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Omission and loss of internal generative organs (prolapse of genitalias)
At the healthy woman the uterus is located in the central part of a small pelvis. The uterus is freely suspended on sheaves therefore its shift in different directions is possible. Mobility of a uterus allows to provide normal development of pregnancy and the correct course of childbirth. Besides, in view of mobility of a uterus intestines, a bladder and other bodies normally work. At the same time at strong filling of a bladder the uterus is displaced up.
If the uterus stays in normal situation, then its maintenance is promoted not only by sheaves, but also muscles of a pelvic bottom which serve for them as a certain support. At gradual weakening of muscles and sheaves there is an omission of walls of a vagina. Owing to such phenomenon establish to the woman the diagnosis "a prolapse of genitalias".
According to data of medical statistics, every tenth woman whose age did not reach 35 years yet suffers from this disease approximately. And after fifty-year age every second woman suffers from a prolapse of genitalias already.
Reasons of a prolapse of genitalias
As a rule, omission and the subsequent loss of generative organs at women is observed at advanced or senile age. At that time and directly the uterus, and her ligaments suffer the certain changes connected with age women. However certain premises to developing of this disease take place already at youthful and young age. The variety of reasons which predetermine development of a prolapse of genitalias is allocated.
During many months of incubation of a fruit there is strong and constant pressure upon pelvic muscles which owing to such influence considerably relax. Especially big load of these muscles occurs on the last trimester of pregnancy.
Respectively, muscles of a pelvic bottom are often injured in the course of childbirth: owing to difficult delivery, if a fruit very big, at buttock presentation, when using obstetric nippers in the course of conducting childbirth, at prompt childbirth and also if there is a serious rupture of a crotch. Generally similar injuries occur at those women whose first labor falls on rather late age. The matter is that after thirty years tissue of a crotch of the woman becomes less elastic and badly stretches.
One more reason of manifestation of a prolapse of genitalias – regular carrying and a raising of heavy objects owing to what intra belly pressure increases.
Omission and loss of generative organs happens at chronic diseases of a respiratory organs which provoke a constant and severe cough. The factor directly influencing development of this disease is also disturbance in a structure and development of connecting fabric which has inborn character. Women with obesity, chronic locks, the wrong arrangement of a uterus often suffer from loss of generative organs. Often the prolapse of the uterus occurs during a menstrual pause when the patient has a change of hormonal balance. For the woman which endured surgical interventions in due time and also numerous childbirth, such disease it is diagnosed much more often.
Features of development of a prolapse of genitalias
Omission of generative organs always develops gradually. The illness progresses rather slowly, and its development is always negatively displayed on quality of life and a condition of the woman. In development of a prolapse of genitalias negative changes in an organism are displayed not only on function of a reproductive system of the woman, but also on functioning of bodies which are located a row (it is about a bladder, a rectum). Often owing to this disease working ability of the woman considerably decreases. Sometimes the prolapse of genitalias leads directly to disability. Often women are afraid to visit the doctor as take loss of generative organs for development of a tumor. As a result, the illness passes into heavier stage.
Stages of a prolapse of genitalias
In medicine it is accepted to distinguish five different extents of omission and loss of generative organs. The first degree is an initial stage of omission of walls of a vagina which happens as an effect of a certain weakening of muscles of an urinogenital diaphragm and a pelvic bottom. In such state insignificant omission of back and front walls of a vagina is observed, at the same time the sexual crack gapes.
At the second degree of an illness of a muscle of a pelvic bottom weaken more considerably. There is a gradual omission of walls of a vagina, at the same time the bladder also falls and the gut (its front wall) is direct.
At the third extent of development of an illness the uterus is already lowered, and her neck is at the level of an entrance to a vagina.
The fourth degree of a disease is characterized by an incomplete prolapse of the uterus. At the same time the neck of uterus already stays outside an entrance to a vagina.
At the last, fifth degree, at the woman the full prolapse of the uterus in the course of which vagina walls are turned out is observed.
Symptoms of a prolapse of genitalias
If at the patient one of initial stages of an illness, then visible symptoms and unpleasant feelings takes place she can not feel in general. If the prolapse of the uterus passes into more serious form, then the patient is periodically tormented by feeling of a foreign body in a vagina. The patient is very often disturbed by pain in the bottom of a stomach which has the pulling character. Sometimes the woman takes such feelings for inflammatory process, an ovulation or usual approach of periods. Pain extends also to a sacrum and a waist later. At late stages of an illness the urination can be broken, and bowel emptying process considerably is at a loss.
Generative organs in the course of loss also suffer certain changes: in them the lymph, blood stagnates. In view of disturbance of normal supply of fabrics with necessary substances in a vagina and on a neck of uterus trophic ulcers develop. Such negative manifestations arise partly and therefore that there is a friction about clothes of a neck of uterus. As a result, it is exposed to high risk of infection. If at the woman trophic vagina and uterus ulcers developed, then at it the quantity gradually increases is more white in which blood can be added.
When the woman has a falling of the womb, at the same time the bladder also falls. In that case the woman suffers from frustration of an urination: perhaps complicated, speeded up urination, and at a strong tension tsistitamozht to arise an urine incontience. As a result development of pyelonephritis or cystitis, and also a renal failure can turn out to be consequence of such pathological changes.
During walking the patient feels constant discomfort that extremely negatively influences quality of her life.
One more important point for the woman at whom omission of generative organs was shown are problems in sex life. Over time at such patient disturbances of psychological character can develop.
Diagnosis of a prolapse of genitalias
To diagnose this disease, the doctor should not apply special efforts. In most cases the most usual survey allows to find a prolapse of genitalias in the gynecologist. For definition of extent of omission and loss of generative organs the doctor can ask the woman to natuzhitsya then performs additional inspection, defining whether omission of walls of a rectum and bladder takes place.
If loss or omission of generative organs is diagnosed for the patient, surely take her on dispensary accounting. Also as additional research the kolkoskopiya is carried out. Such research is conducted with use of the special device – a kolkoskop by means of whom it is possible to perform careful inspection of a uterus. Sometimes to the patient additional inspection at the specialist urologist which is made for the purpose of definition of the general condition of uric system is also appointed.
Treatment of a prolapse of genitalias
The doctor appoints treatment of this illness depending on extent of loss of genitalias. If the first extent of omission of walls of a vagina is diagnosed for the woman, then it is important to take measures to prevent progress of a disease in the future. The special physiotherapy exercises are for this purpose appointed. Exercises in this complex are picked up so that to raise a tone of muscles of a front abdominal wall and a pelvic bottom. Especially for recovery of elasticity of these muscles the complex of so-called exercises of Kegel is developed. These are simple exercises which the woman can carry out for day, staying practically anywhere. Kegel's exercises are repeated postorenny tightenings and the subsequent relaxation of intimate muscles. Besides, the raising of legs from a prone position, standard exercises for support of a prelum abdominale, "bicycle", etc. enters a set of exercises.
Except performance of a complex of physiotherapy exercises women are recommended to do swimming. Quite good alternative to exercises of physiotherapy exercises is long circulation on a ladder, driving the bicycle.
It is very important to carry out all exercises correctly and regularly as at frequent breaks the physiotherapy exercises will be inefficient. Women with initial stages of a prolapse of genitalias should make thrifty use of own health very much: not to lift heavy objects at all, not to allow strong physical tension. Besides, as a method of conservative treatment of a falling of the womb gynecologic massage is applied. For the purpose of activation of a blood-groove in a vagina and strengthenings of sheaves women in a climacteric are often recommended to receive medical treatment for estrogen. One more technique of conservative treatment is used: to the woman the special uterine ring (pessary) is entered. Such actions are taken if operation is impossible in view of existence of contraindications. However such method has also certain shortcomings. In particular, the ring stretches muscles of a pelvic bottom even stronger, and over time the illness is even more aggravated.
At the second degree of a prolapse of genitalias, and also at heavier stages of an illness to women the behavior of surgical intervention is appointed. Today carrying out different types of operations which are selected depending on degree of an illness, age of the woman, her general state of health practices. Also other factors are considered. After carrying out operational intervention the doctor appoints symptomatic therapy to eliminate an inflammation.
If the woman does not plan pregnancies any more, operation on removal of a uterus is possible. Operations at loss of generative organs in most cases are performed without cuts on a stomach, carrying out all manipulations through a vagina.
It is important that the optimum technique of treatment was defined by the doctor, after the correct high-quality therapy the illness is not shown repeatedly, and the woman after the recovery period feels perfectly.
Prevention of a prolapse of genitalias
That omission of generative organs was not shown after the delivery, in the post-menstrual period, the woman needs to approach questions of own health consciously. If the woman waits for the kid, she should be prepared for childbirth surely carefully. In the course of patrimonial activity future mother has to carry out accurately all councils of the midwife not to allow emergence of gaps.
It is important not to allow locks also: in this case it is necessary to pick up correctly a food allowance, to walk, drink much enough liquid every day.
Not less important for prevention of this unpleasant illness regularly to pass survey at the gynecologist. Not less once in half a year is recommended to do to women it. Sometimes for obtaining additional data the doctor also appoints carrying out ultrasonography of a uterus.
The woman has to avoid a raising of weights which weight exceeds 10 kg. If all preventive measures are carefully observed, then rice of developing of an illness considerably decreases. Besides, adhering to such recommendations, the woman with the first stage of a prolapse of genitalias can normally transfer pregnancy and give birth to the child.