Prolapse of the vagina and uterus Shymkent

Prolapse of the vagina and uterus

Prolapse of female genitalia is a pathological process characterized by the displacement of the genitals from their normal position and their descent beyond the natural boundaries. Vaginal prolapse is more common, and complete vaginal prolapse is quite rare; typically, the anterior wall or mucous membrane of the vagina protrudes. Prolapse of the uterus is less common.

Reasons

The pathological reason underlying the prolapse of the genitals is the weakness or failure of the pelvic floor muscles. Causes of weakness or insufficiency include:

• Severe prolonged labor, accompanied by perineal tear.
• Multiple births.
• Physically demanding labor.
• Hormonal metabolism disruption leading to a decrease in the production of steroid hormones.
• Chronic diseases accompanied by impaired microcirculation in the soft tissues, muscles, and ligaments of the perineum.

Symptoms

One of the main complaints of patients is the noticeable protrusion of organs through the genital slit, particularly heightened during physical exertion. Over time, the prolapsed mucous membrane of the vagina and the lining of the uterus may become discolored, develop cracks, surface erosion, and may be associated with contact bleeding. In addition to the visible prolapse, patients may report pulling pains in the lower abdomen, irregularities in menstruation, urinary incontinence, difficulty emptying the bowel during defecation, and a sensation of incomplete bowel emptying.

Diagnostic

The diagnosis of direct prolapse of the genitals is typically straightforward, and it is made by a gynecologist during a physical examination of the patient. All patients with prolapse of the female genital organs usually undergo ultrasound, examination of hormonal status, colposcopy, and, if indicated, separate diagnostic curettage. Additionally, consultation with a urologist and coloproctologist may be recommended.

Treatment

The therapeutic approach to female genital prolapse depends on the degree of prolapse, the patient’s age, and the presence of concomitant pathology. In the absence of indications or in the presence of contraindications to surgical treatment, a set of measures aimed at strengthening the musculoskeletal apparatus of the perineum (including therapeutic gymnastics, etc.) is prescribed. Various surgical treatments are available for prolapse of the genitals in women, and the choice of method is determined by the degree of prolapse and the condition of the musculoskeletal apparatus of the perineum. An adequate diagnostic and treatment program can be recommended only after consulting a gynecologist.