Prolapse (prolapse) of the uterus and vagina
Prolapse of the uterus is a condition that can happen to any woman, especially after childbirth or in adulthood. Yes, it can be embarrassing to talk about such things, but it is important to understand: there are no shameful problems, and a timely visit to the doctor can prevent serious complications. Prolapse affects the usual rhythm of life, causing discomfort, problems with urination and even pain during intimacy. Ask for help in time.
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Diagnostics
In order to accurately determine the stage of uterine prolapse and choose the best treatment, doctors conduct a comprehensive examination, which includes several steps.
After receiving all the results, the doctor determines the degree of prolapse and develops an individual treatment plan. The earlier the diagnosis is carried out, the more chances there are to avoid complications and surgical operations.
If you are faced with uterine prolapse or other gynecological problems, do not postpone a visit to the doctor. At the K+31 clinic, we offer accurate diagnostics and modern treatment methods that will help you regain comfort and confidence. Call, sign up for a consultation, and you can always find prices for services on our website.
- Complaint collection and inspection In the first step, the doctor listens to the patient's complaints. They ask about the symptoms: heaviness, pain, problems with urination or defecation. It is important to discuss the history of childbirth, surgeries and the presence of chronic diseases. Then an examination is carried out on a gynecological chair. The doctor assesses the position of the cervix, the condition of the genitals and the degree of prolapse
- Ultrasound of the pelvic organs Ultrasound helps to visualize the position of the uterus, the condition of the pelvic floor muscles and ligaments. Concomitant pathologies such as fibroids or cysts are also excluded
- Urodynamic study In case of complaints of urinary incontinence or frequent urges, the doctor checks the function of the bladder. The study shows how much prolapse affects the functioning of the urinary system
- Colposcopy The method is used to assess the condition of the vaginal mucosa and cervix
- MRI If the situation is difficult, the doctor may prescribe magnetic resonance imaging. The method helps to see the condition of the ligaments, the location of internal organs and identify serious changes in the tissues
- Functional tests To assess the displacement of organs, the patient is sometimes asked to strain during the examination. This helps to understand how the position of the uterus changes under load
- Laboratory tests Additionally, smears may be prescribed to check for infections and blood tests to rule out inflammatory processes
Stages of uterine prolapse
First stage
At this stage, the uterus descends slightly, but the cervix remains within the vagina. Symptoms are subtle but may include:
- Feeling of heaviness or pressure in the lower abdomen, especially after physical exertion
- Mild discomfort when standing or walking for long periods of time
- Rare episodes of difficulty urinating
At the first stage, conservative methods are usually prescribed. These are exercises to strengthen the pelvic floor muscles (Kegel gymnastics), physiotherapy and the use of pessaries - special devices that support the uterus in the correct position.
Second stage
The cervix descends to the entrance to the vagina or slightly protrudes beyond it when straining. Symptoms become more pronounced:
- Feeling of a foreign body or pressure in the vagina
- Pain in the lower back or lower abdomen, worsening at the end of the day
- Discomfort or pain during sexual intercourse
- Frequent or difficult urination, possible episodes of incontinence
- Problems with bowel movements, including constipation
An integrated approach is required here. In addition to pessaries and gymnastics, laser treatment or physiotherapy may be recommended to strengthen the ligaments. In case of significant discomfort, surgical intervention, such as suspension of the uterus using special materials.
Third stage
At this stage, the cervix partially or completely extends beyond the vagina. This causes a number of unpleasant symptoms:
- Constant sensation of a foreign body between the legs
- Pain when walking, sitting, or even at rest
- Irritation and inflammation of the mucous membrane due to constant friction
- Frequent urge to urinate, difficulty emptying the bladder completely
- Problems with bowel movements: chronic constipation or difficulty having a bowel movement
At this stage, conservative methods no longer help. The only solution is surgery. Depending on the situation, the doctor may suggest uterine suspension, ligament repair, or plastic correction to fix the organs in an anatomically correct position.
Fourth stage
The uterus falls out of the vagina completely, causing severe physical and emotional distress. Symptoms include:
- Severe pain and pressure in the lower abdomen
- Inability to sit or walk without constant discomfort
- Chronic inflammation and damage to the mucous tissue of the prolapsed uterus
- Severe difficulty urinating and defecating
Treatment at this stage is only surgical. The doctor may suggest removal of the uterus (hysterectomy) or reconstructive surgery to restore the position of the organs. The choice of method depends on the age of the patient, the state of health and the need to preserve reproductive function.
General information
Causes of prolapse and prolapse of the uterus and vagina
Causes of vaginal and uterine prolapse:
- Childbirth and pelvic floor injuries. Most often, prolapse is associated with injuries that occur during natural childbirth. Stretching or tearing tissues in large fetuses, multiple pregnancies, or rapid labor weaken the muscles, which reduces their ability to hold the uterus in a normal position
- Age and hormonal changes. With age, especially after menopause, the pelvic tissues lose their elasticity. A decrease in estrogen levels worsens the condition of connective tissues, which increases the risk of prolapse
- Physical activity. Frequent lifting of weights or performing physically demanding work can gradually weaken the pelvic floor muscles. This is especially dangerous if the body is already weakened after surgery or childbirth
- Chronic constipation. Constant straining during defecation creates increased pressure in the pelvic area. Over time, this pressure disrupts the structure of the muscles and ligaments that hold the uterus together
- Overweight. Excess weight increases the load on the pelvic organs. Constant pressure can cause displacement
- Pelvic surgery. After removal of the uterus or other operations, the balance in the supporting tissues of the pelvis may be disturbed. This can provoke the prolapse of neighboring organs
- Genetic predisposition. Some women have weak connective tissue from birth
- Chronic diseases. A persistent cough with bronchitis, asthma or other diseases increases intra-abdominal pressure. This accelerates the process of weakening the muscles and ligaments of the pelvis
Also, chronic diseases such as diabetes mellitus impair blood circulation and reduce tissue stability.
"Lack of physical activity is another important reason. When the pelvic floor muscles weaken due to a sedentary lifestyle, they cease to effectively support the pelvic organs. This becomes especially noticeable if there is also excess weight or other risk factors," says the doctor of the K+31 clinic (Moscow).
Answers to popular questions
We have answered the most popular questions to dispel doubts and help you understand the details.
Can the disease return after treatment?
Unfortunately, recurrence is possible. This is most often due to the fact that not all provoking factors have been eliminated. For example, constant lifting of weights, excess weight or repeated childbirth can provoke organ prolapse again.
How to treat complications?
If the prolapse is accompanied by infections, inflammation or tissue erosion, these problems are eliminated first. For example, antibacterial drugs are used for infections, and anti-inflammatory drugs are used to relieve swelling and pain.
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What is uterine prolapse?
Uterine prolapse is a condition in which the uterus moves down towards the vagina. Prolapse occurs due to weakening of the pelvic floor muscles and ligaments that are supposed to hold the pelvic organs in place.
The problem occurs when the structures that support the pelvic organs lose their strength and elasticity. The causes can be different and include both congenital factors and acquired changes.