Prolapse of the uterine wall. Prolapse of the posterior wall of moisture, what to do, treatment with folk remedies. A set of therapeutic exercises

The specialists at the Frau Klinik Aesthetic Gynecology Department offer patients a full range of both non-surgical and surgical methods for treating pathologies.

Non-invasive methods include:

As part of surgical treatment, patients undergo:

Uterine prolapse - what is it?

The disease occurs when the tone of the muscular structures of the pelvic floor decreases. The essence of the problem is the gradual displacement of the body of the uterus towards the vagina, while its cervix is ​​in its previous position. In severe cases of pathology, even complete prolapse of the organ can occur.

Gynecologists distinguish three categories of disease:

1. The location of the uterus is slightly changed, it is shifted closer to the vagina, and there is a slight deformation of the cervix.
2. The position of the uterus is significantly changed, it sags inside the vagina, as a result of which it changes shape.
3. Extreme stage: the uterus does not have a fixed position, it can move outside the vaginal cavity partially or completely.

Causes and factors contributing to prolapse of the uterus and vagina

Reduced amount of collagen in connective tissue

A slowdown in the rate of production of collagen fibers in the body entails a gradual stretching of the ligaments, and, as a result, leads to prolapse of the pelvic organs.

Decreased muscle tone

The disease occurs when the tone of the muscular structures of the pelvic floor decreases. The process may be due to both physiological changes in the pregnant woman’s body and overload on the pelvic muscles during childbirth, as well as neglect of the doctor’s recommendations regarding the nutrition and physical activity of the young mother. The correct (healthy) location of the uterus is between the rectum and the bladder. If tone is lost, the muscles can no longer prevent the uterus from moving towards the vagina.

Mechanical damage and birth injuries

The position of the uterus is also affected by injuries to the perineum received by a woman during childbirth or for some other reason. In the case of a difficult birth and long-term stress, the abdominal muscles may also suffer.

Age-related changes

As a woman ages, the production of estrogen decreases, which leads to a gradual loss of muscle tone. During menopause, symptoms of uterine prolapse bother women much more often.

Excess weight and gastrointestinal problems

In some cases, uterine prolapse can be provoked by: excess body weight, which creates a constant additional load on all internal organs, as well as chronic pathologies of the digestive system (constipation, etc.).

Symptoms of uterine prolapse

At an early stage, the disease practically does not manifest itself at all, so it is most often recognized during an examination by a gynecologist or using an ultrasound.

In some cases, the process of descent is uneven: for example, only the back or front wall can change location. Therefore, the choice of treatment must be made taking into account all the features of the course of the disease.

With significant prolapse of the uterus, the pain becomes more intense, sharp pain occurs even when trying to sit down.

Diagnostics

If the problem is detected in a timely manner, there is a high chance of preventing the appearance of painful symptoms and surgical intervention.

The set of diagnostic procedures includes:

• examination on a gynecological chair,
• instrumental diagnostics,
• lab tests.

If necessary, the doctor may additionally prescribe: urography, ultrasound of the pelvic organs, colposcopy, tomography, urinalysis. In some cases, the opinions of specialized specialists are required: a proctologist and a urologist.

Treatment of prolapse of the vaginal walls without surgery

Surgical treatment of uterine prolapse

The diagnosis of uterine prolapse does not always imply surgery. In most cases, it is possible to cope with the pathology using conservative methods.

Surgical treatment is indicated in cases of uterine prolapse. There are two options for solving the problem: hysterectomy (complete removal of the organ) or its fixation.

Young patients

Perineoplasty with thread- a minimally invasive procedure, the purpose of which is the aesthetic and functional correction of the female perineum. Solves problems such as genital gaping, genital prolapse. To perform perineoplasty, a bidirectional vaginal mesothread made of biodegradable material is used, which over time, disintegrating inside the tissue, is replaced by collagen fibers. Result: strengthening of the perineal area, formation of an organic frame inside the tissues. Depending on the indications, the vaginal thread is inserted into the muscle layer or directly under the skin.

The procedure lasts about 1 hour and is performed on an outpatient basis. The patient returns home the same day.

Colpoperineolevatoplasty- an operation that involves suturing the vaginal wall and muscles. It is performed in tandem using synthetic non-biodegradable meshes. Implants create a supporting and reinforcing effect on the pelvic tissues.

3 types of vaginal surgery:

1. the anterior wall is strengthened (if it and the bladder prolapse);
2. the posterior wall is corrected to strengthen the rectum;
3. The installation of both implants is performed in case of complete prolapse of the uterus, the organ is fixed with special ligaments.

Colporrhaphy- an operation aimed at correcting the size of the vagina. Depending on the situation, the doctor sutures its front or back wall.

At the first stage, the part of the mucous membrane to be corrected is selected. It is excised longitudinally, after which the tissues are stitched together in layers. The vagina becomes narrower. Using this method, it is possible to remove postpartum scars.

Older patients

Median colporrhaphy- the operation is performed on elderly women. This intervention excludes the possibility of sexual activity, as well as gynecological examination and cervical biopsy. Therefore, the presence of cervical cancer pathologies is a contraindication to the use of this method.

Radical method- used for severe forms of uterine prolapse, when the only option is removal of the organ. A hysterectomy is performed if there is no need to preserve the woman's fertility. The method involves a subsequent special course of treatment, exercise therapy, diet, and minimizing physical activity.

Surgical techniques

Operations for prolapse of the walls of the uterus and vagina

Why can’t we delay solving the problem?

Uterine prolapse is a serious pathology. Without treatment, patients experience many associated problems:

• urinary incontinence;
• bladder pinching;
• chronic constipation;
• rectal prolapse;
• intestinal dysfunction;
• vaginal inversion, etc.

Dear women! Please don't put off taking care of your health. Listen to your body. The earlier the disease is diagnosed, the faster and easier it will be to treat. Be healthy!

Gynecologists treating uterine prolapse at the Frau Klinik

What exercises will help with prolapse of the anterior wall of the uterus? Uterine prolapse is a female pathology that often appears as a result of labor as a consequence of increased weakness of the pelvic floor. This disease is accompanied by the progression of unpleasant symptoms, and treatment often requires surgical intervention. If the uterine prolapse is not severe, it can be treated with a special Kegel complex and gymnastics, and if the pathology progresses, wearing a pessary is prescribed and surgery is performed.

Characteristics of the disease

The prolapse of the anterior and posterior walls of the genital organ is its incorrect position as a result of weakening of the muscles and ligaments in the pelvic area.
Some symptoms of this pathological condition of a woman’s body can be identified:

• The appearance of a feeling of high blood pressure;
• Severe pain in the lower abdomen;
• Disorders of urination;
• The appearance of specific discharge from the vagina.

Prolapse of the anterior and posterior walls of the uterus is often complicated by the fact that it ends in prolapse.

This disease causes a change in the position of the cervix below a certain limit, but the exit of the cervix from the vagina is not observed. If a reproductive organ appears, doctors diagnose prolapse.

Prolapse of the anterior wall often occurs under the influence of the following factors:

• After childbirth with a large fetus;
• For overweight and obesity;
• For a chronic cough;
• After a difficult birth or severe injuries;
• For dysplasia;
• After a long labor.
• Congenital anomalies of the pelvic region;
• After gynecological surgical interventions performed on organs;
• Insufficient estrogen production during menopause.

Prolapse of the anterior wall is usually determined when a specialist conducts a gynecological examination on a chair.

To diagnose uterine pathology, the doctor asks the woman to push, which allows her to determine the displacement of the vaginal walls, rectum and bladder.

Features of eliminating the disease

Treatment of prolapse of the anterior wall of the uterus is prescribed taking into account the following nuances:

• The degree of progression of the disease and the possibility of organ loss;
• The presence of additional gynecological diseases;
• Restoration of menstruation and maintenance of reproductive function;
• Age of the patient;
• The presence of problems with the functioning of neighboring organs;
• Possible degree of risk during surgery and the use of anesthesia.

Taking into account all these factors, the specialist chooses the necessary tactics and can prescribe both conservative treatment and surgical intervention.

If, when the anterior wall is displaced, the uterus does not reach the genital slit, and there are no malfunctions in the functioning of neighboring organs, then surgical treatment can be dispensed with:

1. Prescribing therapeutic exercise, the main task of which is to strengthen the pelvic muscles. Kegel gymnastics and the Yunusov complex give positive results.
2. Carrying out gynecological massage.
3. Taking hormonal medications with estrogens, which helps strengthen the ligamentous apparatus.
4. The patient is transferred to easier work.
5. Using special ointments for insertion into the vagina, which contain hormones.

If conservative therapy does not bring the desired result, then treatment of prolapse of the organ neck is carried out by surgery.

Special exercises

Special gymnastics and the Kegel complex give a good result when the anterior wall of the genital organ prolapses. They should be done only after consultation with a specialist, while strictly controlling your breathing. These exercises can be done both on your back and in a position on all fours.

Kegel exercises

Cervical prolapse and prolapse are one of the common problems faced by patients at any age. Mostly this disease is diagnosed after childbirth, as well as in the absence of sports and low body weight. Exercises help improve the tone of the pelvic floor muscles, and treatment with their help is usually prescribed at the first signs of the disease. Treatments using Kegel exercises do not require a large amount of space in the room, and they can be performed almost anywhere.

The Kegel complex consists of the following stages:

1. It is necessary to slowly squeeze and relax the muscles as if the woman wants to stop urinating. At the very beginning, this hold is done for several seconds, after which the muscles relax. Gradually, it is important to learn to keep the muscles in a tense state for a long time.
2. The muscles of the pelvic area and pelvic floor are tensed. To perform this exercise, you should squeeze your pelvic muscles and gradually pull them inward and upward. At the very beginning, such actions must be performed at a slow pace, gradually making them faster and more rhythmic.
3. The pelvic muscles must be learned to relax and tighten, and this must be done very quickly. At the very beginning, such exercises should be done approximately 15-20 times and gradually increase them to 100 or more.

To perform this exercise, you will have to push as you would during childbirth.

When tense, it is necessary to hold this state of the body for a few seconds. At first, such exercises are performed only a few times, and gradually their number is increased to 40-50 times.

Carrying out such a complex allows you to use not only the muscles of the perineum, but also in the abdominal area.

Treatment of prolapse or prolapse of the cervix using the Kegel complex allows not only to relieve a woman of a gynecological disease, but also to eliminate problems in her sexual life.

Contraindications to exercises

Despite the fact that the Kegel complex allows you to achieve positive results in eliminating pathology of the anterior wall of the genital organ, sometimes you will have to abandon them.
You should not do such exercises in the following cases:

• Progression of acute forms of inflammation in the pelvic organs;
• Malignant neoplasms;
• Bleeding after operations;
• Vascular pathologies in the pelvic organs and lower extremities.

To obtain the desired result and avoid various complications, it is important to consult with your doctor before starting the Kegel complex.

You need to understand that uterine prolapse is a serious pathology, so you should not self-medicate.

Gymnastics for illness

Special gymnastics are used when the anterior wall of the organ is lowered or when it falls out, and is also recommended for preventive purposes. Such gymnastics can be performed on all fours or lying on your back.

At home, a woman can do the following exercises in the supine position:

• Raise your legs one at a time without bending them;
• Cycling at a moderate pace for at least 20 revolutions;
• You need to lift your feet off the floor, put them behind your head and try to touch your toes to the floor.
• Raise your straight legs at an angle of 45 degrees and return them back.
• Place your hands under your head and connect your legs to each other. Gently lift the pelvis and stretch the muscles of the anus.

Such actions must be performed slowly, and be sure to control your breathing. In addition, the ideal time to conduct such physical therapy is a few hours before meals.

If cervical prolapse becomes severe and causes cervical prolapse, then such pathology will have to be treated with surgery. If it is necessary to preserve reproductive function, radical removal of the reproductive organ is performed, that is, extirpation. After complete removal of the reproductive organ, physiological problems often arise that affect the acts of urination and defecation.

After your hysterectomy, you can do Kegel exercises, but it is important to empty your bladder before you begin. The following exercise gives a good result: tense the pelvic muscles as if the woman wants to stop urination or release gases from the intestines. Initially after surgery, the patient may not feel muscle compression, but in fact it is present.

Carrying out such a workout requires a completely relaxed state of the abdominal muscles, buttocks and legs, so you should carefully monitor their condition. After surgery, it is recommended to perform such Kegel exercises several times a day.

Therapeutic Kegel exercises should be done daily after childbirth and when removing the reproductive organ. They not only strengthen the pelvic muscles in women, but also help get rid of problems with urination and prevent the development of hemorrhoids.

Prevention of pathology

Prolapse of the anterior and posterior walls of the uterus and its cervix is ​​a dangerous pathological condition of the female body. In order to prevent its loss, it is important to follow certain preventive measures long before the disease is diagnosed.

From early childhood it is necessary to follow a rational regimen. Various exercises that help strengthen the abdominal press have a positive effect on the condition of a woman’s body. In addition, special importance is attached to the correct management of pregnancy and childbirth.

Most often, uterine prolapse develops after childbirth, so during pregnancy it is recommended:

• Eating right, which will help prevent the birth of a large fetus and rupture of the perineum;
• Adequate nutrition allows you to avoid intestinal problems and prevent prolapse of the reproductive organ.

After childbirth, it is necessary to avoid heavy physical activity, and it is recommended to do a complex to strengthen the muscles of the pelvic area.

The prolapse of the anterior wall of the genital organ is a complex pathology, but at the initial stage of development it can be cured with the help of special Kegel exercises and therapeutic exercises. If the disease reaches the last stage, treatment is carried out only through surgery.

Vaginal prolapse or vaginal prolapse is an abnormal condition in the female reproductive system, which mainly occurs in women who have given birth after the age of fifty due to a weakening of the pelvic floor, but it can also occur in women aged 30 to 45 years (forty cases out of a hundred) , as well as up to thirty years (ten cases out of a hundred). Vaginal prolapse is not always associated with the birth process; in three percent of cases, the abnormal condition develops in young and nulliparous girls.

Causes or mechanism of vaginal prolapse. Prolapse of the vaginal walls (prolapse) is expressed in a change in the anatomical location of the pelvic organs against the background of weakening of the muscles of the abdominal region and pelvic floor. Why is this happening? Due to increased pressure inside the abdominal region, the elasticity of the ligaments is gradually lost, which is why they are unable to maintain the internal organs (in particular the bladder, uterus, rectum) in the required physiological position. Hence, the increase in organ pressure gradually leads to loss of muscle tone of the perineum and prolapse of vaginal tissue.

Many factors can contribute to the development of this condition, including:

• Congenital anomaly of connective tissue development.
• Increased intra-abdominal pressure (chronic constipation, frequent ARVI, accompanied by cough).
• Development of complications during childbirth (long labor, perineal trauma, large fetus, use of obstetric forceps during childbirth).
• Sudden weight loss due to obesity.
• Tumor changes in the genital organs.
• Hard physical labor.
• An operation to remove the uterus when the vaginal dome was not fixed.
• Changes in the body that occur with age (loss of tissue elasticity (after 60 years)).
• Number of births (after the birth of the second child, the risk of prolapse of the vaginal walls increases significantly).

The course of the disease is characterized by a slow pace at the beginning and rapid progression in the future, often accompanied by inflammatory diseases.

During the development of the disease, either the anterior or posterior wall of the vagina can undergo prolapse, or both at the same time. In clinical practice, the most common occurrence is prolapse of the anterior wall, which is inevitably accompanied by prolapse of the bladder and urethra. When the posterior vaginal wall prolapses, there is a high risk of rectal prolapse or rectal prolapse.

Degrees of vaginal prolapse.

• The first degree is prolapse of the posterior, anterior or both walls of the vagina, while the vulva itself does not extend beyond the boundaries of the entrance.
• The second degree is partial prolapse of the anterior wall of the vagina with part of the bladder (cystocele) or the posterior wall with part of the rectum (rectocele), accompanied by bulging of the walls outward.
• The third degree is complete prolapse of the vaginal walls, mainly accompanied by uterine prolapse.

Signs of prolapse and prolapse of the vaginal walls. In the early stages of development, the disease does not manifest itself in any way. The first alarm bells signaling illness are pain during sexual intercourse and weakening of sensations during this process. Further, heaviness and pressure in the vulva may be felt; as it progresses, inflammation, swelling of the genital fissure, discomfort during urination, incontinence (of urine, stool and gas), and nagging pain in the abdomen and lumbar region are added.

Prolapse of the anterior vaginal wall most often manifests itself in the form of the development of chronic cystitis against the background of stagnation of urine, and the posterior wall - in the form of constipation and a feeling of the presence of a foreign object in the vulva.

A complication of prolapse of any of the vaginal walls is often prolapse and then prolapse of the uterus, which manifests itself in the form of excessive sanguineous or bloody discharge.

Diagnosis of prolapse and prolapse of the vaginal walls. Detection of the disease is not difficult; when examined in a gynecological chair, the walls of the vagina and cervix protruding from the genital tract are noticeable. The doctor adjusts them and then assesses the condition of the pelvic floor muscles. In this case, additional consultation with a urologist and proctologist is required.

Prolapse of the vaginal walls and pregnancy. Pregnancy with this condition is possible, but the degree of development of the disease should be taken into account. The first degree of the disease allows you to give birth without prior surgery. In this case, exercises to strengthen the pelvic muscles and abs will help. With a progressive degree of the disease, surgical intervention and recovery are necessary, only then can you become pregnant. Otherwise, prolapse of the vagina is fraught with prolapse of the uterus.

And one more nuance, after the operation you will no longer be able to give birth on your own; a caesarean section is indicated.

Treatment of prolapse of the vaginal walls. Prolapse of the vaginal walls, if diagnosed early, can be eliminated conservatively; in more advanced and complicated cases, surgical intervention is performed. Timely treatment significantly reduces the risk of complications.

Conservative therapy. Therapy is indicated for minor prolapse of the vaginal walls and is expressed in the use of a set of exercises, the purpose of which is to increase the muscle tone of the pelvic floor, including Kegel exercises (squeezing and relaxing the muscles of the perineum), and physical therapy exercises. At the same time, therapy is prescribed for the general strengthening of the body, while nutrition is not the least important (no heavy foods that can cause constipation and complicate the problem).

During menopause, women are prescribed hormone replacement therapy to improve blood circulation and strengthen the muscles and ligaments of the pelvic organs.

If surgery is contraindicated for a woman for any reason, to prevent complete prolapse of the uterus, the patient is fitted with uterine rings (pessaries) - a device for supporting internal organs is inserted into the vulva. The pessary is selected for each patient individually, after which regular monitoring by a gynecologist is indicated to exclude the development of serious complications (purulent and ulcerative processes, irritation and swelling of the mucous membrane, ingrowth of the pessary into the cervix or vulva). To prevent these phenomena, the doctor prescribes douching and washing the vagina. If weakness of the vaginal muscles does not allow insertion of a pessary, then a hysterophore is used - a device that holds the uterus by means of a pessary connected to a bandage attached to the waist.

Gymnastics (set of exercises) for prolapse of the vaginal walls at an early stage (can be used as a preventive measure for the disease).

Exercises while standing on all fours:

• As you inhale, raise your straightened right arm and left leg, and as you exhale, lower it. Do six repetitions. Then do the same thing, only with the left hand and right foot.
• As we inhale, we lower our head and draw in the muscles of the perineum; on the way out, we relax, raise our head and bend in the lower back. Do ten repetitions.
• Bend your elbows and alternately raise your right and left legs. Do twelve repetitions with each leg.

Exercises while lying on your back.

• Arms along the body, legs straightened and joined together. Slowly, while exhaling, we raise our legs, while inhaling, we spread them apart, while we exhale, we close them, and while inhaling, we return to the starting position. Do eight repetitions.
• Hands under your head, feet together. Raise the pelvis while simultaneously retracting the muscles of the anus. Do ten repetitions slowly.
• At an average pace we make a “bicycle” of twenty revolutions.
• Raise straight legs one by one. Do eight times with each leg.
• We lift our legs off the floor, put them behind our heads, and stretch our toes to the floor. Do six approaches at a slow pace.
• Raise your straight legs (together) at an angle of 45° to the floor and return back. Perform slowly eight times.
• Bend your knees (foot on the floor, arms under your head) and spread them slightly. Raise your pelvis from the floor, spread your knees wide and pull the anus muscles inward. Do ten approaches.

Exercises should be performed slowly and monitor your breathing. Do it two hours before meals or two hours later. Class time is not limited.

Kegel exercises.

• We strain the pelvic muscles in steps, from low effort to maximum, each position should be fixed for several seconds. We relax in the same way.
• Hold urination for 10-20 seconds.
• Moderate straining (as during childbirth).

Surgery for prolapse and prolapse of the vaginal walls (vaginal wall plastic surgery). After examining the patient with the participation of a proctologist and urologist, the doctor prescribes treatment, taking into account the severity of the pathology, the degree of prolapse, the patient’s age and the individual characteristics of her body. As a rule, surgical treatment with elements of plastic surgery is recommended. Basically, this is colpoplasty, which involves suturing the vaginal walls. There are two types of colpoplasty:

• Colporrhaphy - removal of “excess” tissue from the vaginal walls and stitching them together during prolapse and prolapse; the operation is aimed at restoring the anatomical location of the organs by strengthening the pelvic floor muscles. Can be front or back.
• Colpoperineorrhaphy is a reduction of the posterior wall of the vagina (against the background of overstretching after childbirth) by suturing it and tightening the perineal muscles.

Surgery is performed using general anesthesia. The choice of surgical technique is determined by the surgeon, taking into account visual and video colposcopic examination, analysis of the condition of the tissues of the walls of the vulva and the presence of concomitant diseases of the pelvic organs.

Postoperative period. After assessing the patient’s general condition after the intervention, the doctor discharges her, usually on the second day after the intervention. To prevent the development of complications and speed up the recovery period, it is necessary to strictly follow all the doctor’s recommendations, namely:

• During the first five days, treat the perineum with an antiseptic.
• Take antibiotics prescribed by your doctor.
• For two weeks, to avoid overstraining the operated muscles, sitting is prohibited.
• In the first week, it is recommended to eat liquid or semi-liquid foods to prevent the development of constipation.
• Eliminate physical activity, including sports, for at least a month.
• It is recommended to resume sexual activity no earlier than five weeks after surgery.

Modern equipment and microsurgery capabilities allow the operation to be performed with minimal trauma. After the intervention there are no visible marks or scars left on the body.

Prevention of prolapse of the vaginal walls.

• Correct suturing of ruptures or cuts of the perineum during childbirth.
• Mandatory physical education before, during and after childbirth.
• Do exercises to strengthen the pelvic floor muscles during pregnancy and after childbirth.
• Learn to urinate in portions, squeezing the stream several times during one urination.
• Protect yourself from carrying heavy objects.
• Balanced nutrition, including during pregnancy.
• Gentle conservative management of childbirth and prevention of maternal injuries.
• Learn to pull your vulva up while walking.

Treatment of prolapse of the vaginal walls with folk remedies. Treatment with traditional medicine can only be effective at an early stage and in combination with other treatment methods prescribed by a doctor, including exercises.

Quince can be brewed and drunk as tea; it gives tone to the muscles of the uterus. Brew 100 g of dried fruits and a liter of water using a water bath.

An alcohol tincture of astragalus root is also considered an effective traditional medicine against this disease. Take nine parts of vodka for some of the chopped roots. Keep the mixture for two weeks in a cool, dark place. Then strain. Take three times before the main meal (breakfast, lunch, dinner), with plenty of water. The treatment course includes thirty days; if necessary, the course can be repeated after two weeks.

Mix 50 g of linden blossom and lemon balm, add 70 g of white damask and 10 g of alder root. Grind the mixture. Take two tablespoons, brew 200 ml of boiling water and leave until completely cool. Take half a glass three times a day before meals. The course of treatment is twenty-one days; after a two-week break, the course can be repeated.

Datura is effective as a remedy for sitz baths in cases of partial prolapse. Pour 20 g of herb into seven liters of boiling water and keep in a water bath for fifteen minutes. After this, the infusion should be cooled to 38 degrees. Use for a sitz bath, lasting no more than ten minutes.

What to do if you have vaginal prolapse?

What to do if you have vaginal prolapse? With the first degree of pathology, it is possible to use conservative treatment methods. These include: exercise, gynecological massage and herbal medicine. All these methods are needed to increase the tone of the pelvic muscles and reduce the likelihood of vaginal prolapse.

There is another method of combating vaginal prolapse - a pessary or otherwise - a uterine ring. It is located in the vagina, which helps maintain the cervix in a physiological position.

As a result, the uterus is in a slightly elevated state, since the pessary covers the cervix and holds the entire organ. It is rational to use such a ring for minor prolapse or in old age, with the expectation that age-related changes contribute to a decrease in organ size and weight.

The disadvantage of the pessary is the need for frequent washing, as well as individual selection in volume. In addition, the use of a bandage, which also supports the pelvic organs, is considered mandatory.

Treatment of vaginal prolapse

Treatment tactics are determined by the degree of development of the pathology, the woman’s age and the presence of concomitant diseases. It is customary to distinguish two directions in treatment - conservative and surgical.

Conservative treatment of vaginal prolapse is used in the 1st degree of prolapse, when the vaginal structures do not cross the border of the genital fissure. It consists of limiting physical activity, lifting weights, conducting a course of gynecological massage, as well as performing special physical exercises.

Treatment of vaginal prolapse is aimed at strengthening the pelvic muscles, supporting structures and abdominal muscles, thanks to which the internal organs maintain their physiological location. In addition, during the process of massage and exercise, blood circulation in the pelvis is activated, which is also necessary for treatment.

Surgery for vaginal prolapse

The method of treating the pathology - surgery for vaginal prolapse is to perform colpoplasty, the essence of which is based on suturing the vaginal walls. There are two types of this type of surgery: colporrhaphy and colpoperineorrhaphy.

The first form of surgery involves resection (excision) of the tissues of the vaginal walls that have “stretched” with further suturing of the remaining structures. In the process of colpoperineorrhaphy, the size of the posterior wall is reduced by suturing it, as well as the pelvic muscles are tightened.

Surgery for vaginal prolapse may involve an additional step that involves surrounding internal organs such as the bladder, urethra and rectum. To reduce the symptoms of dysfunction of these organs, it is necessary to restore their physiological location.

Plastic surgery can be performed using your own tissues or using implants. Surgery is performed under general or epidural anesthesia. The choice is based on the volume of the proposed operation, its duration and the woman’s health condition.

Surgery for prolapse of the anterior vaginal wall

In order to tighten the organs, ensuring their physiological location, and prevent the formation of new defects that can provoke a relapse, surgery is used to prolapse the anterior vaginal wall.

In addition, surgery improves a woman's sexual activity and is used to treat urinary incontinence.

Surgery for prolapse of the anterior vaginal wall is called anterior colporrhaphy. Modern equipment allows the use of vaginal access, which is less traumatic than laparoscopy and access through the abdominal cavity.

The preparatory period before surgery includes the use of hormonal agents, especially for women in menopause. They are necessary to improve local blood circulation, which has a positive effect on the postoperative recovery period.

After surgery, it is necessary to use antibacterial drugs to prevent infection of the surgical site, as well as painkillers, with the exception of aspirin. In addition, it is recommended to abstain from sexual activity for at least a month.

Surgery for prolapse of the posterior vaginal wall

An operation is performed when the posterior wall of the vagina is prolapsed to resect the intestine, which protrudes towards the vagina and puts pressure on its posterior wall, and to restore the rectovaginal septum.

Surgical intervention consists of eliminating intestinal protrusion, strengthening the wall of the (anterior) rectum, the septum between the intestine and the vagina, as well as normalizing the function of the anal sphincter.

Surgery for prolapse of the posterior vaginal wall involves suturing the intestinal wall with a group of muscles that lift the ani, which helps strengthen the septum between the organs.

In the presence of concomitant pathology and involvement of surrounding organs in the pathological process, the scope of surgical intervention is increased to eliminate the physiological location of the structures.

Thus, it is possible to combine the main direction of the operation with the treatment of prolapse of the anterior vaginal wall, hemorrhoids, polypous formations or anal fissure. As a result, surgical time increases. In addition, in some cases, endoscopic treatment with the placement of a mesh implant is allowed.

Exercises for vaginal prolapse

The close connection of the vagina with the uterus predisposes them to joint prolapse, first the vagina, and then the uterus. Exercises for vaginal prolapse have a strengthening effect on the muscles with which the organs maintain their physiological location.

The maximum result can be obtained by using these exercises at the initial stage of vaginal prolapse, since in addition to it, the surrounding structures are not yet involved in the pathological process.

The simplest exercise to train is to stop urinating by squeezing the muscles. If you periodically stop the stream during urination, this will help strengthen the muscles and overcome urinary incontinence.

Exercises for vaginal prolapse should be performed at different paces throughout the day. Of course, you shouldn’t train constantly, but doing a few exercises 3-4 times a day will soon help normalize muscle tone.

The training can be done while sitting at the computer, standing at a bus stop, or at home in the “lying” and “standing on all fours” positions.

Kegel exercises for vaginal prolapse

Before you start doing exercises, you need to determine which muscles you will have to work and where they are located. To do this, you should try to stop the stream while urinating and remember how to do this. These muscles will have to be trained in the future.

Kegel exercises for vaginal prolapse include 3 types of execution. Firstly, this is the compression of those very detected muscles. However, the execution should be slow, squeezing the muscles to count to 3 and slowly relax them.

After this, you need to do the same thing, only quickly. And finally, “pushing out” is performed by tensing the abdominal muscles, as during childbirth, but much weaker.

In order to monitor the correctness of the exercises, it is recommended to insert a finger into the vagina and monitor the contractions.

First, you need to start with 10 times of each exercise, performing 5 times a day, and then gradually increase the load. After a week, you should add 5 repetitions to each exercise, and so on until you get 30 repetitions. To maintain the effect, you can stop at this load and perform these 3 exercises 30 times 5 times a day.

Bandage for vaginal prolapse

Prolapse of organs occurs due to their loss of the muscular framework that supports them. Thus, after pregnancy and childbirth, muscle relaxation is most often observed to such an extent that vaginal prolapse is possible.

A bandage for vaginal prolapse is necessary in order to maintain constant intra-abdominal pressure without rises, which affects the location of the uterus and vagina. The bandage gives the muscles time to restore their tone and strengthen the organs in physiological positions.

Despite its effectiveness, the bandage should not be used continuously for vaginal prolapse, as the organs need rest. So, it is not rational to use it at night, since neither gravity nor pressure contribute to vaginal prolapse.

During even minor physical activity (walking, doing housework), it is necessary to wear a bandage to support the organs. In addition, it is mandatory after operations on the uterus and vagina, since the muscles in the postoperative period are the weakest and are not able to perform their main function.

Folk remedies for vaginal prolapse

In order to treat the pathological condition, it is recommended to simultaneously use physical exercises and folk remedies for vaginal prolapse. For this purpose, a collection of herbs is used, taken orally, in the form of baths or douching.

For the decoction, you need to take lemon balm and linden flowers - a quarter cup each, white damselfish - 70 g and alder root - 1 dessert spoon. After thoroughly grinding, you need to select 30 g of the mixture and pour one glass of boiling water.

The decoction should infuse for approximately 1 hour, after which it should be filtered and taken 100 ml three times a day before meals, half an hour. The duration of the course is 20 days, and then a break is needed - half a month.

For douching, you will need to prepare a solution from quince, which must be crushed and filled with water, the volume of which is 10 times greater than the quince. After boiling for 25 minutes, filter the broth and cool to a warm, comfortable temperature. Douching with this solution helps increase muscle tone.

Exercise therapy for vaginal prolapse

Exercises must be repeated every morning before meals, starting with the minimum load and gradually increasing it. Exercise therapy during vaginal prolapse helps restore the previous muscle tone and strengthen them significantly longer.

“Bicycle” is an exercise that everyone has long been familiar with. To perform it, just lie down and pedal an imaginary bicycle for about a minute, raising your legs to 45°. “Scissors” are performed in the same way, but with straight legs.

Lie on the floor, place a rolled cushion under your buttocks, while keeping your back on the floor. The left leg must be raised straight up to 90°, and then lowered and replaced with the other. Repeat up to 8-12 times.

The exercise becomes more complicated by removing the roller and raising both legs at the same time to an angle perpendicular to the floor. Standing near a chair, you need to hold on to it and move your leg to the side to perform circular movements for 30 seconds. Then change the direction, and then the leg. Also, while standing, you need to swing your legs up to 7 times each, stand in the “swallow” pose for about a minute.

Vaginal prolapse can bother women at any age, but there is an effective way to prevent weakening of the muscles - this is physical exercise, so if you really want to, you can independently reduce the chances of developing pathology.

Unpleasant sensations in the vagina due to physical tension, compression of the pelvic floor muscles, and intimate life are a reason for a woman to consult a specialist. The problem may be a displacement of the uterine body and is fraught with serious consequences and a threat to the woman’s health.

Symptoms of the disease

The body of the uterus shifts unevenly; the posterior or anterior surface descends. The process of prolapse of the posterior vaginal wall, which causes pressure on the rectum, is called rectocele. The early stage of this disease is practically asymptomatic.

The first thing a woman begins to feel is pain during sex. The disease in later stages is characterized by the following symptoms:

At the last stage, a woman can no longer be sexually active. Simultaneously with the prolapse of the uterine body, erosions and other inflammatory processes occur.

Treatment methods for vaginal prolapse

The treatment method for rectocele depends on the degree of prolapse; for this purpose, ultrasound examinations, urography, colposcopy are prescribed, laboratory tests are taken, smears and feces are examined.

Uterine prolapse is a serious disease, ignoring which always leads to irreversible consequences.

Early diagnosis will allow you to get rid of this problem at the first stage and avoid unpleasant consequences. What to do if prolapse of the posterior wall is diagnosed; this disease is treated surgically, laser correction or conservative treatment.

Laser correction is a modern non-surgical method using modern technologies. This is the safest and most effective treatment for rejuvenation and restoration of turgor of the vaginal walls.

Surgery is performed for stages 2 and 3 of displacement. During surgery, the surfaces are tightened and sutured, and implants are implanted to fix the organs. In addition to the above-described treatment methods for vaginal prolapse, drug therapy is prescribed, as well as a gymnastic complex.

Surgical intervention

If treatment for prolapse was not started in time, in advanced stages, the only way to eliminate organ prolapse is to use a surgical scalpel. Modern surgery offers women diagnosed with posterior wall prolapse to undergo surgery and plastic surgery at the same time. This type of colpoplasty is called posterior colporrhaphy.

The purpose of the operation is to remove excess tissue, narrow the vaginal opening, and restore the anatomical location of the organs.

This surgery has its own characteristics. The surgeon needs to remove the excess tissue flap on the vaginal wall adjacent to the perineum. The size of the cut fabric should be such that the seams will not come apart later if overstressed.

For the first 3 - 4 days, patients are prescribed bed rest, the woman is under the supervision of a doctor in the hospital. The rehabilitation period after colporrhaphy lasts 1.5 months. At this time you cannot:

• lift weights;
• exercise;
• have a sexual life;
• eat foods that cause constipation.

Contraindications to colporrhaphy include sexually transmitted diseases, heart disease, and acute stages of thrombophlebitis.

Conservative therapy

In mild forms of prolapse, the following help restore the anatomical location of organs:

• insertion of support devices (pessary);
• physiotherapy;
• diets;
• wearing a bandage;
• drug therapy;
• folk remedies.

A woman who uses corrective rings must wear a bandage, maintain strict hygiene and see a doctor.

A strict diet consisting of plant fiber also helps. Products containing a high percentage of fiber help facilitate the easy passage of stool through the intestines. It is recommended to take laxatives and eubiotics that restore intestinal microflora.

Along with diet, pharmaceuticals and physical therapy, it is recommended to use recipes from traditional medicine that help increase muscle tone. These are douching and baths with quince solution, internal decoctions of lemon balm, alder, linden blossom, and white damask.

It is necessary to wear a support bandage for rectocele, especially for women after childbirth, when muscle tone is weakened. You cannot wear the device all the time; your body must rest.

Exercise therapy and Kegel exercises

Physical therapy and special Kegel exercises will help restore the anatomical positions of organs and strengthen muscle tone. Exercise therapy is carried out at the first stage under the supervision of an instructor; later, the woman can perform a simple gymnastic complex on her own.

The following exercises allow you to get the greatest therapeutic effect:

1. "Bike". Performed lying down at a slow pace 20 times.
2. Raising legs from a lying position. 8 times.
3. Raising the pelvis with compression of the muscles of the anus and vagina. Legs bent at the knees, knees together, arms either along the body or under the head.
4. "Birch". Raise your legs straight up, arms support your back.
5. Putting your legs behind your head while lying on your back.
6. Simultaneously raising the right arm and left leg from the “on all fours” position. 6 times, then change arms and legs.
7. "Cat". Position “on all fours”, slow alternating bends in the lower back with breathing. 8 times.
8. "Plank". Performed on straight arms or elbows. 15 - 20 seconds.

The Kegel complex is effective for genital prolapse. These are three simple but effective exercises: stepwise tension and relaxation of the pelvic muscles, holding the stream when urinating for a few seconds and moderate efforts, as during labor.

Non-surgical treatment

Aesthetic gynecology specialists successfully deal with the problem of restoring the tone of the muscular structures of the vagina. Laser correction is carried out using special medical equipment and takes up to 30 minutes. This non-invasive treatment method is carried out using a laser beam. A laser is used to heat and evaporate excess tissue. Such technologies promote better regeneration, increased blood circulation, and the production of collagen fibers.

After the laser procedure, normal turgor is restored, tissues acquire elasticity, and the volume of the vagina decreases. Uncomfortable sensations disappear, the normal process of urination is restored.

The cost of laser therapy in aesthetic gynecology clinics depends on the degree of wall prolapse:

Prolapse of internal organs is a serious pathology, it is dangerous due to its unique consequences. The sooner the disease is diagnosed, the faster it can be cured.

Treatment of prolapse of the vaginal walls according to recipes from the newspaper “Herald of Healthy Lifestyle”.

Kegel exercises will help you avoid surgery
A 47-year-old woman contacted the newspaper: a diagnosis of “Prolapse of the vaginal walls” was made, and surgery was proposed. But she is afraid to go under the knife. I heard that exercise helps to cope with this problem. He asks me to tell you about these exercises.

Gynecologist A.I. Shashina answers. The main causes of prolapse of the vaginal walls are prolonged work on the feet or work associated with lifting weights. These two reasons will lead to the development of this disease in 99% of cases. Therefore, first of all, a woman needs to reconsider her lifestyle and change jobs.

The exercises that the reader writes about were developed by the German gynecologist Arnold Kegel. They strengthen the pelvic floor very well.

These are the exercises.
1. First you need to learn how to squeeze and unclench the muscles of the perineum. Tighten them as if you are trying to stop urination. Hold the muscles in this state for 3 seconds. Relax.
2. The same exercise, but at a fast pace - quickly contract and relax these muscles.
3. Squeeze the muscles of the perineum and remain in this position for as long as possible - 1-1.5 minutes.
4. Imagine that you need to push something out of the muscles of the perineum. Tighten your muscles (push) with medium strength. Try to hold this position longer.
Kegel exercises can be performed in any position, it does not matter fundamentally, even sitting, even lying down, even standing. If only it was convenient for the woman herself to do them.
In the first week, perform each exercise 10 times, 3-5 approaches per day.
In the second week - 15 repetitions.
In the third week - 20 repetitions.
Continue to increase the number of repetitions until you reach 100 times. Gradually, the pelvic floor muscles will become so strong that no surgery will be needed to correct the prolapse of the vaginal walls.
(HLS 2015, No. 8, p. 22).

Content

Displacement of the physiological position of the uterus and disruption of the structure of connective tissues leads to prolapse of the vaginal walls, eversion of the vagina itself and the exit of the cervical canal. Pathology can also affect the full functioning of neighboring organs, for example, compressing intestinal loops, ureters, and bladder, which invariably leads to disturbances in bowel movements and problems in the functioning of the genitourinary system.

Prolapse or prolapse of the uterus mainly affects women over 40 years of age who have suffered injuries or radical interventions of the genitourinary system, for example, complex, protracted labor, abdominal surgery. The disease has a slow tendency to progress, gradually leading to major problems associated with complete loss of ability to work and exercise.

If the necessary treatment is not provided, complete prolapse can become dangerous not only to the health, but also to the life of the patient.

Reasons for appearance

The main cause of the pathology is a violation of the synergy of mobile muscle and supporting connective tissues of the abdomen. As a result of such deformation, the muscles are not able to hold the body of the uterus, intestinal loops and appendages in the required position. Becoming too heavy for the frame, the organs put excessive pressure on the pelvic floor, which gradually loses its elastic properties and weakens, and the internal genital organs are increasingly shifted downward.

Many different factors can contribute to the development of pathology, for example:

• regular sharp increase in intra-abdominal pressure (frequent cough, chronic constipation);
• dysplasia or congenital malformations of connective tissue;
• sudden loss of a large amount of weight after obesity;
• changes in the structure of tissues of the reproductive system as a result of tumors;
• excessive physical activity;
• difficulties during the birth process (perineal ruptures, use of obstetric forceps, delivery of a large fetus, prolonged, difficult birth process);
• hysterectomy without fixation of the vaginal dome;
• multiple births (already during the second birth, the risk of developing prolapse increases significantly);
• loss of muscle elasticity with age, especially during hormonal changes of menopause.

Prolapse of the vaginal walls is characterized by a rather leisurely course during the development of the disease and rapid progression in the future. Often the disease is accompanied by various inflammatory processes.

The most common form of the disease is prolapse of the anterior wall; less often, the posterior part of the uterus is displaced, and sometimes the pathology affects both uterine walls at once.

Together with the anterior uterine part, prolapse of the urethra and bladder usually occurs. Posterior wall prolapse can cause rectal prolapse.

Stages of prolapse of the uterine walls

There are three main stages of the disease:

• 1st degree – in this case there is a slight displacement of the internal genital organs and uterus, there is no prolapse;
• 2nd degree (partial prolapse) - the cervical canal descends into the vestibule of the vagina or slightly emerges from it, and the uterine cavity is located in the vagina;
• 3rd degree (complete prolapse) - the walls of the vagina and a significant part of the body of the uterus are located outside the genital organs.
• It is worth noting that not a single stage of the disease can be treated with medication. Any prolapse or displacement of the uterus requires surgery.

Symptoms

Often the pathology is accompanied by the formation of hernial processes on the anterior and posterior walls of the vagina. The hernial sac may include most of the genitourinary system: the bladder, urethra, vaginal walls, intestinal loops and rectum.

With total prolapse of the 3rd degree, there is also an inversion of the vaginal walls outward. At the same time, there is a downward displacement of the bottom of the bladder and its posterior part, and often there is an exit of intestinal loops through the posterior wall of the vagina.

The main complaints of patients with prolapse of the anterior vaginal wall are pain in the lower abdomen and lower back, discomfort when walking, decreased ability to work and a feeling of swelling in the genitals. Upon closer examination, the woman also notices:

• pseudo-erosion;
• ectropion;
• lengthening of the cervical canal and its hypertrophy;
• polyps on the surface of the cervix;
• bedsores;
• dryness of the vaginal walls;
• disturbances in the structure of the endometrium (sharp thickening or thinning);
• endocervicitis.

Carrying out a histological examination, which is often prescribed if prolapse of the anterior wall is suspected, allows us to identify:

• inflammatory processes of the internal genital organs;
• microcirculation disorders in some areas of the reproductive system;
• para- and hyperkeratosis;
• sclerosis.

Violations also affect some other organs of the genitourinary system. Women often complain of problems with urination; less often, acute retention is noted. Laboratory tests of urine in such patients show significant deviations in its composition, for example, leukocyturia, bacteriuria, and the presence of salts. Further examinations help identify a number of the following disorders:

• deepening of mucosal grooves and trabecularity;
• deviations from the normal position of the ureteric orifices;
• chronic cystitis;
• decreased tone and atony of the sphincter-detrusor bladder;
• dilatation of the ureter;
• nephroptosis;
• renal dysfunction.

Intestinal ailments such as hemorrhoids, gas and fecal incontinence, constipation and anal sphincter insufficiency are noted only in the most advanced stages of the disease.

The appearance of severe pain piercing, cutting character in the lower abdomen is a reason to immediately consult a gynecologist.

You can detect symptoms of prolapse of the anterior wall of the uterus yourself.

When you independently palpate the inside of the vagina, you can clearly feel the swelling and swelling of the outer wall. This may also cause severe pain.

Changes can also be noticeable on the outside. The genitals swell, and the vaginal edge turns out and becomes very noticeable from the outside.

The appearance of atypical discharge interspersed with blood may also be an indicator of the presence of pathology.

Painful sensations during prolapse and prolapse of the uterus become much more intense and are difficult to confuse with menstruation or cystitis. One of the main signs of the disease is also the sensation of a foreign object. Many patients diagnosed with prolapse and prolapse come for examination complaining of a feeling of a growing tumor.

Diagnostics

Diagnosing the disease is usually not difficult. Only in some cases, in the initial stages, additional examinations should be done to exclude tumor growths (cyst, fibroids, fibroids) on the anterior wall of the uterus. Also, studies can be supplemented to exclude cancer of the cervix and vaginal walls. At the initial stage of the disease, it is also difficult to determine which wall of the uterus, posterior or anterior, is responsible for the development of the disease.

The disease is detected during examination in a gynecological chair. The specialist asks the patient to push, as a result of which the internal genital organs descend or come out.

To determine the presence of complications in the form of kidney pathology, problems with the ovaries or the presence of fibroids, it is necessary to do an ultrasound examination and undergo general blood and urine tests. If concomitant ailments are identified, treatment is carried out together.

Unfortunately, the diagnosis of connective tissue damage, the weakening of which becomes the main cause of prolapse of the internal genital organs, does not exist today. Indirect indicators of the development of prolapse can be such signs as:

• umbilical hernia;
• haemorrhoids;
• varicose veins;
• varicocele.

Conservative treatment

Conservative treatment methods can be useful only at the very beginning of the disease, when there is only a slight loss of elasticity and slight prolapse of the walls of the uterus.

Treatment methods boil down to taking strengthening medications and physiotherapeutic methods, the purpose of which is to increase the tone of the pelvic floor muscles.

One of the most effective preventive methods for minor pelvic floor prolapse is Kegel exercises. They involve training the vaginal muscles by alternately squeezing and relaxing them. If you do such training regularly and a sufficient number of times, after a few months you can notice significant improvements.

Nutrition also plays an important role in the treatment of the disease. Preference should be given to light and quickly digestible foods, while avoiding heavy foods that contribute to constipation and complicate bowel function. Hormone replacement therapy is indicated for postmenstrual women. Preparations containing estrogen will help get rid of most of the symptoms of menopause, improve blood circulation and help maintain the elasticity of the ligaments and muscles of the pelvic organs.

Surgery

After examination by several specialists (proctologist, gynecologist, urologist), the degree of prolapse or prolapse of the pelvic organs is determined and surgery is prescribed. It is worth noting that the surgical treatment method is the most reliable and long-term way to get rid of the disease.

One of the most popular surgical methods is colpoplasty with suturing of the vaginal walls. There are two main ways to perform such plastic surgery of the internal genital organs.

• Colpoperineorrhaphy - occurs by reducing the posterior wall by tightening it and suturing the muscle tissue. Usually performed after overstretching of the perineum during the birth process.
• Colporrhaphy is the resection of excess tissue formed during the stretching process and the installation of internal organs in an anatomically correct position. It can be performed on both the anterior and posterior vaginal wall.

The procedure is performed using general anesthesia. The choice of operating method is selected strictly individually, after clarifying the diagnosis, the patient’s age, her general health and the presence of concomitant diseases.

The use of microsurgery methods in modern medicine allows this surgical intervention to be performed with low trauma and a minimum of complications. There are also no visible traces of the operation left on the woman’s body, and the rehabilitation period takes only a few weeks.

Discomfortable sensations in the vagina due to tension or contraction of the anterior wall of the abdominal cavity force a woman to consult a gynecologist. Sometimes this can occur at rest, as well as during sexual intercourse.

Similar unpleasant symptoms can be caused by prolapse of the vaginal walls (vaginal prolapse). This is a serious disease that requires careful diagnosis and comprehensive treatment.

Causes of prolapse of the anterior (posterior) vaginal wall

There are many factors that can contribute to the occurrence of this pathology, and these include:

• prolapse of the posterior (anterior) wall of the vagina after a difficult birth, or as a result of ruptures and other injuries received during the birth process;
• pathology of microcirculation processes of lymph and blood in the pelvic area;
• dysplasia (systemic deficiency) of connective tissue;
• systematic lifting of significant weights by a woman;
• obesity;
• physical inactivity, insufficiently active lifestyle;
• disturbance or decrease in estrogen production;
• bronchial asthma, bronchitis or constipation - these diseases contribute to increased intra-abdominal pressure.

Degree of development of pathology

Experts divide vaginal prolapse into three degrees, which differ in the severity of the pathology:

• first degree - moderate drooping of the walls (both or one), caused by the pressure of organs that have shifted downward;
• with grade 2 prolapse of the vaginal walls, the pressure on them from the uterus or other internal organs increases several times. This is often accompanied by the presence of the body of the uterus in the vagina, and the pharynx of the cervix almost in the vestibule;
• third degree of prolapse, the most severe - eversion of the vaginal walls outward and even prolapse of the uterus.

In addition, vaginal prolapse can be caused by displacement of specific pelvic organs. So, they divide:

• cystocele - prolapse of the anterior wall of the vagina, under the pressure of a pathologically displaced bladder. It occurs due to weakened muscles or stretched ligaments that hold it in place;
• rectocele - prolapse of the posterior wall of the vagina, experiencing intestinal pressure.

Symptoms of vaginal prolapse

The prolapse of the vaginal walls does not occur on its own - it is a symptom of a general change in the location of other internal organs in this area - they create pressure on the vaginal walls.

Some symptoms of this pathology are felt by the woman herself, but an accurate diagnosis is made by a specialist doctor after a detailed examination.

This is often accompanied by uterine hypertrophy, cervical canal polyps, and pseudo-erosions. As a result of this, dryness of the vaginal mucosa, its thickening or thinning, appears.

When examining, it often turns out that microcirculation is impaired due to sclerotic changes in the lymphatic and blood vessels.

Already in the first stages of the disease, women feel painful impulses in the lower back, lower abdomen, experience difficulty with active movements, and their ability to work is noticeably reduced.

Tissue irritation, itching, and severe dryness of the mucous membrane appear. This often leads to the appearance of erosions (ulcers) in the vaginal area. Sex during vaginal prolapse brings pain.

Organ prolapse provokes frequent urination, urinary incontinence, and sometimes a reverse reaction occurs - urinary retention.

Almost always, vaginal prolapse is accompanied by intestinal dysfunction - constipation occurs, uncontrolled gas secretion, hemorrhoids appear, and cases of fecal incontinence occur.

Treatment

When treating prolapse of the vaginal walls, both surgical and conservative methods can be used.

Conservative methods

These include the installation of a pessary. This internal organ support device, made of silicone or plastic, is inserted into the vagina. This procedure is used infrequently, only when absolutely necessary.

The device is selected individually for each patient. Women who have it installed are under constant supervision of a specialist, as complications are possible:

• irritation and swelling of the vaginal mucosa;
• ulcerative and purulent processes;
• ingrowth of an installed pessary into the tissue of the cervix or vagina.

To prevent these phenomena, the doctor prescribes douching, rinsing, and it is possible to change the device model.

Such treatment is allowed only for moderate prolapse of the vaginal walls. If this is not possible due to weakness of the vaginal muscles, a hysterophore is used. This device helps hold the uterus in place using a pessary connected to a band that is attached to the waist.

Such methods are a typical palliative, which almost never leads to a complete recovery. Therefore, surgical intervention is most often the most effective, except in cases where it is clearly contraindicated.

Surgical methods

The method of surgical intervention is chosen by a specialist depending on the degree of development of the pathology, the age of the patient and the individual characteristics of her body.

• colpoperineorrhaphy - this operation is performed on the back wall of the vagina, when the rectum prolapses into the vagina. It is sutured and levatoroplasty is performed, which ensures retention of organs in the pelvic cavity;
• an operation is performed on the anterior wall of the vagina to raise and secure the bladder during its descent, and to relieve the vagina from its excess pressure;
• Median colporrhaphy is performed for vaginal prolapse. Such an operation is recommended for women who have passed reproductive age, when the use of other radical methods is not recommended. The operation is quite easy to tolerate and in most cases has favorable results;
• Colpoperineocleisis (incomplete closure of the vagina) is also performed on elderly patients. The operation narrows the vaginal cavity, forming a dense septum that absorbs excess pressure from the abdominal cavity;
• The method of vaginal-vesical interposition is used for combined prolapse of the anterior wall of the vagina, uterus and bladder. During the operation, the round ligaments are shortened and fixed, which will create support for the organs fixed in their normal position. After this operation, pregnancy is excluded. In general, the technique gives good results without complications;
• if vaginal prolapse is directly related to the displacement of the uterus, then, depending on the indications, operations are performed to secure this organ in the abdominal cavity (ventrosuspension or ventrofixation), partial resection followed by plastic surgery (“Manchester” operation) or even complete amputation.

Gymnastics or Kegel exercises for vaginal prolapse

Gymnastic exercises have a good effect on vaginal prolapse. When performing them, you must be sure to monitor your breathing.

Perform the exercises while lying on your back or standing on all fours.

Exercises while lying on your back

Exercises while standing on all fours

• As you inhale, you need to lower your head, stretch your right arm up, and lift your left leg and stretch it back, lower your leg and arm as you exhale. The same is done with the right leg and left arm. Repeat the exercise 6 times;
• the head is lowered down while inhaling while simultaneously contracting the muscles of the perineum. Next, relax the muscles as you exhale, raise your head and bend your spine. You need to do this exercise 10 times;
• lean on your elbows, alternately lift your left and right legs up. The exercise is repeated 12-14 times.

Kegel exercises

There is a well-known set of Kegel exercises that allows you to strengthen the muscle walls of the pelvic area. They are simple and accessible to every woman at any time of the day:

• the so-called Kegel lift. The pelvic muscles are tensed in stages, from small efforts to maximum, making sure to fix each position for several seconds. Relaxation is carried out in the same order;
• delaying urination for 10-20 seconds - this will not cause harm, but will help strengthen the muscles and ligaments;
• moderate straining - as during labor;
• Regular performance of such exercises will become a reliable assistant for a woman in counteracting the extremely unpleasant syndrome of prolapse of the vaginal walls.

It is therapeutic exercises that become the main means of helping to completely get rid of such pathology without resorting to surgical intervention.