the patient is strictly prohibited from heavy loads.

If such procedures are ineffective, the patient is prescribed a pessary. These are special rings with different diameters. They are made of thick rubber and filled with air inside, which allows these rings to be elastic and elastic. They are inserted by a doctor into a woman’s vagina and provide some kind of support for the organ. Uterine rings when the uterus prolapses, they rest against the walls of the vagina and stop the cervix in one place.

Quite often, such an operation is performed on women in old age or when carrying a child. When introducing such rings into the vagina, a woman needs to undergo regular treatment folk remedies, that is, douching with decoctions of herbs, potassium permanganate or furatsilin.

If necessary, doctors perform more traumatic types of surgery with suturing of the ligaments and muscles of the organ.

Additionally, a diet is prescribed to normalize the functioning of the gastrointestinal tract, wearing a bandage and gymnastics.

• tighten the lower abdomen;
• imitate attempts;
• perform a “bicycle”;
• “boat” in a lying position;
• walking up the steps.

There are quite a lot of exercises to strengthen the pelvic floor muscles, however, doctors recommend choosing ones that will not be difficult. You need to strain the muscles in the lower abdomen moderately so as not to provoke complications.

Wearing a bandage is also considered an effective remedy for uterine prolapse. He has great support female organs at the right level. It must be worn temporarily, no more than 12 hours per day. From time to time you need to give the body a rest and relaxation; for this it is advisable to remove the bandage when resting.

Complications

If after the birth of a child or with frequent physical exercise If a woman's uterus begins to change its location and shape, then it is necessary urgent help doctors In case of untimely provision medical care the uterus becomes covered with cracks, which lead to the formation of bleeding ulcers, bedsores and their infection.

Cervical prolapse provokes a disruption of the blood supply to the organ and the appearance of stagnation. Complete prolapse of the uterus can lead to strangulation and necrosis of the organ.

Prevention

You can prevent uterine prolapse in young or elderly women with simple rules:

• no need to carry weights;
• bring the stool back to normal;
• reduce body weight;
• train your pelvic floor muscles.

To prevent the formation of the disease during the postpartum period, it is not advisable for a woman to carry heavy weights.

Is everything correct in the article? medical point vision?

Answer only if you have proven medical knowledge

Diseases with similar symptoms:

Prolapse of the uterus is its unnatural position when the organ is below its anatomical and physiological border. This happens due to weakness of the pelvic muscles after pregnancy, as well as the uterine ligaments. Majority clinical cases accompanied by displacement or very low location of the organ, when it is as close as possible to the bottom of the vagina. Among the complications, the main one is the risk of prolapse of the uterus from the vaginal opening.

Prolapse of the uterus and vagina up to their loss from the genital slit in medicine is called a pelvic floor hernia or genital prolapse (from the Latin prolapsus - fallen out).

This is serious gynecological pathology, which causes patients not only physical, but also psychological suffering, leads to violation reproductive functions, sexual disorders and a number of secondary somatic and infectious complications.

A woman with this disease will not be able to avoid visiting a doctor, because genital prolapse without appropriate treatment progresses steadily and can cause disability.

Development mechanism and stages

The anatomical norm is a certain “suspended” state of the uterus and appendages inside human body. This position of the reproductive organs provided by the muscles and ligaments of the pelvic floor, which hold all the pelvic organs.

In case of functional failure of the pelvic floor or its hernia, all these organs gradually shift downward and protrude outward. The most common type of female internal genital organs that fall out and fall out is genital prolapse. diagnosed in approximately 10% of women.

If the bladder also descends along with them, a cystocele is diagnosed, if reproductive organs“pulling” the rectum downwards – rectocele.

Depending on how much the uterus and vagina have moved downward from their anatomically normal position, distinguish degrees of uterine prolapse:

• first– the walls of the vagina are lowered, the cervix is ​​displaced down to approximately half the length of the vagina;
• second– the cervix is ​​lowered down to the entrance to the vagina and can be visible in the gaping genital slit;
• third– the cervix falls out of the genital slit, while the uterus itself is inside the vagina;
• fourth– complete prolapse of the genitals outwards.

Causes and risk factors in women

Genital prolapse develops as a result of a combined or isolated effect the following reasons:

• Weakening of the muscles and ligaments of the pelvic floor as a result age-related changes or due to congenital weakness of connective tissue. This explains the prevalence of the disease among menopausal or post-menopausal women and the hereditary nature of the disease.
• Injuries to the muscles of the perineum and genital organs. Most often, functional failure of the pelvic floor and uterine prolapse is diagnosed after childbirth, especially if it was accompanied by complications.
• Increased intra-abdominal pressure, as a result of which the internal organs are gradually squeezed out.

Risk factors for uterine prolapse are:

• large number history of vaginal birth;
• difficult birth with ruptures and episiotomy;
• use of obstetric techniques and aids during childbirth (Kristeller maneuver, obstetric forceps or vacuum);
• bearing and giving birth to a large child;
• heavy physical labor, including heavy lifting and standing for long periods of time;
• menopause, decline;
• backward bend of the uterus;
• frequent constipation which lead to increased intra-abdominal pressure and frequent muscle strain as a result of pushing during bowel movements;
• tumors in the pelvis;
• overweight;
• chronic cough due to asthma or bronchitis;
• congenital diseases connective tissue;
• involution of the uterus in old age;
• ascites;
• surgical interventions in the pelvic area.

Specific and nonspecific symptoms

At the beginning, the disease may not manifest itself in any way. Women with 1-2 degrees of prolapse may not even be aware that they have genital prolapse. Patients who are attentive to their health may detect the presence of the following specific symptoms :

• a feeling of heaviness in the lower abdomen, which intensifies in the evening or after standing for a long time;
• feeling foreign object in the vagina: patients feel that they have something inside them that looks like a small ball or tampon.

Nonspecific symptoms genital prolapse, which can simultaneously be signs of other pathologies and therefore require careful differential diagnosis, are:

• chronic dull ache in the lower back and sacrum;
• profuse vaginal leucorrhoea, often mixed with blood;
• problems with urination: partial urinary incontinence when coughing or laughing, urinary retention and discomfort during it;
• problems with emptying the rectum: increased constipation, a feeling of fullness in the intestines coupled with the inability to defecate, partial incontinence of gases and feces;
• discomfort during sexual intercourse.

If at the initial stage of the disease only a gynecologist can detect it during a manual examination on a chair, then with a severe degree of the disease the patient herself may notice a drooping cervix and vaginal walls in the genital slit.

First aid: when and which doctor to go to

At the slightest suspicion of incompetence of the pelvic floor muscles, and even more so if any uncharacteristic protrusions are detected in the genital slit, a woman should consult a gynecologist immediately. Only a specialist can determine the degree of pathology and the treatment methods necessary in each specific case.

Every woman should undergo an examination by a gynecologist after childbirth and during menopause. Exactly In the postpartum and menopausal periods, genital prolapse occurs most often– therefore, it is necessary to do everything possible to diagnose this disease in time.

Overview of therapy methods

Treatment method	Brief description	When can it be used
Lifestyle correction	diet to prevent constipation reducing physical activity and, if necessary, changing the type of activity performing general strengthening gymnastics practicing sports that help strengthen the abdominal and perineal muscles (yoga, Pilates, swimming)	This is a secondary treatment method that can be used for any degree of disease, coupled with drug correction and in the recovery period after surgery
Physiotherapy	Kegel exercises to strengthen intimate muscles and pelvic floor complex of special therapeutic gymnastics	is the leading treatment method for stage 1-2 disease
Orthopedic correction	the use of vaginal pessaries that fix the cervix in the correct position use of bandages	used infrequently, with 1-2 degrees of disease
Drug treatment	hormone replacement therapy, in which estrogens can be used either orally or topically in the form of vaginal suppositories	used for severe estrogen deficiency in women during menopause
Surgery	removal of the uterus or its extirpation - for older women and complete genital prolapse ventrofixation: organ-saving surgery using an endoprosthesis - a special mesh that holds the uterus in the correct position levatoroplasty with fixation of the genitals with one’s own tissues	Used for 3-4 degrees of prolapse or earlier - if ineffective conservative methods treatment for 6-12 months. It is advisable to give birth to a child before surgery, since after such an operation difficulties may arise with carrying a pregnancy, and natural childbirth will become impossible.

All operations for uterine prolapse can be performed either laparoscopically or through the vagina.

Learn from the video about physical exercises (including Kegel exercises) for the prevention and treatment of women with uterine prolapse in the initial stages, which can be performed at home:

Safe folk remedies without surgery

Traditional methods of treating uterine prolapse in most cases do not justify themselves, since in severe cases of uterine prolapse only surgical intervention can help. But with a minor degree of illness, some traditional methods treatments are quite acceptable– subject to prior consultation with your doctor.

• Special exercises and massage. Performed on an empty stomach, preferably after defecation. Stand in a knee-elbow position and vigorously shake your pelvis, performing quick movements from side to side. Then lie on your back, place a hard pillow under your pelvis and, with light pulling movements, stroke your stomach in the direction from bottom to top (from the pubic bone to the navel).
• Herbal teas that increase muscle tone. Decoction or infusion of lemon balm, coltsfoot, oregano: mix herbs 2 tbsp. each and brew with boiling water in a thermos, drink 150 ml three times a day before meals.
• Egg-lemon tincture. Grind the shells of 5 eggs into flour and mix with the pulp of 5 lemons. Leave for 4 days and add a bottle of vodka. Leave for another three days and strain. Drink the resulting tincture twice a day, 50 g each. After the tincture is finished, take a break for a month and repeat the course of treatment. In total, you need to drink three bottles of the medicinal mixture.
• Steam baths. You will need a pre-prepared decoction of chamomile (half a liter) and a spoonful of birch tar. In the evening, you need to heat the broth to a temperature of 70-80 degrees and pour it into a bucket with a fly in the ointment at the bottom. Sit over the bucket so that the steam reaches your bare crotch. The course of treatment will require 8 procedures.

How to treat uterine prolapse in women at home - the following set of exercises to strengthen the pelvic floor muscles will help with this disease:

What not to do

To prevent your condition from worsening, When the uterus prolapses, you cannot:

• stand on your feet for a long time;
• lift weights;
• cause constipation;
• straining during bowel movements;
• avoid sexual life (only in the early stages of the disease).

Full sex life with orgasm trains the pelvic floor muscles no worse than any exercise - it is important not to stop having sex when the uterus prolapses to an initial degree.

Disease prevention

Prevention of genital prolapse especially important for women after childbirth and on the eve of menopause– it is at this time that the risk of weakening the pelvic floor and the occurrence of uterine prolapse is especially high.

How to prevent uterine prolapse? For the purpose of prevention, all women are recommended to:

• avoid any conditions that provoke an increase in intra-abdominal pressure: constipation, chronic cough;
• avoid heavy physical labor;
• perform Kegel exercises at least 10-20 times a day;
• fight excess weight;
• wear a bandage during and after pregnancy;
• train and strengthen the muscles of the back and anterior abdominal wall;
• Visit your gynecologist regularly.

Patients' opinions

Before studying reviews about the treatment of uterine prolapse and prolapse in women, find out more about what symptoms and signs it is accompanied by, risk factors, what needs to be done for this disease and how to cure it from the video:

Ekaterina, 32 years old:

“After my second birth, I developed sensitive issue– 2nd degree uterine prolapse. I had an operation during which my uterus was tightened with a special mesh and vaginal plastic surgery was performed. She tolerated the intervention well and recovered quickly.”

Larisa, 56 years old:

“During menopause, uterine prolapse appeared. I was afraid that they would immediately schedule an operation for me, but for now I only get by hormonal therapy and regularly perform special exercises. While my illness is not progressing, the doctor even noticed a slight improvement.”

Olga, 40 years old:

“I treated uterine prolapse with visceral massage. It was very painful during the process, and after that it became even worse. I had to have surgery. It would be better if I immediately consulted a doctor rather than use questionable treatment methods!”

Uterine prolapse should not be ignored. It's better to do everything necessary measures on conservative treatment of early stage disease than inevitably ending up on the surgical table as a result of the progression of the disease.