Vaginal prolapse is a problem many women face. Pathology develops against the background of a decrease in the tone of muscle structures in the pelvic area, as a result of which the internal organs of the reproductive system are shifted down. In the initial stages, the disease is sometimes amenable to conservative therapy, but in severe cases, surgery is indispensable.
Of course, many women are interested in additional questions. Why does the disease develop? What symptoms should I look for? How is vaginal prolapse treated? This information will be of interest to many women.
What is a pathology?
Vaginal wall prolapse is a pathology that is associated with a decrease in muscle tone in the pelvis, weakening of the ligaments that support the natural position of the organs. Under the influence of various factors, the uterus begins to lower, pressing on the vagina, which leads to its displacement. In the most severe cases, the pathology ends with the prolapse of the walls of the vagina.
According to statistics, this is a very common problem. Every third patient over 45 years old suffers from a prolapse of the vagina of one degree or another. Despite the fact that older women are more prone to the disease, it is also diagnosed in young women, however, in them weakening of ligaments and muscles is associated with complicated childbirth. It is believed that each subsequent birth several times increases the likelihood of a similar problem in the future. In nulliparous patients, omission of the uterus and vaginal walls is also possible, but it is usually associated with congenital malformations of the connective tissue.
The main causes of the development of the disease
Vaginal wall prolapse is not an independent disease - it is only a consequence of other problems. Currently, several risk factors are distinguished:
- As already mentioned, vaginal prolapse most often develops after childbirth, especially if the pregnancy and the birth process itself have passed with a complication.
- Risk factors include injuries to the perineum and other tissues (this may be the result of various gynecological procedures).
- Pathology may be the result of age-related changes. Collagen synthesis activity decreases, as a result of which connective tissue weakens, and ligaments begin to stretch. This contributes to the prolapse of the pelvic organs.
- A negative factor is obesity. Overweight creates additional stress on the pelvic organs, which contributes to the displacement of the reproductive organs.
- Risk factors include some pathologies of the gastrointestinal tract. For example, with constant constipation, an increase in pressure in the pelvis is observed.
- Some chronic diseases, which are accompanied by an increase in intra-abdominal pressure, can also provoke vaginal prolapse. This is observed, for example, in asthma, bronchitis, etc.
- The cause may be the formation and growth of a tumor (both benign and malignant) in the pelvic area.
- The condition of ligaments and collagen synthesis is also affected by sharp changes in the hormonal background. Menopausal women are most prone to this type of pathology due to estrogen deficiency.
- Sedentary work, lack of exercise, a sedentary lifestyle, malnutrition, constant stress are also risk factors.
During the diagnosis, it is very important to establish what exactly provoked the displacement of the genitals, since in many respects the therapy depends on it.
What are the symptoms of the disease?
Vaginal prolapse progresses gradually, so signs may not even appear at the initial stages. Occasionally, women are disturbed by pulling pains in the lower abdomen, which, however, remain unattended, because the patient perceives them as symptoms of a premenstrual syndrome.
As the organs are displaced, normal blood circulation is disturbed. This leads to thinning and excessive dryness of the vaginal mucosa. Some women report a decrease in sensitivity during intercourse. Sometimes sexual intercourse is accompanied by severe soreness.
Subsequently, small erosions appear on the vaginal mucosa. The list of symptoms also includes uncharacteristic vaginal discharge, sometimes with an admixture of blood. Some women complain of a constant sensation of a foreign body in the vagina, which is associated with a displacement of the uterus and intestines.
The features of the course of the disease also matter. For example, omission of the anterior vaginal wall affects the functioning of the bladder. Frequent urination is observed. Many patients complain of incontinence, periodic leakage of urine. Another picture is also possible - stagnation of urine in the bladder occurs, which leads to the development of chronic forms of inflammation (cystitis).
The omission of the posterior wall of the vagina is associated with a violation of the intestines. Women with a similar diagnosis suffer from constant constipation, uncontrolled emission of gases. Pathology increases the risk of hemorrhoids or exacerbation of existing hemorrhoids. In the most severe cases, fecal incontinence develops.
Stages of the development of the disease
It is worth noting that the symptoms of vaginal prolapse directly depend on the stage of development of the disease. There are three stages of disease progression.
- At the first stage, there is a moderate prolapse of the vagina (anterior / posterior wall or both). At the same time, there are no external signs.
- The second stage of the pathology is accompanied by an increase in pressure from the uterus and other pelvic organs. In this case, the uterus falls to the level of the vagina, and the cervix is located almost on the eve of the vagina.
- The third stage is the most difficult - the walls of the vagina are almost completely turned outward. At this stage, uterine prolapse is possible.
Forms of the disease and their features
Weakness of the ligamentous apparatus can be expressed in different ways.
- The most common prolapse of the anterior vaginal wall is that it is often traumatized during childbirth. Since the organs of the excretory system are located nearby, this form of pathology sometimes leads to the development of cystocele - together with the vaginal wall, it lowers the bladder and urinary canal.
- Lowering of the posterior wall is less commonly diagnosed. This form of the disease is accompanied by a partial or complete destruction of the endotasic fascia, which separates the intestines from the vagina. As a result of such changes, part of the rectum presses on the back wall of the vagina, bending it - a kind of “bubble” forms. Women in such cases, as a rule, complain of a foreign body sensation.
- In some cases, the omission of both walls is observed.
Diagnostic measures
As a rule, a simple gynecological examination is enough to suspect the patient has a prolapse. Of course, in the future, additional examinations are carried out:
- Ultrasound and computed tomography help determine the presence of tumors, injuries and other pathologies that could cause a prolapse.
- Blood and urine tests are needed in case an infection occurs.
- Also check the level of sex hormones in the blood of a woman.
- If there is suspicion of the development of urinary tract obstruction, then the patient is sent for urography.
- Colposcopy makes it possible to examine the cervix, detect erosion and ulcers on the vaginal mucosa.
- In some cases, a biopsy is additionally performed (if there is reason to suspect the onset of malignant tissue degeneration).
Vaginal wall prolapse: conservative treatment
Such treatment is possible only at the initial stage of the development of pathology. In this case, it is very important to strengthen the muscles of the pelvis, vagina, abdominal wall. All this helps to distribute the load and relieve stress from the ligaments of the small pelvis. Also, patients are recommended courses of therapeutic massage, which also improve blood flow to the muscles of the pelvis, provide normal nutrition to tissues, strengthen ligaments, and prevent stagnation.
Some patients have a pessary - this is a special device made of special plastic or silicone, which is installed in the vagina and supports the cervix. It is worth noting immediately that this is a temporary measure. The installation of the pessary only does not allow the organs to lower. Moreover, wearing such a device carries some risks. A list of possible side effects is as follows:
- swelling and inflammation of the vaginal mucosa;
- suppuration of tissues, the formation of ulcers;
- when worn for a long time, the pessary can grow into the tissue of the vagina.
That is why doctors recommend that patients periodically change the models of this device. In addition, douching is necessary daily, which will help to avoid inflammation and suppuration. Pessaries are established only if surgery to lower the vagina for one reason or another is not possible.
Special exercises
Special exercises for lowering the vagina really help strengthen muscles and ligaments, activate blood circulation. This is unlikely to help return the displaced organs to their natural position, but they will definitely prevent their further omission. A set of Kegel exercises should be done every day:
- An effective urinary retention is 10-20 seconds. During this, the muscles of the vagina and pelvis tighten. Gradually, muscle structures become stronger.
- Tighten your pelvic and vaginal muscles and maintain this state for several seconds. Now you can relax, after which the exercise needs to be repeated. Each time, try to stay in a state of maximum tension at least a few seconds longer. This is a simple exercise that can be done anytime, anywhere - you just need to repeat it daily.
- While walking, tighten your vagina from time to time - this also helps to strengthen muscles, eliminate stagnation and normalize blood circulation.
There are other exercises that will also positively affect the functioning of the organs of the reproductive system:
- Lie on your back, put your hands behind your head, keep your feet together. Now slowly raise your legs up, and then slowly lower as well, while trying to strain the muscles of the anus. Repeat manipulations at least 10-12 times.
- Helps to strengthen muscles and the well-known exercise "bicycle".
- Stay on your back, but stretch your arms along your body. On exhalation we raise both legs, on inspiration we part them apart, on exhalation we again shift together and on the next inspiration we lower them to the floor. All movements should be slow and controlled. Repeat the exercise at least 6-8 times.
- Now bend your knees and slightly apart. Now slowly lift the pelvis up, while squeezing the muscles of the buttocks, anus and vagina. Slowly back down to the floor. Repeat the exercise 10 times.
- Get on your knees, rest against the floor with your elbows bent. Now slowly straighten and raises the right leg, while straining the muscles of the perineum. Repeat 12 times with each foot.
Surgical treatment of vaginal wall prolapse. Operation and its features
To date, only surgery is a truly effective method of therapy. The choice of procedure depends on many factors, including the patient’s age, her intentions to have children, the presence of concomitant complications, as well as the form and stage of such a pathology as vaginal prolapse. The operation can be carried out in different ways:
- Colporaphia of the anterior or posterior wall is the least dangerous way. First, the doctor restores the normal position of the internal organs (intestines or bladder), and then removes the stretched tissue of the vagina and hem the walls.
- Colpoperineorephia is a procedure that involves suturing the stretched posterior wall of the vagina after childbirth. Next, the doctor conducts a lift of the muscles that hold the rectum in its natural position.
- If there is complete prolapse of the vagina and uterus, then a more radical procedure is sometimes performed - complete or partial amputation of the uterus.
This is how vaginal prolapse is eliminated. The operation is performed under general anesthesia. Within two days after the procedure, the patient should be under the supervision of a doctor. During rehabilitation, it is important to adhere to some rules:
- take antibiotics (this will help prevent bacterial infection of the tissues);
- within the first five days, treat the perineal region with an antiseptic (the doctor will select the appropriate solution);
- during the first two weeks, the patient can lie, stand, walk, but not sit - this will help to avoid divergence of stitches and muscle strain;
- in the first 7-10 days, patients are advised to eat mashed potatoes, liquid soups, in short, chopped food (it is very important to prevent constipation);
- you need to abandon training and increased physical activity for at least a month;
- sexual life can be resumed five weeks after the procedure, but in no case earlier.
Descent and pregnancy
If the patient had an omission and she underwent a full course of treatment, then pregnancy is possible. After a mild pathology that was eliminated with the help of exercises and other methods of conservative therapy, childbirth can take place naturally. If the treatment of the prolapse was performed surgically, then a cesarean section cannot be dispensed with.
Alternative methods of treatment
There are some folk recipes that help improve blood circulation in the pelvic organs, prevent the development of the inflammatory process and the appearance of erosion.
- Decoctions of lemon balm, chamomile, oak bark, string, sage are perfect for warm sitting baths - they can be done daily.
- Quince tea will also be beneficial. Pour 100 g of dried, chopped fruits with a liter of water and brew (preferably in a water bath). If desired, the broth can be sweetened before use.
- A mixture of linden flowers and lemon balm grass (50 g of each ingredient), 10 g of alder root and 70 g of white cinnamon will come in handy. All components are mixed. Two tablespoons of the herbal mixture should be poured with a glass of boiling water, cover and leave to cool completely. Strain the infusion, divide into three doses and drink for the day.
Of course, such drugs can only be used as adjuvants - they help the body recover faster after therapy. In any case, before using broths, you should always consult a doctor.
Preventive measures: how to prevent organ displacement?
You already know why in most cases vaginal prolapse develops. Photos, symptoms, treatment methods are, of course, important issues. But if you adhere to some rules, then you can significantly reduce the risk of a similar problem:
- It is important to eat right, treat constipation and chronic diseases on time.
- Physical activity will help keep muscles in good shape.
- Kegel exercises are recommended to be done not only to treat an existing omission, but also to prevent the occurrence of a problem.
- If possible, refuse lifting and carrying weights, as this creates increased pressure in the abdominal cavity and pelvic area.
- If tears / dissection of the perineum occurred during childbirth, it is important to properly repair the damaged areas.
It is important to consult a doctor as soon as you notice the first alarming symptoms of vaginal prolapse. The reviews of experts indicate that the disease is much easier to treat if therapeutic measures were started in the early stages of the development of pathology.