Uterine prolapse and ovarian cyst. Exercises to strengthen the pelvic and vaginal muscles

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

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

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

Causes of pathology

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

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

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

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

Among the provoking factors of the syndrome note:

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

Manifestations

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

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

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

Required Research

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

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

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

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

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

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

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

Therapy

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

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

Possibility of pregnancy

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

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

- displacement of the internal genital organs with their partial or complete exit outwards from the genital slit. When the uterus prolapses, pressure is felt on the sacrum, a foreign body in the genital gap, urination and defecation disorders, pain during intercourse, and discomfort when walking. Prolapse of the vagina and uterus is recognized during a gynecological examination. Treatment of uterine prolapse is surgical, taking into account the degree of prolapse and the age of the patient. If surgical treatment is impossible, women are shown the use of a pessary (uterine ring).

General information

It is considered as a hernial protrusion, which is formed when the functions of the closing apparatus - the pelvic floor - fail. According to the results of various studies conducted by gynecology, genital prolapse accounts for about 30% of gynecological pathology. Prolapse of the uterus and vagina rarely develops in isolation: the anatomical proximity and commonality of the supporting apparatus of the pelvic organs causes displacement after the genitals of the bladder (cystocele) and rectum (rectocele).

There are partial (incomplete) prolapse of the uterus, characterized by displacement of only the cervix, and complete prolapse, in which the uterus is entirely outside the genital gap. When the uterus prolapses, elongation of the cervix develops (lengthening). Usually, prolapse is preceded by a state of uterine prolapse - some displacement below the normal anatomical level within the pelvic cavity. Under the prolapse of the vagina is understood such a displacement, in which its anterior, posterior and upper walls are shown from the genital slit.

Causes of prolapse of the uterus and vagina

The leading role in the development of prolapse of the uterus and vagina belongs to the weakening of the ligaments and muscles of the diaphragm, pelvic floor, anterior abdominal wall, which become unable to hold the pelvic organs in their anatomical position. In situations of increased intra-abdominal pressure, the muscles cannot provide adequate resistance, which leads to a gradual downward displacement of the genital organs under the pressure of the acting forces.

Weakening of the ligamentous and muscular apparatus develops as a result of birth injuries, perineal ruptures, multiple pregnancies, multiple births, the birth of large children, radical interventions on the pelvic organs, leading to the loss of mutual support of the organs. Uterine prolapse is facilitated by an age-related decrease in estrogen levels after menopause, a weakening of the uterus's own tone, and exhaustion.

An additional load on the pelvic muscles develops with excess weight, conditions accompanied by an increase in intra-abdominal pressure (cough, chronic bronchitis, bronchial asthma, ascites, constipation, pelvic tumors, etc.). A risk factor for uterine prolapse is hard physical work, especially during puberty, after childbirth, in menopause. More often, prolapse of the uterus and vagina occurs in old age, but sometimes it develops even in nulliparous young women with congenital disorders of the innervation of the pelvic floor or muscle hypoplasia.

The position of the uterus plays a role in the development of genital prolapse. In the normal position (anteversion-anteflexia), the pelvic floor muscles, pubic bones, and bladder walls serve as a support for the uterus. With retroversion and retroflexion of the uterus, prerequisites are created for the emergence of a hernial ring, prolapse of the walls of the vagina, then the uterus with appendages. Due to stretching of the ligamentous apparatus, vascularization, trophism and lymph outflow are disturbed. Prolapse of the uterus and vagina is more likely to affect representatives of the Caucasian race; in African American and Asian women, the pathology is less common.

Classification of uterine and vaginal prolapse

According to the degree of displacement of the uterus, 4 degrees of prolapse are distinguished.

Diagnosis of uterine and vaginal prolapse requires the involvement of related specialists - a urologist and a proctologist. Urological examination of patients with uterine prolapse may include a study of a general urine test, bacteriological culture of urine, excretory urography, ultrasound of the kidneys, chromocystoscopy, urodynamic studies. In the course of a proctological examination, the presence and severity of rectocele, sphincter insufficiency, and hemorrhoids are clarified. Uterine prolapse is differentiated from vaginal cysts, uterine fibroids, and cervical changes from cervical cancer.

Treatment of uterine and vaginal prolapse

The only radical method to eliminate prolapse of the uterus and vagina in gynecology is surgical intervention. In preparation for the operation, ulceration of the mucosa is treated, and a thorough sanitation of the vagina is performed. The technique of surgery for uterine prolapse depends on the degree of prolapse, somatic status and age of the woman.

In the case of incomplete prolapse of the uterus in young women who have given birth, a "Manchester" operation can be performed, including anterior colporrhaphy with shortening of the cardinal ligaments and colpoperineolevatoroplasty, and with elongation and hypertrophy of the cervix, ruptures and erosions of the cervix - with its amputation. Another option for intervention in women of childbearing age with uterine prolapse can be an operation that includes anterior colporrhaphy, colpoperineoplasty, exercise therapy aimed at strengthening muscles, constipation is prevented, heavy physical labor and stress are excluded.

Conservative therapy for uterine and vaginal prolapse is symptomatic and includes the use of a uterine ring (pessary), a hysterophore (supporting bandage attached to a belt), and large vaginal tampons. Such methods entail additional overstretching of the reduced vaginal walls, which over time increases the risk of uterine prolapse. In addition, prolonged use of a pessary can lead to the formation of pressure sores. The use of various supporting devices for uterine prolapse requires daily douching of the vagina and regular, twice a month, examination of the patient by a gynecologist.

Forecast and prevention of uterine and vaginal prolapse

Timely surgical intervention for uterine prolapse is prognostically favorable. Most women regain social activity and sexual life. After organ-preserving interventions, pregnancy is possible. The management of pregnancy in patients undergoing surgery for uterine prolapse carries additional risks and requires increased precautions. Sometimes even after elimination of prolapse of the uterus, repeated prolapse of the genitals develops. In the palliative treatment of uterine prolapse (using a pessary), irritation and swelling of the vaginal mucosa, ulceration, bedsores, infections, infringement of the cervix in the lumen of the ring, and the formation of rectal and vesicovaginal fistulas often develop.

Prevention of uterine and vaginal prolapse includes proper obstetric care during childbirth, careful suturing of perineal and birth canal tears, careful performance of vaginal operations, and timely surgical treatment of minor genital prolapse. In the postpartum period, for the prevention of uterine prolapse, it is necessary to fully restore the state of the pelvic floor muscles - the appointment of special gymnastics, laser therapy, electrical stimulation of the pelvic floor muscles. Fitness classes, exercise therapy, rational nutrition, maintaining optimal weight, eliminating constipation, and eliminating hard work are of preventive importance.

Inflammatory processes that occur in the female genital organs are dangerous because they can quickly spread to the entire system, causing serious changes in the structure of tissues, disrupting the natural state of the uterus and appendages. In women, inflammation of the uterus, ovaries is often the cause of ectopic pregnancy, infertility and other complications. Early diagnosis and treatment of such pathologies can prevent the transition of the disease into a chronic form. With the appearance of unusual discharge, pain in the lower abdomen, it is necessary to clarify the diagnosis as soon as possible.

The ovaries are endocrine glands that produce female sex hormones, estrogen and progesterone. Hormonal imbalance can be the cause of breast tumors, violations of the cycle and the nature of menstruation, the onset of early menopause. The consequences of hormonal disorders are serious diseases of the uterus.

Inflammation of the ovaries (oophoritis) disrupts the functioning of the entire reproductive system. The process can affect only one organ (unilateral inflammation) or spread to both (bilateral). Often this disease is accompanied by inflammation of the fallopian tubes (salpingitis). In this case, adnexitis occurs, simultaneous inflammation of the ovaries and tubes. At the first stage, the inflammatory process occurs only in the mucous membrane, but then spreads to the tissues.

Causes and types of ovarian inflammation

The cause of inflammation of the ovaries is infection in them. Depending on the nature of the infection that causes the disease, two types of oophoritis are distinguished: nonspecific and specific.

Non-specific. The causative agents of infection are opportunistic microbes. They are always present in the human body and are activated when immunity is weakened, hypothermia, and stress. Such microbes are staphylococci, streptococci, E. coli, Candida fungi.

Specific. Inflammation is caused by sexually transmitted infections (syphilis, chlamydia, trichomoniasis, gonorrhea), as well as tuberculosis pathogens.

Inflammation of the ovaries can occur as a result of the following processes:

penetration of infection from the external genitalia through the cervix, uterine cavity and fallopian tubes;
infection from the intestines and urinary organs if the rules of personal hygiene are not observed;
the spread of infection to the ovaries with inflammation of the intestine or appendicitis;
infection during an abortion, installation of an intrauterine device, operations on the pelvic organs;
transmission of infection through the blood or lymph from other organs prone to inflammation (for example, with tonsillitis).

Addition: The occurrence of oophoritis is facilitated by factors such as weakened immunity, hypothermia, uncontrolled intake of certain drugs, overwork, stress, and lack of nutrition.

Video: Causes and prevention of ovarian inflammation

Forms and symptoms of the disease

Inflammation of the ovaries in women can exist in acute, subacute and chronic forms. In this case, the symptoms are similar, but expressed in varying degrees.

Acute inflammation. It has pronounced signs that usually make a woman urgently seek medical attention.

Subacute inflammation. This form occurs in patients with tuberculosis. The signs of the disease are the same as in the acute form, but it is more difficult to recognize them, since they are masked by the symptoms of the underlying disease.

Chronic inflammation. If a woman does not go to the doctor in a timely manner, the treatment is not completed, the disease can become chronic, in which the signs are smoothed out. There are periods of temporary improvement in the condition, followed by an exacerbation of the disease.

Symptoms in the acute form of the disease

Signs of acute inflammation are:

Severe pain in the lower abdomen, on one side or both. The pain is felt not only in the ovaries, but also extends to the groin. There are aching pains in the sacrum, lower back. Painful sensations intensify before menstruation, as well as with hypothermia.
Increased body temperature, chills. It is not possible to bring down the temperature with the help of conventional antipyretics. There are temperature fluctuations.
Headache, aching joints and muscles.
Frequent and painful urination.
Copious discharge from the genitals. They can be transparent, white, yellow, brown, green, with impurities of blood or pus.
Bleeding between periods.
Violation of the menstrual cycle.
Digestive disorder.
Pain during intercourse.
Insomnia, irritability, fatigue.

Palpation of the ovaries is difficult because of their swelling and pain.

Features of the chronic form of inflammation

If the inflammation becomes chronic, then it periodically exacerbates. Usually the reason is colds or infectious diseases, physical or mental stress, indigestion, diseases of the genitourinary system. If a woman smokes or drinks alcohol frequently, the risk of exacerbations increases.

In some cases, the disease does not recur, the woman is only concerned about the discharge and the irregular onset of menstruation. This course of inflammation of the ovaries is typical, for example, in gonorrhea. However, gradually there is a thickening of the walls of the fallopian tubes, the formation of adhesions in the ovaries.

With a unilateral process, pain is localized at the site of inflammation. If it occurs on the right side, then the symptoms of oophoritis can be confused with the symptoms of appendicitis. Careful diagnosis of the disease is required.

Often, inflammation that occurs on one side spreads to the second ovary. In women suffering from chronic inflammation of the ovaries, the usual symptom is the presence of persistent scanty discharge (leucorrhoea). Usually, patients go to the doctor for examination and treatment if pregnancy does not occur.

Consequences of inflammation of the ovaries

The greatest danger is bilateral chronic inflammation of the ovaries. Its symptoms are not as pronounced as in the acute form. The woman periodically feels healthy, the treatment is not completed. As a result, ovarian dysfunction (impaired hormone production) can form. This condition is characterized by the absence of ovulation in a woman, the possibility of conception. In this case, there is an irregular onset of menstruation, fluctuations in their intensity and duration.

Ovarian dysfunction, hormonal disorders can cause diseases of the mammary glands, as well as pathological changes in the tissues of the uterus, up to the occurrence of malignant tumors. Inflammation causes complications such as obstruction of the fallopian tubes, miscarriage, ectopic pregnancy, inflammatory diseases of the kidneys and intestines.

Diagnosis of oophoritis

It is not always possible to establish the presence of oophoritis only on the basis of symptoms, since a similar picture is observed in diseases such as appendicitis, ectopic pregnancy, peritonitis, tumor diseases of the uterus and ovaries. To clarify the diagnosis, you need to know about the presence and methods of treating previous diseases, the nature and time of occurrence of ailments, the existence of complications in a woman during childbirth, abortion, intrauterine procedures. The localization of pain, the nature of the discharge, the existence of other signs of inflammation are specified.

During a gynecological examination presence of puffiness and morbidity of ovaries, changes of mobility of appendages comes to light.

Lab tests blood, urine and a smear from the vagina allow you to determine the presence of an inflammatory process by an increased content of leukocytes.

ultrasound pelvic organs is done to clarify the nature of the disease.

Bacteriological analysis smear. Allows you to find out the type of opportunistic microorganisms and their sensitivity to various antibiotics.

ELISA(enzymatic immunoassay) - determination of the type of infection by the presence of antibodies corresponding to it in the blood. The method allows you to approximately assess the nature of the infection. It is used to detect chlamydia, mycoplasmosis, trichomoniasis and other latent infections.

PCR(polymerase chain reaction) - a method that allows you to determine with 100% accuracy the type of viruses that caused inflammation by their DNA (including detecting the human papillomavirus, herpes, the causative agent of tuberculosis, chlamydia and others).

Hysterosalpingoscopy. The method is used to detect structural changes resulting from inflammation. The organs are filled with a special fluid, and then with the help of ultrasound, they monitor its progress through the pipes, clarify their patency.

Laparoscopy. Allows you to examine the uterus, tubes, ovaries. The most effective diagnostic method. An optical device with a camera is inserted through a small hole in the abdominal wall.

Treatment of oophoritis

The method of treatment depends on the form of the disease and the type of infection that caused it.

In the acute form, treatment is carried out in a hospital. A woman needs to stay in bed. Cold compresses are applied to the lower abdomen. Antibacterial, analgesic, antipyretic drugs, general restorative drugs are used. Antibiotics in the treatment are selected depending on the sensitivity of the infectious agent.

In the subacute form of the disease, quartz irradiation of the site of inflammation is used. In chronic inflammation, drug treatment is used, as well as physiotherapy and therapeutic baths.

The following methods apply:

Hirudotherapy- treatment with leeches to remove adhesions, relieve swelling and inflammation.
electrophoresis- the introduction of drugs through the skin using a weak direct electric current.
Gynecological massage. Allows you to eliminate adhesions, increase the tone of the uterus, restore its normal location.
Magnetotherapy– treatment with a low frequency magnetic field. It has anti-inflammatory, analgesic effect.
Laser therapy, IR, UV irradiation- optical methods of elimination of microorganisms.

Note: If inflammation of the ovaries resulted from a sexually transmitted infection, then both sexual partners should be treated simultaneously. Sexual contact should be avoided during this time.

In the treatment of advanced chronic diseases, one has to deal with the presence of complications requiring surgical intervention.

Video: Complications of inflammation of the ovaries

For the prevention of oophoritis, it is necessary to timely treat any inflammatory processes in the body, strengthen the immune system, lead a healthy lifestyle, use condoms, and regularly undergo gynecological examinations.

Prolapse of the uterus- incorrect position of the uterus, displacement of the fundus and cervix below the anatomical and physiological boundaries due to weakening of the pelvic floor muscles and uterine ligaments. It is manifested by a feeling of pressure, discomfort, pulling pains in the lower abdomen and in the vagina, urination disorder (difficulty, frequent urination, urinary incontinence), pathological discharge from the vagina. May be complicated by partial or complete prolapse of the uterus.

The most common variants of the incorrect location of the internal genital organs of a woman are the prolapse of the uterus and its prolapse (uterocele). When the uterus is lowered, its cervix and bottom are displaced below the anatomical boundary, but the cervix is not shown from the genital slit even when straining. The exit of the uterus beyond the genital gap is regarded as a prolapse. The downward displacement of the uterus precedes its partial or complete prolapse. In most patients, prolapse and prolapse of the uterus is usually accompanied by a downward displacement of the vagina.

Prolapse of the uterus is a fairly common pathology that occurs in women of all ages: it is diagnosed in 10% of women under 30 years old, at the age of 30-40 years it is detected in 40% of women, and after the age of 50 it occurs in half. 15% of all operations on the genitals are performed for prolapse or prolapse of the uterus.

The prolapse of the uterus is most often associated with a weakening of the ligamentous apparatus of the uterus, as well as the muscles and fascia of the pelvic floor, and often lead to displacement of the rectum (rectocele) and bladder (cystocele), accompanied by a disorder in the functions of these organs. Often, uterine prolapse begins to develop even in childbearing age and always has a progressive course. As the uterus descends, the accompanying functional disorders become more pronounced, which brings the woman physical and moral suffering and often leads to partial or complete disability.

The normal position of the uterus is its location in the small pelvis, at an equal distance from its walls, between the rectum and the bladder. The uterus has an anterior inclination of the body, forming an obtuse angle between the neck and the body. The cervix is tilted backwards, forms an angle of 70-100° with respect to the vagina, its external os is adjacent to the posterior wall of the vagina. The uterus has sufficient physiological mobility and can change its position depending on the filling of the rectum and bladder.

The typical, normal location of the uterus in the pelvic cavity is facilitated by its own tone, interposition with adjacent organs, the ligamentous and muscular apparatus of the uterus and pelvic floor. Any violation of the architectonics of the uterine apparatus contributes to the prolapse of the uterus or its prolapse.

Classification of prolapse and prolapse of the uterus

There are the following stages of prolapse and prolapse of the uterus:

prolapse of the body and cervix - the cervix is determined above the level of the entrance to the vagina, but does not protrude beyond the genital gap;
partial prolapse of the uterus - the cervix is shown from the genital gap during straining, physical exertion, sneezing, coughing, lifting weights;
incomplete prolapse of the body and bottom of the uterus - the cervix and partly the body of the uterus protrude from the genital gap;
complete prolapse of the body and the bottom of the uterus - the exit of the uterus beyond the genital gap.

Causes of prolapse and prolapse of the uterus

Anatomical defects in the pelvic floor, which develop as a result of:

damage to the muscles of the pelvic floor;
birth injuries - when applying obstetric forceps, vacuum extraction of the fetus or extracting the fetus by the buttocks;
transferred surgical operations on the genitals (radical vulvectomy);
deep ruptures of the perineum;
violations of the innervation of the urogenital diaphragm;
congenital malformations of the pelvic region;
estrogen deficiency that develops in menopause;
connective tissue dysplasia, etc.

Risk factors in the development of uterine prolapse and its subsequent prolapse are numerous births in history, heavy physical labor and heavy lifting, advanced and senile age, heredity, increased intra-abdominal pressure caused by obesity, abdominal tumors, chronic constipation, cough.

Often, the interaction of a number of factors plays a role in the development of uterine prolapse, under the influence of which the weakening of the ligamentous-muscular apparatus of the internal organs and the pelvic floor occurs. With an increase in intra-abdominal pressure, the uterus is forced out of the pelvic floor. The prolapse of the uterus entails the displacement of anatomically closely related organs - the vagina, rectum (rectocele) and bladder (cystocele). The rectocele and cystocele are enlarged by internal pressure in the rectum and bladder, causing even more prolapse of the uterus.

Symptoms of prolapse and prolapse of the uterus

If untreated, uterine prolapse is characterized by a gradual progression of displacement of the pelvic organs. In the initial stages, uterine prolapse is manifested by pulling pains and pressure in the lower abdomen, sacrum, lower back, sensation of a foreign body in the vagina, dyspareunia (painful intercourse), the appearance of leucorrhoea or bloody discharge from the vagina. A characteristic manifestation of uterine prolapse are changes in menstrual function such as hyperpolymenorrhea and algomenorrhea. Often, with the prolapse of the uterus, infertility is noted, although the onset of pregnancy is not excluded.

In the future, urological disorders are added to the symptoms of uterine prolapse, which are observed in 50% of patients: difficult or frequent urination, the development of a symptom of residual urine, stagnation in the urinary organs and further infection of the lower and then upper urinary tract - cystitis, pyelonephritis develop , urolithiasis disease. Prolonged prolapse and prolapse of the uterus leads to overstretching of the ureters and kidneys (hydronephrosis). Often the displacement of the uterus from top to bottom is accompanied by urinary incontinence.

Proctological complications in the prolapse and prolapse of the uterus occur in every third case. These include constipation, colitis, fecal and gas incontinence. Often, it is the painful urological and proctological manifestations of uterine prolapse that make patients turn to related specialists - a urologist and a proctologist. With the progression of uterine prolapse, the leading symptom is a formation that is independently detected by a woman, protruding from the genital slit.

The protruding part of the uterus looks like a shiny, dull, cracked, sore surface. In the future, as a result of constant traumatization when walking, the bulging surface often ulcerates with the formation of deep bedsores, which can bleed and become infected. With the prolapse of the uterus, a violation of blood circulation in the pelvis develops, the occurrence of congestion, cyanosis of the uterine mucosa and swelling of the adjacent tissues.

Often, when the uterus is displaced below the physiological boundaries, sexual life becomes impossible. Patients with uterine prolapse often develop varicose veins, mainly of the lower extremities, due to impaired venous outflow. Complications of prolapse and prolapse of the uterus can also be infringement of the prolapsed uterus, bedsores of the walls of the vagina, infringement of intestinal loops.

Diagnosis of prolapse and prolapse of the uterus

Prolapse and prolapse of the uterus can be diagnosed at a gynecological consultation during a gynecological examination. To determine the degree of prolapse of the uterus, the doctor asks the patient to push, after which, with a vaginal and rectal examination, he determines the displacement of the walls of the vagina, bladder and rectum. Women with a displacement of the genital organs are registered in the dispensary. Without fail, patients with such a pathology of the uterus undergo colposcopy.

In cases of prolapse and prolapse of the uterus, requiring organ-preserving plastic surgery, and with concomitant diseases of the uterus, additional examination methods are included in the diagnostic complex:

hysterosalpingoscopy and diagnostic curettage of the uterine cavity;
ultrasound diagnostics of the pelvic organs;
taking smears for flora, the degree of purity of the vagina, bacterial culture, as well as for determining atypical cells;
urine culture to rule out urinary tract infections;
excretory urography to rule out urinary tract obstruction;
computed tomography to clarify the condition of the pelvic organs.

Patients with uterine prolapse are examined by a proctologist and urologist to determine the presence of rectocele and cystocele. They are assessing the condition of the sphincters of the rectum and bladder to detect incontinence of gases and urine during stress. Omission and prolapse of the uterus should be distinguished from uterine eversion, vaginal cysts, born myomatous node and differential diagnosis should be carried out.

Treatment of uterine prolapse and prolapse

When choosing a treatment strategy, the following factors are taken into account:

The degree of prolapse or prolapse of the uterus.
The presence and nature of gynecological diseases associated with uterine prolapse.
The need and possibility of restoring or maintaining menstrual and reproductive functions.
The age of the patient.
The nature of violations of the functions of the sphincters of the bladder and rectum, colon.
The degree of anesthetic and surgical risk in the presence of concomitant diseases.

Taking into account the totality of these factors, the treatment tactics is determined, which can be both conservative and surgical.

Conservative treatment of uterine prolapse and prolapse

When the uterus is lowered, when it does not reach the genital gap and the functions of adjacent organs are not impaired, conservative treatment is used, which may include:

physiotherapy exercises aimed at strengthening the muscles of the pelvic floor and abdominals (gymnastics according to Kegel, according to Yunusov);
gynecological massage;
estrogen replacement therapy, which strengthens the ligamentous apparatus;
local introduction into the vagina of ointments containing metabolites and estrogens;
transferring women to lighter physical work.

If it is impossible to carry out surgical treatment for prolapse or prolapse of the uterus in elderly patients, the use of vaginal tampons and pessaries, which are thick rubber rings of various diameters, is indicated. Inside the pessary contains air, giving it elasticity and resilience. After insertion into the vagina, the ring provides support for the displaced uterus. When inserted into the vagina, the ring rests against the vaults of the vagina and fixes the cervix in a special hole. The pessary should not be left in the vagina for a long time because of the risk of developing bedsores. When using pessaries for the treatment of uterine prolapse, it is necessary to carry out daily vaginal douching with a decoction of chamomile, solutions of furacilin or potassium permanganate, and show a gynecologist twice a month. Pessaries can be left in the vagina for 3-4 weeks, then taking a break for 2 weeks.

Surgical treatment of uterine prolapse and prolapse

A more effective radical treatment for uterine prolapse or prolapse is a surgical operation, the indications for which are the ineffectiveness of conservative therapy and a significant degree of displacement of the organ. Modern operative gynecology for uterine prolapse and prolapse offers many types of surgical operations that can be structured according to the leading feature - anatomical education, which is used to correct and strengthen the position of organs.

The first group of surgical interventions includes vaginoplasty - plastic surgeries aimed at strengthening the muscles and fascia of the vagina, bladder and pelvic floor (for example, colpoperineolevathoroplasty, anterior colporrhaphy). Since the muscles and fascia of the pelvic floor are always involved in the prolapse of the uterus, colpoperineolevathoroplasty is performed in all types of operations as the main or additional stage.

The second large group of operations involves the shortening and strengthening of the round ligaments supporting the uterus and their fixation to the anterior or posterior wall of the uterus. This group of operations is not so effective and gives the greatest number of relapses. This is due to the use for fixation of the round ligaments of the uterus, which have the ability to stretch.

The third group of operations for the prolapse and prolapse of the uterus is used to strengthen the fixation of the uterus by stitching the ligaments together. Some operations of this group deprive patients of the ability to bear children in the future. The fourth group of surgical interventions consists of operations with fixation of displaced organs to the walls of the pelvic floor (sacral, pubic bone, pelvic ligaments, etc.).

The fifth group of operations includes interventions with the use of alloplastic materials used to strengthen the ligaments and fix the uterus. The disadvantages of operations of this type include a significant number of relapses of uterine prolapse, rejection of the alloplast, and the development of fistulas. The sixth group of operations for this pathology includes surgical interventions that lead to a partial narrowing of the vaginal lumen. The last group of operations includes the radical removal of the uterus - hysterectomy, in cases where there is no need to preserve the childbearing function.

Preference at the present stage is given to combined surgical treatment, including both fixation of the uterus, and plastic surgery of the vagina, and strengthening of the ligamentous-muscular apparatus of the pelvic floor in one of the ways. All types of operations used in the treatment of uterine prolapse or prolapse are performed by vaginal access or through the anterior abdominal wall (cavitary or laparoscopic access). After the operation, a course of conservative measures is necessary: exercise therapy, diet therapy to eliminate constipation, exclusion of physical activity.

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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 undergo surgery for this disease during their lifetime. In women after surgery, in more than a third of cases, a recurrence of genital prolapse occurs.

The older the woman, the more likely she is to have this disease. These conditions occupy up to a third of all gynecological pathology. Unfortunately, in Russia, after the onset of menopause, many patients do not go to the gynecologist for many years, 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 frequent gynecological operations. Thus, in the United States 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 back, and the body of the organ itself is tilted forward, forming an angle open to the front with the axis of the vagina. The bladder is adjacent to the anterior wall of the uterus, the posterior wall of the cervix and vagina is in contact with the rectum. From above the bladder, the upper part of the body of the uterus, the intestinal wall are covered with peritoneum.

The uterus is held in the pelvis by the force of its own ligamentous apparatus and by the muscles that form the perineal region. With the weakness of these formations, its omission or loss begins.

There are 4 degrees of the disease.

The external uterine os descends to the middle of the vagina.
The cervix, along with the uterus, moves down to the entrance to the vagina, but does not protrude from the genital gap.
The external pharynx of the cervix moves outside the vagina, and the body of the uterus is higher without going out.
Complete prolapse of the uterus into the perineum.

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. These shortcomings are deprived of the modern classification of genital prolapse, adopted by most foreign experts.

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

Stage I: the most drop-down zone is more than 1 cm above the hymen;
Stage II: this point is 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 the length of the vagina by more than 2 cm.

Causes and mechanism of development

The disease often begins at the woman's fertile age, that is, before the onset of menopause. Its course is always progressive. As the disease develops, there are dysfunctions of the vagina, uterus, and surrounding organs.

For the appearance of genital prolapse, a combination of two factors is necessary:

increased pressure in the abdominal cavity;
weakness of the ligamentous apparatus and muscles.

Causes of uterine prolapse:

a decrease in estrogen production that occurs during menopause and postmenopause;
congenital weakness of the connective tissue;
trauma to the muscles of the perineum, in particular, during childbirth;
chronic diseases accompanied by impaired blood circulation in the body and increased intra-abdominal pressure (intestinal diseases with constant constipation, respiratory diseases with prolonged severe coughing, obesity, tumors of the ovaries, 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 a normal position. Increased pressure in the abdominal cavity "squeezes" the organ down. Since the anterior wall is connected to the bladder, this organ also begins to follow it, forming a cystocele. The result is urological disorders in half of the women with prolapse, for example, urinary incontinence when coughing, physical effort. The posterior wall, when lowered, "pulls" the rectum behind it with the formation of a rectocele in a third of patients. Often there is a prolapse of the uterus after childbirth, especially if they were accompanied by deep muscle ruptures.

Increase the risk of disease multiple births, intense physical activity, genetic predisposition.

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

Clinical picture

Patients with pelvic organ prolapse are 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 successful treatment 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 the pathology of neighboring organs:

episodes of acute urinary retention, 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 the quality of their life, leads to tension in family relationships, negatively affects the woman's psyche and forms the so-called pelvic descent syndrome, or pelvic dysynergy.

Often develops varicose veins with swelling of the legs, cramps and a feeling of heaviness in them, trophic disorders.

Diagnostics

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

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

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

An ultrasound examination of the uterus, appendages and bladder is prescribed. It helps to determine the extent of surgery. In the early stages of the disease, colposcopy is performed. Magnetic resonance imaging helps to assess the altered anatomy of the small pelvis.

To diagnose urinary incontinence, urologists use a combined urodynamic study, but when organs are prolapsed, its results are distorted. Therefore, such a study is optional.

If necessary, endoscopic diagnostics is prescribed: hysteroscopy (examination of the uterus), cystoscopy (examination of the bladder), sigmoidoscopy (study of the inner surface of the rectum). Typically, such studies are necessary for suspected cystitis, proctitis, endometrial hyperplasia or polyp, cancer. Often, after the operation, 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 bottom of the small pelvis, and their strengthening;
normalization of the functions of neighboring organs.

Prolapse of the uterus of the 1st degree is treated conservatively on an outpatient basis. The same tactic is chosen for uncomplicated genital prolapse of the 2nd degree. What to do with the prolapse of the uterus in mild cases of the disease:

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

Is it possible to pump the press when the uterus is lowered? When lifting the body from a prone position, intra-abdominal pressure increases, which contributes to further pushing the organ out. Therefore, therapeutic exercises include tilts, squats, leg swings, but without straining. It is carried out in a sitting and standing position (according to Atarbekov).

At home

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

Massage

Gynecological massage is often used. It helps to restore the normal position of the organs, improve their blood supply, and eliminate discomfort. Usually, 10 to 15 massage sessions are performed, during which the doctor or nurse, with the fingers of one hand inserted into the vagina, lifts the uterus, and with the other hand, circular massage movements are made 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 trouble associated with an inferior sex life, and is not accompanied by inflammatory and other complications.

Surgery

How to treat uterine prolapse III-IV degree? If, despite all conservative methods of treatment or due to the patient's late request for medical help, the uterus has gone beyond the vagina, the most effective method of treatment is prescribed - surgical. The purpose of the operation is to restore the normal structure of the genital organs and correct the disturbed functions of neighboring organs - urination, defecation.

The basis of surgical treatment is vaginopexy, that is, fixing the walls of the vagina. With urinary incontinence, the strengthening of the walls of the urethra (urethropexy) is simultaneously performed. If there is weakness of the muscles of the perineum, they are plastic (recovered) with strengthening of the neck, peritoneum, supporting muscles - colpoperineolevathoroplasty, in other words, suturing of 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 the walls of the vagina (colporrhaphy), loop operations, sacrospinal fixation of the vagina or uterus, strengthening the vagina with the help of special mesh implants are performed.

With laparotomy (an incision of the anterior abdominal wall), the operation for prolapse of the uterus consists in fixing the vagina and cervix with its own tissues (ligaments, aponeurosis).

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

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

Vaginal colpopexy (strengthening the cervix with access through the vagina) can be performed under conduction, epidural anesthesia, intravenous or endotracheal anesthesia, which expands its use in the elderly. This operation uses a mesh-like implant that strengthens the pelvic floor. The duration of the operation is about 1.5 hours, the 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 long-term complication is erosion of the vaginal wall.

Laparoscopic surgery is performed under endotracheal anesthesia. During it, a mesh prosthesis is also used. Sometimes amputation or extirpation of the uterus is performed. The field of operation requires early activation of the patient. An extract is carried out on the 3-4th day after the intervention, outpatient rehabilitation lasts up to 6 weeks.

Within 6 weeks after the operation, a woman should not lift weights of more than 5 kg, sexual rest is required. Within 2 weeks after the intervention, physical rest is also necessary, then you can already do light housework. The average period of temporary disability is from 27 to 40 days.

What to do in the long term after the operation:

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

Features of the treatment of pathology in the elderly

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

In the initial stages of the disease in elderly patients, when the uterus is prolapsed, a gynecological ring is used. This is the so-called pessary made of synthetic material, which is inserted deep into the vagina and supports its arch, preventing the uterus from descending. The ring is removed at night and washed well, and in the morning the woman sets it back. The gynecological pessary does not have a therapeutic effect. When using it, inflammatory complications are possible - colpitis, vaginitis, cervicitis, as well as erosion (you can read about cervical erosion here).

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

A woman must perform therapeutic exercises.

With a significant prolapse, a surgical operation is performed, often this is the removal of the uterus through a vaginal access.

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 with the prolapse of the walls of the uterus. Yes, there are no special obstacles to conception in the early stages if the disease is asymptomatic. If the omission is significant, then before the planned pregnancy it is better to be operated on 1-2 years before conception.

Preservation of pregnancy with proven uterine prolapse is fraught with difficulties . Is it possible to bear a child with this disease? Of course, yes, although the risk of pathology of pregnancy, miscarriage, premature and rapid birth, bleeding in the postpartum period is significantly increased. In order for the pregnancy to develop successfully, you need to constantly be observed by a gynecologist, wear a bandage, use a pessary if necessary, engage in physiotherapy exercises, and take medications prescribed by a doctor.

What threatens the prolapse of the uterus in addition to possible problems with carrying a pregnancy:

cystitis, pyelonephritis - infections of the urinary system;
vesicocele - saccular dilation of the bladder, in which urine remains, causing a feeling of incomplete emptying;
urinary incontinence with irritation of the skin of the perineum;
rectocele - expansion and prolapse of the ampulla of the rectum, accompanied by constipation and pain during bowel movements;
infringement of intestinal loops, as well as the uterus itself;
eversion of the uterus with its subsequent necrosis;
deterioration in the quality of sexual life;
a decrease in the overall quality of 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, she is exhausted by constant pain and discomfort when walking, she does not feel healthy.

Prevention

The prolapse of the walls of the uterus can be prevented in this way:

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

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Prevalence

Omission of the pelvic organs is quite widespread. For example, in India, this pathology is found in almost every woman, and in the United States, this disease is diagnosed in 15 million of the fairer sex.

The statistics on pelvic organ prolapse are striking:

age up to 30 - the disease occurs in every tenth woman;
age 30 - 45 years - pathology is diagnosed in 40 women out of a hundred;
age over 50 years - every second woman suffers from prolapse of the pelvic organs.

According to an epidemiological study, every eleventh woman worldwide will be operated on for this pathology, due to the high risk of developing genital prolapse. The fact of recurrence of the disease, for which more than 30% of patients are operated on again, makes one think.

Location of the pelvic organs

The uterus is a hollow, pear-shaped organ of smooth muscle. The main task of the uterus is to carry and give birth to a child. Normally, it is located along the wire axis of the pelvis (in the center and along the line running down from the head to the legs). The body of the uterus is somewhat tilted anteriorly, forming an angle open towards the anterior abdominal wall (anteflexio position). The uterine fundus is at the level or outside the plane of the entrance to the small pelvis.

The second angle is formed between the cervix and the vagina, which is also open anteriorly. In front of the uterus is in contact with the bladder, and behind with the rectum. Both the uterus and the appendages have a certain physiological mobility, which is necessary for their normal functioning (the course of pregnancy / childbirth, the work of adjacent organs: the bladder / rectum). At the same time, the uterus in the small pelvis is securely fixed, which prevents its prolapse. Fixation of the uterus is carried out by the following structures:

suspension ligaments (wide, round ligaments of the uterus, ovarian ligaments) - due to them, the uterus and appendages are fixed to the walls of the pelvis;
muscles and fascia of the pelvic floor and the anterior wall of the abdomen (their normal tone ensures the correct location of the internal genital organs, and with the loss of muscles of elasticity and elasticity, prolapse of the pelvic organs develops);
tight ligaments that attach the uterus to adjacent organs (urea / rectum), to the fascia and pelvic bones.

What is pelvic organ prolapse?

Omission (prolapse) of the pelvic organs is a disease in which there is a violation of the location of the uterus and / or vaginal walls, characterized by displacement of the genital organs either before entering the vagina, or their protrusion (falling out) beyond its borders. Often, genital prolapse leads to prolapse and protrusion of the bladder with the formation of a cystocele and / or rectum - rectocele. The disease is progressive and develops when the muscle layer of the pelvic floor fails, the ligaments that support the uterus are stretched, and intra-abdominal pressure increases. Prolapse of the pelvic organs for ease of understanding can be called a hernia.

The location of the uterus in the normal position and in pathology

Causes of prolapse

The omission of the genital organs is due to a number of reasons that can be divided into several groups:

injury to the pelvic floor;
violation of the synthesis of steroids (in particular estrogen);
failure of connective tissue formations;
chronic somatic diseases that are accompanied by impaired blood supply, metabolic processes or cause an increase in intra-abdominal pressure.

Pelvic floor injury
The first group of reasons is mainly due to complicated childbirth. These can be ruptures of the perineum of 3-4 degrees, the use of obstetric forceps in the period of expulsion of the fetus, childbirth with a large fetus, rapid childbirth, childbirth with an incorrect position of the fetus (breech and foot presentation), multiple pregnancy. Often, trauma to the pelvic floor muscles during childbirth occurs in "old" primiparous women, when the perineum has lost its elasticity and ability to stretch, and during repeated births (short breaks between births or multiple births). Of no small importance in the development of prolapse of the pelvic organs is both hard physical work and the constant lifting of weights, which leads to a regular increase in intra-abdominal pressure.

Steroid production
The lack of estrogen production, as a rule, is observed in the pre- and postmenopausal periods, but may be due to hormonal disorders in women of reproductive age. Estrogens are responsible for the tone and elasticity of muscles, connective tissue structures and skin, their deficiency contributes to stretching of the ligaments and the muscle layer of the pelvic floor.

Connective tissue failure
The insolvency of connective tissue formations is said to occur when there is a "systemic" insufficiency of connective tissue due to a genetic predisposition (congenital heart defects, astigmatism, hernias).

chronic diseases
Chronic diseases leading to disorders of microcirculation and metabolic processes (diabetes mellitus, obesity), as well as maintaining intra-abdominal pressure at a high level (pathology of the respiratory system - persistent cough) or diseases of the digestive tract (problems with defecation, constipation) also provoke the development of genital prolapse .

Classification

For practical activities, the following classification of genital prolapse is most convenient:

1 degree is determined by the prolapse of the cervix no further than up to ½ of the length of the vagina;
at grade 2, the cervix and / or vaginal walls descend to the entrance to the vagina;
3 degrees are spoken in the case of the location of the cervix and vaginal walls outside the vagina, while the body of the uterus is located above;
if the uterus and vaginal walls are determined outside the vagina, this is already grade 4.

Clinical picture, symptoms

The course of the disease is slow, but steadily progressive, although in some cases the process can develop relatively quickly, especially considering that in recent years there have been more and more women of young reproductive age among the contingent of patients. Prolapse of the genitals leads to functional disorders of almost all pelvic organs:

From the reproductive system

There is a feeling of a foreign body in the vagina, which is joined by heaviness and discomfort in the lower abdomen and lower back. It is characteristic that after taking a horizontal position or after sleep, these complaints disappear, and their intensification occurs towards the end of the day or after heavy lifting / heavy physical work. When the uterus and / or vagina prolapse, patients feel a “hernial sac” in the perineum, which not only makes it difficult to have sex (coitus is possible only after the organ is repositioned), but also walking. The uterus and vaginal walls, when examined, look either dull or shiny, with dry mucous membranes, on which there are numerous abrasions and cracks. At 3-4 degrees of diseases, trophic ulcers and bedsores often appear due to constant friction of the uterus and vaginal walls against clothing and impaired blood supply to them (venous congestion).

The appearance of trophic ulcers often provokes infection of nearby tissue with the development of purulent complications (parametritis and others). The downward displacement of the uterus leads to disruption of the normal blood flow in the small pelvis, which causes blood stagnation in it and is accompanied by pain and a feeling of pressure from below in the abdomen, discomfort, pain in the sacral and lumbar regions, which are aggravated by walking. Due to congestion, the mucous membranes of the uterus and vagina become cyanotic and swell.

In addition, the menstrual function also suffers, which is manifested by algomenorrhea and hyperpolymenorrhea. Infertility often develops, although pregnancy is not excluded.

From the urinary system

The functions of the urinary system are also disturbed, which is manifested by difficult urination, the presence of residual urine and its stagnation. As a result, infection of the lower urinary tract (urethra, bladder), and then the upper ones (ureters, kidneys) occurs. If complete prolapse of the genitals exists long enough, then obstruction of the ureters (formed stones), the development of hydronephrosis and hydroureter are possible. Stress incontinence (coughing, sneezing, laughing) is also noted. Secondary complications are inflammation of the kidneys and bladder, urolithiasis, and so on. It should be noted that urological complications occur in every second patient.

From the large intestine

Prolapse of the pelvic organs is accompanied by the development of proctological complications, which is typical for every third patient. Constipation is often found, and it should be noted that, on the one hand, they act as the cause of the pathology, and on the other hand, the consequence and clinical sign of the disease. The function of the large intestine is also disturbed, which is expressed in the form of colitis. A rather painful and unpleasant manifestation of pathology is the inability to retain feces and gases. Gas / fecal incontinence is caused either by injury to the tissues of the perineum, the walls of the rectum and rectal sphincter (during childbirth) or the development of deep functional disorders of the pelvic floor muscles.

Phlebeurysm

Women suffering from genital prolapse often develop varicose veins, particularly in the lower extremities. The development of varicose veins is provoked by a violation of the outflow of blood from the veins, which occurred due to changes in the location of the pelvic organs and insufficiency of connective tissue structures.

Treatment

The treatment of pelvic organ prolapse is determined by several factors:

the degree of prolapse of the genitals;
concomitant gynecological pathology (endometrial polyps, endometriosis, uterine tumors, etc.);
the desire and ability to maintain reproductive and menstrual functions;
clinical manifestations of functional disorders of the large intestine and rectal sphincter;
the age of the patient;
concomitant somatic (general) diseases (risk degree of surgery and general anesthesia).

Treatment of pathology can be carried out conservatively and surgically.

Conservative therapy

Conservative therapy is carried out for women with 1 - 2 degree of the disease. It is recommended to give up heavy physical work and prohibit heavy lifting (no more than 3 kg). Also shown are therapeutic exercises according to Atarbekov, exercises that strengthen the abdominal muscles (“bicycle”, tilts in the prone position, lifting the legs in a horizontal position), Kegel exercises (compression and relaxation of the muscles of the perineum). You should also review the diet, giving preference to fermented milk products, vegetables and fruits (normalization of the intestines). With a lack of estrogen, intravaginal suppositories or a cream (Ovestin) are prescribed.

In case of contraindications (severe somatic diseases), it is recommended to wear a vaginal pessary (ring) made of plastic or rubber for surgical treatment. But prolonged wearing of a pessary aggravates the course of the disease, as there is an even greater stretching of the pelvic floor muscles.

Exercises for prolapse of the pelvic organs

Surgical intervention

Surgical intervention is performed with complete and incomplete prolapse of the uterus and vagina. Several types of operations have been developed:

strengthening and maintaining the pelvic floor (colpoperineolevathoroplasty);
shortening of the round ligaments and fixation of the uterus with them;
strengthening the cardinal and sacro-uterine ligaments (suturing them, transposition, etc.);
fixation of the uterus to the pelvic bones;
strengthening the ligamentous apparatus of the uterus with alloplastic materials;
partial obliteration of the vagina;
extirpation of the uterus by the vaginal route (premenopausal and postmenopausal women).

Prevention

Prevention of the development of prolapse of the pelvic organs includes compliance with the following recommendations:

Mode of physical labor and education
Excessive physical work and especially heavy lifting should be avoided already in childhood, especially for adolescent girls, when menstrual and reproductive functions are formed.
Pregnancy/delivery management
Genital prolapse provokes not only a large number of births, but also the tactics of their management. When providing surgical aids in childbirth (imposition of obstetric forceps and a vacuum escochleator, pelvic aid, etc.), it contributes to the occurrence of intrapelvic injuries of the lumbosacral plexus (subsequently, paralysis of the obturator and sciatic nerves develops), deep ruptures of the soft tissues of the perineum with the involvement of the sphincter of the rectum and urethra which later leads to the formation of urinary and fecal incontinence. If possible, one should not allow a protracted course of the straining period, perform an episiotomy (if there is a threat of rupture of the perineum) and strive to correctly compare the soft tissues of the perineum when they are sutured in case of a rupture or incision.
Rehabilitation in the postpartum period
With special care after childbirth, prevention of the development of purulent-septic complications should be carried out (treatment of perineal wounds with antiseptics, perineal hygiene, if necessary, antibiotic therapy). Rehabilitation measures are also carried out to restore the functionality of the pelvic floor (special gymnastics, laser treatment, electrical stimulation of the muscles of the perineum).
Nutrition and drinking regimen
Eat a constipation-free diet (high in fiber). You should also drink up to 2.5 - 3 liters of fluid per day.

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

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

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

Figure 2

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

Figure 3

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

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

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

the body of the uterus is located above it

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

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

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

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

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

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

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

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

Signs and symptoms of an ovarian cyst in women

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

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

Tests and tests for ovarian cysts

For the diagnosis of this pathology use:

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

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

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

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

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

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

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

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

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

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

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

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

Picture 1

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

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

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

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

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

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

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

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

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

I degree prolapse:

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

Grade II prolapse:

the cervix extends beyond the genital slit,

III degree prolapse (complete prolapse):

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

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

Disease Definition

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

2. Transvaginal ultrasound examination.

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

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

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

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

Causes of ovarian cysts in women

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

irregular menstrual cycles;

hormonal disorders (eg, hypothyroidism);

6 modern ways to treat uterine cysts

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

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

Uterine cysts - what is it

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

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

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

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

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

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

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

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

Cyst symptoms

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

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

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

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

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

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

lower abdominal pain;
uncharacteristic discharge;
elevated body temperature.

As a result of these complications, infertility often develops.

Causes of pathology

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

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

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

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

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

How to treat a cyst in the uterus

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

Methods of surgical treatment:

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

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

Dangerous symptoms of uterine fibroids and ovarian cysts

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

Ovarian cyst

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

signs

Symptoms of this pathology include the following:

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

Causes

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

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

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

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

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

Signs of uterine fibroids

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

The malaise manifests itself:

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

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

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

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

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

Diagnostics of education

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

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

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

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

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

Treatment

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

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

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

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

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

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

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